Central Texas Veterans Health Care System, Temple, TX; Center for Applied Health Research, Baylor Scott & White Healthcare, Temple, TX.
Portland VA Medical Center, Portland, OR.
Am J Infect Control. 2018 Jun;46(6):668-673. doi: 10.1016/j.ajic.2018.02.001. Epub 2018 Apr 11.
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.
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.
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.
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.
环境消毒不充分对医源性感染是一个严重的威胁。消毒实践中的技术进步,包括无接触设备,为改善感染控制提供了巨大的希望。我们评估了一种这样的设备,即便携式脉冲氙紫外线(PX-UV)装置,在 4 家退伍军人事务部医院进行的实施试验中对微生物负担的影响。
在终末房间清洁前后采集环境样本:2 个设施将 PX-UV 消毒纳入其清洁方案,2 个设施仅进行手动消毒。从携带耐甲氧西林金黄色葡萄球菌(MRSA)或需氧菌菌落(ABC)的房间采集 5 个高接触表面的标本。未调整的前后计数减少和负二项式回归模型分别对 PX-UV 与单独手动清洁进行了比较。
共采集了 70 个样本。总体而言,与对照组相比,PX-UV 分别使 MRSA 和 ABC 的计数减少了 75.3%和 84.1%,而对照组仅减少了 25%-30%。调整基线计数后,手动清洁的房间比 PX-UV 房间的残留水平明显更高。综合分析显示,发病率比为 5.32(P = .0024),床栏、托盘桌和厕所扶手的 PX-UV 消毒效果也明显更好。
这项多中心研究表明,在使用 PX-UV 设备的设施中,几种常见病原体的消毒效果显著降低。未评估实验室减少对感染率的临床影响,这是一个关键的未来研究问题。然而,当将这些方法整合到日常医院操作中时,它们代表了一种实用的策略。