Fickenscher Marie-Claire, Stewart Madeline, Helber Ryan, Quilligan Edward J, Kreitenberg Arthur, Prietto Carlos A, Gardner Vance O
Hoag Orthopedics Education and Research, Hoag Orthopedic Institute, Irvine, CA, United States.
Department of Orthopedic Surgery, Center for Orthopedic & Sports Excellence, Los Angeles, CA, United States.
Infect Prev Pract. 2023 Jul 28;5(3):100301. doi: 10.1016/j.infpip.2023.100301. eCollection 2023 Sep.
In operating room (OR) surfaces, Nosocomial pathogens can persist on inanimate surfaces for long intervals and are highly resistant to traditional surface cleaning.
This study compares traditional chemical operating room terminal disinfection to a unique operator-driven device that emits germicidal UV light at short distance onto vertical and horizontal surfaces.
A randomized crossover analogous protocol assigned 40 end-of-day operating rooms into either group A (chemical then UVC treatments) or group B (UVC then chemical treatments). Initial Staphylococcal cultures were obtained prior to disinfection treatment, after the first treatment, and after the second treatment at 16 most commonly contaminated sites to represent overall room contamination. Success was defined as no growth and failure as 1 or more colony forming units. Thoroughness of chemical treatment vs UVC treatment was compared and used to determine if the second treatment was additive to the first treatment within each group.
The operator driven UVC device outperformed chemical treatment in reducing the number of contaminated sites in the OR by more than half (<0.001). Operator-driven UVC reduced contaminated sites after chemical treatment by nearly half (<0.001). In contrast, chemical treatment after operator-driven UVC did not significantly reduce the number of contaminated sites. The mean employee time of disinfection for chemical treatment was 49 minutes and for the operator-driven UVC emitter 7.9 minutes (<0.001).
This study demonstrates that addition of an operator-driven UVC emitter to OR rooms between cases could be helpful in overall decreasing the number of contaminated sites.
在手术室表面，医院病原体可在无生命表面长期存活，且对传统的表面清洁具有高度抗性。
本研究将传统的化学手术室终末消毒与一种独特的、由操作人员驱动的设备进行比较，该设备可在近距离向垂直和水平表面发射杀菌紫外线。
采用随机交叉类似方案，将40间当日手术结束后的手术室分为A组（先化学处理后紫外线处理）或B组（先紫外线处理后化学处理）。在消毒处理前、首次处理后以及在16个最常污染部位进行第二次处理后，获取初始葡萄球菌培养物，以代表整个房间的污染情况。成功定义为无生长，失败定义为有1个或更多菌落形成单位。比较化学处理与紫外线处理的彻底性，并用于确定每组内第二次处理是否对第一次处理有累加作用。
操作人员驱动的紫外线设备在减少手术室污染部位数量方面比化学处理效果好一半以上（<0.001）。操作人员驱动的紫外线在化学处理后将污染部位减少了近一半（<0.001）。相比之下，操作人员驱动的紫外线处理后进行化学处理并没有显著减少污染部位的数量。化学处理的平均员工消毒时间为49分钟，操作人员驱动的紫外线发射器为7.9分钟（<0.001）。
本研究表明，在手术间隙向手术室添加操作人员驱动的紫外线发射器有助于总体减少污染部位的数量。
