Poster Dianne L, Miller C Cameron, Obeng Yaw, Postek Michael T, Cowan Troy E, Martinello Richard A
National Institute of Standards and Technology, Gaithersburg, Maryland, USA.
Vision Based Consulting, Bethesda, Maryland, USA.
Proc SPIE Int Soc Opt Eng. 2018;10730. doi: 10.1117/12.2500431.
Nation-wide, healthcare-associated infections (HAIs) infect one in every 25 hospital patients, account for more than 100,000 deaths and increase medical costs by around $96-147B, each year. Ultraviolet-C (UV-C) antimicrobial devices are shown to reduce the incidence of many of these HAIs by 35% or more, through the deactivation of the pathogen's DNA chain following irradiation with a wavelength of ~254 nm. This irradiation does not kill the cells, per se but effectively prevents the cells from multiplying. Clinical case reductions of 30-70% in Clostridium difficile (.) have been reported with similar results for methicillin-resistant Staphylococcus aureus (MRSA), and others. The methodology works, but, the adoption of UV-C technology by the healthcare industry has been sporadic. This is largely due to the lack of definitive knowledge and uniform performance standards or measures for efficacy to help healthcare managers make informed, credible investment decisions. The leveling of the playing field with scientifically certifiable data of the efficacy of antimicrobial devices will enhance acceptance by the healthcare industry and public, at large, as well as facilitate science-based decision making. The National Institute of Standards and Technology (NIST) has engaged with the International Ultra Violet Association (IUVA) and its member companies and affiliates to explore ways to develop needed standards, determine appropriate testing protocols, and transfer the technology to help to reduce these inharmonious market conditions. Collaborative efforts are underway to develop science-based answers to the healthcare industry's questions surrounding standards and measures of device disinfection efficacy, as well as reliability, operations and durability. These issues were recently discussed at the IUVA 2018 America's Conference in Redondo Beach, CA in several panel sessions. A major output of the sessions was the formation of a formal for the development of antimicrobial standards and initiatives for the healthcare industry. The goal of this working group is to provide global guidance, with specific programs and deliverables, on the use of UV technologies and standards to combat HAIs and to further the stated aims of the IUVA on its outreach to the healthcare industry. This paper reviews the strong collaboration between NIST and its industry partners pursuing the development of standards, guidelines and guidance documents related to healthcare applications that include standard methods for validating performance of UV devices and test guidelines for efficacy measurements. In addition, an overview of the issues, problems, and a summary of the needs confronting future growth and success of the UV industry in the Nation's healthcare application space is provided.
在全国范围内，医疗保健相关感染（HAIs）影响着每25名住院患者中的1人，导致超过10万人死亡，每年使医疗成本增加约960亿至1470亿美元。紫外线C（UV-C）抗菌设备已被证明可将许多此类医疗保健相关感染的发生率降低35%或更多，这是通过在波长约为254纳米的照射后使病原体的DNA链失活来实现的。这种照射本身并不会杀死细胞，但能有效阻止细胞繁殖。据报道，艰难梭菌感染的临床病例减少了30%至70%，耐甲氧西林金黄色葡萄球菌（MRSA）及其他病菌感染的情况也有类似结果。该方法有效，但医疗行业对UV-C技术的采用一直很零散。这主要是由于缺乏确凿的知识以及统一的性能标准或疗效衡量方法，无法帮助医疗保健管理人员做出明智、可靠的投资决策。用抗菌设备疗效的科学可认证数据来营造公平竞争环境，将提高医疗行业和广大公众的接受度，并促进基于科学的决策制定。美国国家标准与技术研究院（NIST）已与国际紫外线协会（IUVA）及其成员公司和附属机构合作，探索制定所需标准、确定适当测试方案以及转让技术的方法，以帮助减少这些不协调的市场状况。目前正在开展合作努力，为医疗行业围绕设备消毒疗效以及可靠性、操作和耐用性的标准和措施等问题提供基于科学的答案。这些问题最近在加利福尼亚州雷东多海滩举行的2018年IUVA美国会议的几个小组会议上进行了讨论。会议的一项主要成果是成立了一个正式的工作组，负责制定医疗行业的抗菌标准和倡议。该工作组的目标是提供全球指导，包括具体方案和可交付成果，涉及紫外线技术和标准在对抗医疗保健相关感染方面的应用，并推进IUVA在拓展医疗行业方面的既定目标。本文回顾了NIST与其行业合作伙伴之间为制定与医疗应用相关的标准、指南和指导文件所开展的强有力合作，这些文件包括验证紫外线设备性能的标准方法和疗效测量测试指南。此外，还概述了紫外线行业在国家医疗应用领域未来增长和成功所面临的问题、挑战以及需求。
