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UV disinfection reduced rate of hospital-acquired MDR organisms
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The prevalence of hospital-acquired multidrug-resistant organisms and Clostridium difficile significantly decreased after adding ultraviolet environmental disinfection to the standard cleaning regimen in high-risk areas, according to data published in American Journal of Infection Control.
The decrease in multidrug-resistant (MDR) organisms was led by a significant decrease in vancomycin-resistant enterococci (VRE), which was the hospital’s most common MDR organism.
“MDR organisms plus C. difficile are problematic in acute care settings and it’s known that C. difficile spores can remain stable in the environment for several months,” Janet Haas, PhD, RN, CIC, director of infection prevention and control at Westchester Medical Center in Valhalla, N.Y., told Infectious Disease News. “We found that ultraviolet disinfection correlated with a 20% decrease in MDR organisms plus C. difficile, and it was feasible to use in our acute care setting.”
Janet Haas
The retrospective study took place after the implementation of UV environmental disinfection. The researchers compared the rate of infections in the 30-month period before implementation (January 2009-June 2011) and the rate of infections in the 22-month period after implementation (July 2011-April 2013). The disinfection was used in rooms with contact precautions after standard cleaning.
Use of UV disinfection added an average of 51 minutes to the cleaning time per discharge, which included 31 minutes for the machine to arrive and be set up. In the months before implementing UV disinfection, the rates of hospital-acquired MDR organisms plus C. difficile were steady. The rate also was steady after the implementation but significantly lower: 2.14 cases per 1,000 patient-days after implementation vs. 2.67 cases per 1,000 patient-days before implementation (rate ratio=0.8; 95% CI, 0.73-0.88). In addition to VRE, rates of MRSA, C. difficile and resistant gram-negative bacteria were reduced.
“As a trauma center, we wanted to get ahead of these organisms, but we could not use a technology that might interfere with our ability to immediately abort the cycle and use the room in case of an emergency,” Haas said. “Ultraviolet disinfection was a better choice for us than some of the technologies that require an airing out cycle.”
Haas said that the current practice at her hospital is to use UV disinfection as an adjunct to room cleaning when patients with MDR organisms or C. difficile are discharged. She said the technology could be used in high-risk areas if the rooms are empty — a limitation of UV disinfection is that it can’t be used in an occupied room.
“We currently don’t have dedicated staff to run the machines, therefore we are missing about a quarter of our ‘contact precautions’ discharges,” Haas said. “We would like to see whether we could decrease our MDR organism and C. difficile rates with staff dedicated to running the machines.” — by Emily Shafer
Disclosure: The researchers report no relevant financial disclosures.
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