Ultraviolet-C Light Evaluation as Adjunct Disinfection to Remove Multidrug-Resistant Organisms. (12th October 2021)

• Record Type: Journal Article
• Authors: Rock, Clare; Hsu, Yea Jen; Curless, Melanie S; Carroll, Karen C; Ross Howard, Tracy; Carson, Kathryn A; Cummings, Stephanie; Anderson, Michael; Milstone, Aaron M; Maragakis, Lisa L
• Is Part Of: Clinical infectious diseases. Volume 75:Number 1(2022)
• Page Start: 35
• Page End: 40
• Publication Date: 2021-10-12
• Subjects: UV-C light -- environmental cleaning and disinfection -- C. difficile transmission -- infection prevention -- VRE transmission; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciab896
• Languages: English
• ISSNs: 1058-4838

Abstract

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. Abstract : In this cluster cross-over randomized trial in 5 in-patient cancer/transplant units neither Clostridioides difficile nor vancomycin-resistant enterococci (VRE) transmission rates were reduced by UV-C light disinfection when used in patients' rooms daily and at time of discharge.