脉冲氙紫外线消毒对降低日本医院重症监护病房多药耐药菌的临床和微生物学效果：一项前后对照研究。
Clinical and microbiological effect of pulsed xenon ultraviolet disinfection to reduce multidrug-resistant organisms in the intensive care unit in a Japanese hospital: a before-after study.
机构信息
Division of Infection Control and Clinical Laboratory, Yamagata University Hospital, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
Division of Nursing, Yamagata University Hospital, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
出版信息
BMC Infect Dis. 2020 Jan 29;20(1):82. doi: 10.1186/s12879-020-4805-6.
BACKGROUND
No-touch environmental disinfection using ultraviolet devices has been highlighted in the past several years to control the transmission of multidrug-resistant organisms (MDROs). However, its effectiveness in non-US healthcare settings is yet to be examined. This study aimed to evaluate the effectiveness of disinfection by portable pulsed xenon ultraviolet (PX-UV) devices in controlling transmission of MDROs in a non-US healthcare setting.
METHODS
All patients admitted in the intensive care unit in a 629-bed tertiary referral hospital in Japan from August 2016 to February 2019 were enrolled. During the study period, PX-UV disinfection was added to manual terminal cleaning after every patient transfer/discharge. For microbiological evaluation, surfaces were selected for sampling by contact plates before/after manual cleaning and after PX-UV. After overnight incubation, colonies on the plates were counted.
RESULTS
The incidence of newly acquired methicillin-resistant Staphylococcus aureus (MRSA) declined significantly (13.8 to 9.9 per 10,000 patient days, incidence rate ratio 0.71, p = 0.002), as well as that of newly acquired drug-resistant Acinetobacter (48.5 to 18.1, 0.37, p < 0.001). The percent reduction of the microbiological burden by manual cleaning was 81%, but a further 59% reduction was achieved by PX-UV.
CONCLUSIONS
PX-UV is effective in further reducing the microbial burden and controlling MDROs in a non-US healthcare setting.
背景
在过去的几年中，使用无接触式紫外线设备进行环境消毒已被强调用于控制多重耐药菌（MDRO）的传播。然而，其在非美国医疗保健环境中的有效性尚未得到检验。本研究旨在评估便携式脉冲氙紫外线（PX-UV）设备在控制非美国医疗保健环境中 MDRO 传播方面的有效性。
方法
从 2016 年 8 月至 2019 年 2 月，在日本一家拥有 629 张床位的三级转诊医院的重症监护病房中，所有入院患者均被纳入本研究。在研究期间，在每位患者转科/出院后，除了进行手动终端清洁外，还增加了 PX-UV 消毒。为了进行微生物学评估，在手动清洁前后和 PX-UV 后通过接触平板选择表面进行采样。过夜孵育后，对平板上的菌落进行计数。
结果
新获得的耐甲氧西林金黄色葡萄球菌（MRSA）的发生率显著下降（每 10000 个患者日从 13.8 例降至 9.9 例，发病率比为 0.71，p=0.002），新获得的耐药不动杆菌（48.5 例降至 18.1 例，0.37，p<0.001）也是如此。手动清洁后微生物负荷减少了 81%，但 PX-UV 进一步减少了 59%。
结论
在非美国医疗保健环境中，PX-UV 可有效降低微生物负荷并控制 MDRO。
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