Titus Wong1, Tracey Woznow2, Mike Petrie3, Elena Murzello4, Allison Muniak4, Amin Kadora5, Elizabeth Bryce6. 1. Division of Medical Microbiology and Infection Control, Vancouver General Hospital, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. 2. Division of Medical Microbiology and Infection Control, Vancouver General Hospital, Vancouver, BC, Canada. 3. Business Initiatives and Support Services, Lower Mainland Health Authorities, Vancouver, BC, Canada. 4. Quality and Patient Safety, Vancouver Coastal Health, Vancouver, BC, Canada. 5. School of Business, Capilano University, North Vancouver, BC, Canada. 6. Division of Medical Microbiology and Infection Control, Vancouver General Hospital, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. Electronic address: Elizabeth.Bryce@vch.ca.
Abstract
BACKGROUND: Two ultraviolet-C (UVC)-emitting devices were evaluated for effectiveness in reducing methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile (CD). METHODS: Six surfaces in rooms previously occupied by patients with MRSA, VRE, or CD were cultured before and after cleaning and after UVC disinfection. In a parallel laboratory study, MRSA and VRE suspended in trypticase soy broth were inoculated onto stainless steel carriers in triplicate, placed in challenging room areas, subjected to UVC, and subcultured to detect growth. RESULTS: Sixty-one rooms and 360 surfaces were assessed. Before cleaning, MRSA was found in 34.4%, VRE was found in 29.5%, and CD was found in 31.8% of rooms. Cleaning reduced MRSA-, VRE-, and CD-contaminated rooms to 27.9%, 29.5%, and 22.7%, respectively (not statistically significant). UVC disinfection further reduced MRSA-, VRE-, and CD-contaminated rooms to 3.3% (P = .0003), 4.9% (P = .0003), and 0% (P = .0736), respectively. Surface colony counts (excluding floors) decreased from 88.0 to 19.6 colony forming units (CFU) (P < .0001) after manual cleaning; UVC disinfection further reduced it to 1.3 CFU (P = .0013). In a multivariable model of the carrier study, the odds of detecting growth in broth suspensions after UVC disinfection were 7 times higher with 1 machine (odds ratio, 6.96; 95% confidence interval, 3.79-13.4) for a given organism, surface, and concentration. CONCLUSIONS: UVC devices are effective adjuncts to manual cleaning but vary in their ability to disinfect high concentrations of organisms in the presence of protein.
BACKGROUND: Two ultraviolet-C (UVC)-emitting devices were evaluated for effectiveness in reducing methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile (CD). METHODS: Six surfaces in rooms previously occupied by patients with MRSA, VRE, or CD were cultured before and after cleaning and after UVC disinfection. In a parallel laboratory study, MRSA and VRE suspended in trypticase soy broth were inoculated onto stainless steel carriers in triplicate, placed in challenging room areas, subjected to UVC, and subcultured to detect growth. RESULTS: Sixty-one rooms and 360 surfaces were assessed. Before cleaning, MRSA was found in 34.4%, VRE was found in 29.5%, and CD was found in 31.8% of rooms. Cleaning reduced MRSA-, VRE-, and CD-contaminated rooms to 27.9%, 29.5%, and 22.7%, respectively (not statistically significant). UVC disinfection further reduced MRSA-, VRE-, and CD-contaminated rooms to 3.3% (P = .0003), 4.9% (P = .0003), and 0% (P = .0736), respectively. Surface colony counts (excluding floors) decreased from 88.0 to 19.6 colony forming units (CFU) (P < .0001) after manual cleaning; UVC disinfection further reduced it to 1.3 CFU (P = .0013). In a multivariable model of the carrier study, the odds of detecting growth in broth suspensions after UVC disinfection were 7 times higher with 1 machine (odds ratio, 6.96; 95% confidence interval, 3.79-13.4) for a given organism, surface, and concentration. CONCLUSIONS: UVC devices are effective adjuncts to manual cleaning but vary in their ability to disinfect high concentrations of organisms in the presence of protein.
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