Department of Neurosurgery, Zaozhuang Municipal Hospital, Zaozhuang277101, Shandong Province, P.R. China.
Department of Comprehensive Internal Medicine, Zaozhuang Hospital of Traditional Chinese Medicine, Zaozhuang 277100, Shandong Province, P.R. China.
Epidemiol Infect. 2020 Jul 6;148:e165. doi: 10.1017/S095026882000148X.
Pulsed-xenon-ultraviolet light (PX-UVL) is increasingly used as a supplemental disinfection method in healthcare settings. We undertook a systematic search of the literature through several databases and conducted a meta-analysis to evaluate the efficacy of PX-UVL in reducing healthcare-associated infections. Eleven studies were included in the systematic review and nine in the meta-analysis. Pooled analysis of seven studies with before-after data indicated a statistically significant reduction of Clostridium difficile infection (CDI) rates with the use of the PX-UVL (incidence rate ratio (IRR): 0.73, 95% CI 0.57-0.94, I2 = 72%, P = 0.01), and four studies reported a reduction of risk of methicillin-resistant Staphylococcus aureus (MRSA) infections (IRR: 0.79, 95% CI 0.64-0.98, I2 = 35%, P = 0.03). However, a further four trials found no significant reduction in vancomycin-resistant enterococci (VRE) infection rates (IRR: 0.80, 95% CI 0.63-1.01, I2 = 60%, P = 0.06). The results for CDI and MRSA proved unstable on sensitivity analysis. Meta-regression analysis did not demonstrate any influence of study duration or intervention duration on CDI rates. We conclude that the use of PX-UVL, in addition to standard disinfection protocols, may help to reduce the incidence of CDI and MRSA but not VRE infection rates. However, the quality of evidence is not high, with unstable results and wide confidence intervals, and further high-quality studies are required to supplement the current evidence.
脉冲氙-紫外线（PX-UVL）越来越多地被用作医疗保健环境中的补充消毒方法。我们通过多个数据库进行了系统文献检索，并进行了荟萃分析，以评估 PX-UVL 在降低与医疗保健相关的感染方面的功效。系统评价纳入了 11 项研究，荟萃分析纳入了 9 项研究。对 7 项具有前后数据的研究进行汇总分析表明，使用 PX-UVL 可显著降低艰难梭菌感染（CDI）的发生率（发病率比（IRR）：0.73，95%CI 0.57-0.94，I2 = 72%，P = 0.01），有 4 项研究报告称降低了耐甲氧西林金黄色葡萄球菌（MRSA）感染的风险（IRR：0.79，95%CI 0.64-0.98，I2 = 35%，P = 0.03）。然而，另外 4 项试验发现万古霉素耐药肠球菌（VRE）感染率没有显著降低（IRR：0.80，95%CI 0.63-1.01，I2 = 60%，P = 0.06）。CDI 和 MRSA 的结果在敏感性分析中不稳定。元回归分析表明，研究持续时间或干预持续时间对 CDI 发生率没有影响。我们得出结论，除了标准消毒方案外，使用 PX-UVL 可能有助于降低 CDI 和 MRSA 的发生率，但不能降低 VRE 的感染率。然而，证据质量不高，结果不稳定，置信区间较宽，需要进一步进行高质量的研究来补充现有证据。
