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No-Touch Disinfection Methods to Decrease Multidrug-Resistant Organism Infections: A Systematic Review and Meta-analysis

Published online by Cambridge University Press:  16 November 2017

Alexandre R. Marra ,
Marin L. Schweizer  and
Michael B. Edmond
Alexandre R. Marra*
Affiliation:
Office of Clinical Quality, Safety and Performance Improvement, University of Iowa Hospitals and Clinics, Iowa City, Iowa Division of Medical Practice, Hospital Israelita Albert Einstein, São Paulo, Brazil
Marin L. Schweizer
Affiliation:
Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa The Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, Iowa Division of General Internal Medicine, Department of Internal Medicine, Carver College of Medicine, Iowa City, Iowa
Michael B. Edmond
Affiliation:
Office of Clinical Quality, Safety and Performance Improvement, University of Iowa Hospitals and Clinics, Iowa City, Iowa Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
*
Address correspondence to Alexandre R. Marra, MD, University of Iowa Hospitals and Clinics, C51 GH, 200 Hawkins Drive, Iowa City, IA 52242 (alexandre-rodriguesmarra@uiowa.edu).
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Abstract

BACKGROUND

Recent studies have shown that using no-touch disinfection technologies (ie, ultraviolet light [UVL] or hydrogen peroxide vapor [HPV] systems) can limit the transmission of nosocomial pathogens and prevent healthcare-associated infections (HAIs). To investigate these findings further, we performed a systematic literature review and meta-analysis on the impact of no-touch disinfection methods to decrease HAIs.

METHODS

We searched PubMed, CINAHL, CDSR, DARE and EMBASE through April 2017 for studies evaluating no-touch disinfection technology and the nosocomial infection rates for Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and other multidrug-resistant organisms (MDROs). We employed random-effect models to obtain pooled risk ratio (pRR) estimates. Heterogeneity was evaluated with I2 estimation and the Cochran Q statistic. Pooled risk ratios for C. difficile, MRSA, VRE, and MDRO were assessed separately.

RESULTS

In total, 20 studies were included in the final review: 13 studies using UVL systems and 7 studies using HPV systems. When the results of the UVL studies were pooled, statistically significant reduction ins C. difficile infection (CDI) (pRR, 0.64; 95% confidence interval [CI], 0.49–0.84) and VRE infection rates (pRR, 0.42; 95% CI, 0.28–0.65) were observed. No differences were found in rates of MRSA or gram-negative multidrug-resistant pathogens.

CONCLUSIONS

Ultraviolet light no-touch disinfection technology may be effective in preventing CDI and VRE infection.

Infect Control Hosp Epidemiol 2018;39:20–31

Information

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 1 , January 2018 , pp. 20 - 31
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

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