Zeber John E, Coppin John D, Villamaria Frank C, Williams Marjory D, Copeland Laurel A, Chatterjee Piyali, Choi Hosoon, Jinadatha Chetan
Department of Research, Central Texas Veterans Healthcare System, Temple, Texas, USA.
University of Massachusetts Amherst School of Public Health & Health Science, Amherst, Massachusetts, USA.
Open Forum Infect Dis. 2019 Dec 17;6(12):ofz529. doi: 10.1093/ofid/ofz529. eCollection 2019 Dec.
The reduction in microbial bioburden achieved by terminal disinfection in a hospital may vary considerably by type of disinfectant or cleaner and by environmental service (EVS) personnel. This study estimated whether supplemental ultraviolet (UV) irradiation after disinfection or cleaning reduced bioburden and whether the supplemental effect persisted after adjusting for disinfectant or cleaner type and EVS personnel.
Environmental samples for aerobic bacterial colonies (ABC) and methicillin-resistant (MRSA) were obtained from 5 high-touch surfaces in patient rooms at 3 time points: before manual cleaning, after manual cleaning using 1 of 3 disinfectants or 1 cleaner, and after UV irradiation.
For ABC, the model-estimated mean (95% uncertainty interval) counts were 56% (48%-63%) lower for postmanual + UV compared with manual clean alone, and for MRSA they were 93% (62%-99%) lower for postmanual + UV vs manual clean alone.
Although UV supplementation provides incremental benefit in bioburden reduction across all cleaners or disinfectants tested, it provides the greatest benefit when supplementing cleaners or disinfectants with the lowest disinfection properties. UV irradiation provides additional bioburden reduction to manual cleaning or disinfection, even when accounting for variability introduced by different disinfectants and EVS personnel.
医院终末消毒所实现的微生物生物负荷降低程度可能因消毒剂或清洁剂类型以及环境服务(EVS)人员的不同而有很大差异。本研究评估了消毒或清洁后补充紫外线(UV)照射是否能降低生物负荷,以及在调整消毒剂或清洁剂类型及EVS人员因素后,这种补充效果是否依然存在。
在3个时间点从病房的5个高接触表面采集需氧菌菌落(ABC)和耐甲氧西林金黄色葡萄球菌(MRSA)的环境样本:手工清洁前、使用3种消毒剂之一或1种清洁剂进行手工清洁后,以及紫外线照射后。
对于ABC,与仅手工清洁相比,手工清洁 + UV后的模型估计平均(95%不确定区间)菌落数低56%(48% - 63%);对于MRSA,手工清洁 + UV后的菌落数比仅手工清洁低93%(62% - 99%)。
尽管补充紫外线在所有测试的清洁剂或消毒剂中都能额外降低生物负荷,但在补充消毒性能最低的清洁剂或消毒剂时效果最佳。即使考虑到不同消毒剂和EVS人员带来的变异性,紫外线照射仍能在手工清洁或消毒的基础上进一步降低生物负荷。