Ont Health Technol Assess Ser. 2018 Feb 7;18(1):1-73. eCollection 2018.
Hospital-acquired infections (HAIs) are infections that patients contract while in the hospital that were neither present nor developing at the time of admission. In Canada an estimated 10% of adults with short-term hospitalization have HAIs. According to 2003 Canadian data, between 4% and 6% of these patients die from these infections. The most common HAIs in Ontario are caused by . The standard method of reducing and preventing these infections is decontamination of patient rooms through manual cleaning and disinfection. Several portable no-touch ultraviolet (UV) light systems have been proposed to supplement current hospital cleaning and disinfecting practices.
We searched for studies published from inception of UV disinfection technology to January 23, 2017. We compared portable UV surface-disinfecting devices used together with standard hospital room cleaning and disinfecting versus standard hospital cleaning and disinfecting alone. The primary outcome was HAI from . Other outcomes were combined HAIs, colonization (i.e., carrying an infectious agent without exhibiting disease symptoms), and the HAI-associated mortality rate. We used Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to rate the quality of evidence of included studies. We also performed a 5-year budget impact analysis from the hospital's perspective. This assessment was limited to portable devices and did not examine wall mounted devices, which are used in some hospitals.
The database search for the clinical review yielded 10 peer-reviewed publications that met eligibility criteria. Three studies focused on mercury UV-C-based technology, seven on pulsed xenon UV technology. Findings were either inconsistent or produced very low-quality evidence using the GRADE rating system. The intervention was effective in reducing the rate of the composite outcome of HAIs (combined) and colonization (but quality of evidence was low). For the review of economic studies, 152 peer-reviewed publications were identified and screened. No studies met the inclusion criteria. Under the assumption that two devices would be purchased per hospital, we estimated the 5-year budget impact of $586,023 for devices that use the pulsed xenon technology and of $634,255 for devices that use the mercury technology.
We are unable to make a firm conclusion about the effectiveness of this technology on HAIs given the very low to low quality of evidence. The budget impact estimates are sensitive to assumptions made about the number of UV disinfecting devices purchased per hospital, frequency of daytime use, and staff time required per use.
医院获得性感染（HAIs）是指患者在住院期间感染的疾病，这些感染在入院时并不存在或尚未发展。在加拿大，估计有10%的短期住院成人会发生医院获得性感染。根据2003年加拿大的数据，这些患者中有4%至6%死于这些感染。安大略省最常见的医院获得性感染是由……引起的。减少和预防这些感染的标准方法是通过人工清洁和消毒对病房进行去污处理。已经提出了几种便携式无接触紫外线（UV）光系统来补充当前医院的清洁和消毒措施。
我们检索了从紫外线消毒技术开始到2017年1月23日发表的研究。我们比较了与标准医院病房清洁和消毒一起使用的便携式紫外线表面消毒设备与单独的标准医院清洁和消毒。主要结局是由……引起的医院获得性感染。其他结局是合并的医院获得性感染、定植（即携带传染源但未表现出疾病症状）以及医院获得性感染相关死亡率。我们使用推荐分级评估、制定和评价（GRADE）对纳入研究的证据质量进行评级。我们还从医院的角度进行了为期5年的预算影响分析。该评估仅限于便携式设备，未检查一些医院使用的壁挂式设备。
临床综述在数据库搜索中产生了10篇符合资格标准的同行评审出版物。三项研究关注基于汞的UV-C技术，七项关注脉冲氙气UV技术。使用GRADE评级系统的研究结果要么不一致要么产生非常低质量的证据。该干预措施在降低医院获得性感染（合并）和定植的综合结局发生率方面有效（但证据质量较低）。对于经济研究综述，识别并筛选了152篇同行评审出版物。没有研究符合纳入标准。假设每家医院购买两台设备，我们估计使用脉冲氙气技术设备5年的预算影响为586,023美元，使用汞技术设备的预算影响为634,255美元。
鉴于证据质量非常低到低，我们无法就该技术对医院获得性感染的有效性得出确凿结论。预算影响估计对每家医院购买的紫外线消毒设备数量、白天使用频率以及每次使用所需的工作人员时间所做的假设很敏感。
