John E Zeber1, Christopher Pfeiffer2, John W Baddley3, Jose Cadena-Zuluaga4, Eileen M Stock5, Laurel A Copeland6, Janet Hendricks2, Jwan Mohammadi3, Marcos I Restrepo4, Chetan Jinadatha7. 1. Central Texas Veterans Health Care System, Temple, TX; Center for Applied Health Research, Baylor Scott & White Healthcare, Temple, TX. Electronic address: zeber@uthscsa.edu. 2. Portland VA Medical Center, Portland, OR. 3. Birmingham VA Medical Center, Birmingham, VA. 4. South Texas Veterans Health Care System, San Antonio, TX. 5. Cooperative Studies Program Coordinating Center, Department of Veterans Affairs, Perry Point, MD. 6. Center for Applied Health Research, Baylor Scott & White Healthcare, Temple, TX; VA Central Western Massachusetts Healthcare System, Leeds, MA. 7. Central Texas Veterans Health Care System, Temple, TX.
Abstract
BACKGROUND: Inadequate environmental disinfection represents a serious risk for health care-associated infections. Technologic advancements in disinfection practices, including no-touch devices, offer significant promise to improve infection control. We evaluated one such device, portable pulsed xenon ultraviolet (PX-UV) units, on microbial burden during an implementation trial across 4 Veterans Affairs hospitals. METHODS: Environmental samples were collected before and after terminal room cleaning: 2 facilities incorporated PX-UV disinfection into their cleaning protocols and 2 practiced manual disinfection only. Specimens from 5 high-touch surfaces were collected from rooms harboring methicillin-resistant Staphylococcus aureus (MRSA) or aerobic bacteria colonies (ABC). Unadjusted pre-post count reductions and negative binomial regression modeled PX-UV versus manual cleaning alone. RESULTS: Seventy samples were collected. Overall, PX-UV reduced MRSA and ABC counts by 75.3% and 84.1%, respectively, versus only 25%-30% at control sites. Adjusting for baseline counts, manually cleaned rooms had significantly higher residual levels than PX-UV sites. Combined analyses revealed an incident rate ratio of 5.32 (P = .0024), with bedrails, tray tables, and toilet handrails also showing statistically superior PX-UV disinfection. CONCLUSIONS: This multicenter study demonstrates significantly reduced disinfection across several common pathogens in facilities using PX-UV devices. Clinical impact of laboratory reductions on infection rates was not assessed, representing a critical future research question. However, such approaches to routine cleaning suggest a practical strategy when integrated into daily hospital operations. Published by Elsevier Inc.
BACKGROUND: Inadequate environmental disinfection represents a serious risk for health care-associated infections. Technologic advancements in disinfection practices, including no-touch devices, offer significant promise to improve infection control. We evaluated one such device, portable pulsed xenon ultraviolet (PX-UV) units, on microbial burden during an implementation trial across 4 Veterans Affairs hospitals. METHODS:Environmental samples were collected before and after terminal room cleaning: 2 facilities incorporated PX-UV disinfection into their cleaning protocols and 2 practiced manual disinfection only. Specimens from 5 high-touch surfaces were collected from rooms harboring methicillin-resistant Staphylococcus aureus (MRSA) or aerobic bacteria colonies (ABC). Unadjusted pre-post count reductions and negative binomial regression modeled PX-UV versus manual cleaning alone. RESULTS: Seventy samples were collected. Overall, PX-UV reduced MRSA and ABC counts by 75.3% and 84.1%, respectively, versus only 25%-30% at control sites. Adjusting for baseline counts, manually cleaned rooms had significantly higher residual levels than PX-UV sites. Combined analyses revealed an incident rate ratio of 5.32 (P = .0024), with bedrails, tray tables, and toilet handrails also showing statistically superior PX-UV disinfection. CONCLUSIONS: This multicenter study demonstrates significantly reduced disinfection across several common pathogens in facilities using PX-UV devices. Clinical impact of laboratory reductions on infection rates was not assessed, representing a critical future research question. However, such approaches to routine cleaning suggest a practical strategy when integrated into daily hospital operations. Published by Elsevier Inc.
Authors: John E Zeber; John D Coppin; Frank C Villamaria; Marjory D Williams; Laurel A Copeland; Piyali Chatterjee; Hosoon Choi; Chetan Jinadatha Journal: Open Forum Infect Dis Date: 2019-12-17 Impact factor: 3.835