Ultraviolet-C Light Evaluation as Adjunct Disinfection to Remove Multidrug-Resistant Organisms

Clare Rock, Yea Jen Hsu, Melanie S Curless, Karen C Carroll, Tracy Ross Howard, Kathryn A Carson, Stephanie Cummings, Michael Anderson, Aaron M Milstone, Lisa L Maragakis, Clare Rock, Yea Jen Hsu, Melanie S Curless, Karen C Carroll, Tracy Ross Howard, Kathryn A Carson, Stephanie Cummings, Michael Anderson, Aaron M Milstone, Lisa L Maragakis

Abstract

Background: Our objective was to determine if the addition of ultraviolet-C (UV-C) light to daily and discharge patient room cleaning reduces healthcare-associated infection rates of vancomycin-resistant enterococci (VRE) and Clostridioides difficile in immunocompromised adults.

Methods: We performed a cluster randomized crossover control trial in 4 cancer and 1 solid organ transplant in-patient units at the Johns Hopkins Hospital, Baltimore, Maryland. For study year 1, each unit was randomized to intervention of UV-C light plus standard environmental cleaning or control of standard environmental cleaning, followed by a 5-week washout period. In study year 2, units switched assignments. The outcomes were healthcare-associated rates of VRE or C. difficile. Statistical inference used a two-stage approach recommended for cluster-randomized trials with <15 clusters/arm.

Results: In total, 302 new VRE infections were observed during 45787 at risk patient-days. The incidence in control and intervention groups was 6.68 and 6.52 per 1000 patient-days respectively; the unadjusted incidence rate ratio (IRR) was 0.98 (95% confidence interval [CI], .78 - 1.22; P = .54). There were 84 new C. difficile infections observed during 26118 at risk patient-days. The incidence in control and intervention periods was 2.64 and 3.78 per 1000 patient-days respectively; the unadjusted IRR was 1.43 (95% CI, .93 - 2.21; P = .98).

Conclusions: When used daily and at post discharge in addition to standard environmental cleaning, UV-C disinfection did not reduce VRE or C. difficile infection rates in cancer and solid organ transplant units.

Trial registration: ClinicalTrials.gov NCT02605499.

Keywords: C. difficile transmission; UV-C light; VRE transmission; environmental cleaning and disinfection; infection prevention.

© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.

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Source: PubMed

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