Ultraviolet-C Light Evaluation as Adjunct Disinfection to Remove Multidrug-Resistant Organisms

Ultraviolet-C Light Evaluation as Adjunct Disinfection to Remove Multidrug-Resistant Organisms

Abstract Background Our objective was to determine if the addition of ultraviolet-C (UV-C) light to daily and discharge patient room cleaning reduces healthcare-associated infection rates of vancomycin-resistant enterococci (VRE) and Clostridioides difficile in immunocompromised adults. Methods We p...

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Veröffentlicht in:Clinical infectious diseases 2022-08, Vol.75 (1), p.35-40
Hauptverfasser: Rock, Clare, Hsu, Yea Jen, Curless, Melanie S, Carroll, Karen C, Ross Howard, Tracy, Carson, Kathryn A, Cummings, Stephanie, Anderson, Michael, Milstone, Aaron M, Maragakis, Lisa L
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container_end_page 40
container_issue 1
container_start_page 35
container_title Clinical infectious diseases
container_volume 75
creator Rock, Clare
Hsu, Yea Jen
Curless, Melanie S
Carroll, Karen C
Ross Howard, Tracy
Carson, Kathryn A
Cummings, Stephanie
Anderson, Michael
Milstone, Aaron M
Maragakis, Lisa L
description Abstract Background Our objective was to determine if the addition of ultraviolet-C (UV-C) light to daily and discharge patient room cleaning reduces healthcare-associated infection rates of vancomycin-resistant enterococci (VRE) and Clostridioides difficile in immunocompromised adults. Methods We performed a cluster randomized crossover control trial in 4 cancer and 1 solid organ transplant in-patient units at the Johns Hopkins Hospital, Baltimore, Maryland. For study year 1, each unit was randomized to intervention of UV-C light plus standard environmental cleaning or control of standard environmental cleaning, followed by a 5-week washout period. In study year 2, units switched assignments. The outcomes were healthcare-associated rates of VRE or C. difficile. Statistical inference used a two-stage approach recommended for cluster-randomized trials with
doi_str_mv 10.1093/cid/ciab896
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Methods We performed a cluster randomized crossover control trial in 4 cancer and 1 solid organ transplant in-patient units at the Johns Hopkins Hospital, Baltimore, Maryland. For study year 1, each unit was randomized to intervention of UV-C light plus standard environmental cleaning or control of standard environmental cleaning, followed by a 5-week washout period. In study year 2, units switched assignments. The outcomes were healthcare-associated rates of VRE or C. difficile. Statistical inference used a two-stage approach recommended for cluster-randomized trials with &lt;15 clusters/arm. Results In total, 302 new VRE infections were observed during 45787 at risk patient-days. The incidence in control and intervention groups was 6.68 and 6.52 per 1000 patient-days respectively; the unadjusted incidence rate ratio (IRR) was 0.98 (95% confidence interval [CI], .78 − 1.22; P = .54). There were 84 new C. difficile infections observed during 26118 at risk patient-days. The incidence in control and intervention periods was 2.64 and 3.78 per 1000 patient-days respectively; the unadjusted IRR was 1.43 (95% CI, .93 − 2.21; P = .98). Conclusions When used daily and at post discharge in addition to standard environmental cleaning, UV-C disinfection did not reduce VRE or C. difficile infection rates in cancer and solid organ transplant units. In this cluster cross-over randomized trial in 5 in-patient cancer/transplant units neither Clostridioides difficilenor vancomycin-resistant enterococci (VRE) transmission rates were reduced by UV-C light disinfection when used in patients’ rooms daily and at time of discharge.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/ciab896</identifier><identifier>PMID: 34636853</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Major</subject><ispartof>Clinical infectious diseases, 2022-08, Vol.75 (1), p.35-40</ispartof><rights>The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-65f3b14c8b156a6c959f76523b617096d7ff0f42ee89b94a1e1d2071d164479f3</citedby><cites>FETCH-LOGICAL-c389t-65f3b14c8b156a6c959f76523b617096d7ff0f42ee89b94a1e1d2071d164479f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,782,786,887,1586,27933,27934</link.rule.ids></links><search><creatorcontrib>Rock, Clare</creatorcontrib><creatorcontrib>Hsu, Yea Jen</creatorcontrib><creatorcontrib>Curless, Melanie S</creatorcontrib><creatorcontrib>Carroll, Karen C</creatorcontrib><creatorcontrib>Ross Howard, Tracy</creatorcontrib><creatorcontrib>Carson, Kathryn A</creatorcontrib><creatorcontrib>Cummings, Stephanie</creatorcontrib><creatorcontrib>Anderson, Michael</creatorcontrib><creatorcontrib>Milstone, Aaron M</creatorcontrib><creatorcontrib>Maragakis, Lisa L</creatorcontrib><title>Ultraviolet-C Light Evaluation as Adjunct Disinfection to Remove Multidrug-Resistant Organisms</title><title>Clinical infectious diseases</title><description>Abstract Background Our objective was to determine if the addition of ultraviolet-C (UV-C) light to daily and discharge patient room cleaning reduces healthcare-associated infection rates of vancomycin-resistant enterococci (VRE) and Clostridioides difficile in immunocompromised adults. Methods We performed a cluster randomized crossover control trial in 4 cancer and 1 solid organ transplant in-patient units at the Johns Hopkins Hospital, Baltimore, Maryland. For study year 1, each unit was randomized to intervention of UV-C light plus standard environmental cleaning or control of standard environmental cleaning, followed by a 5-week washout period. In study year 2, units switched assignments. The outcomes were healthcare-associated rates of VRE or C. difficile. Statistical inference used a two-stage approach recommended for cluster-randomized trials with &lt;15 clusters/arm. Results In total, 302 new VRE infections were observed during 45787 at risk patient-days. The incidence in control and intervention groups was 6.68 and 6.52 per 1000 patient-days respectively; the unadjusted incidence rate ratio (IRR) was 0.98 (95% confidence interval [CI], .78 − 1.22; P = .54). There were 84 new C. difficile infections observed during 26118 at risk patient-days. The incidence in control and intervention periods was 2.64 and 3.78 per 1000 patient-days respectively; the unadjusted IRR was 1.43 (95% CI, .93 − 2.21; P = .98). Conclusions When used daily and at post discharge in addition to standard environmental cleaning, UV-C disinfection did not reduce VRE or C. difficile infection rates in cancer and solid organ transplant units. In this cluster cross-over randomized trial in 5 in-patient cancer/transplant units neither Clostridioides difficilenor vancomycin-resistant enterococci (VRE) transmission rates were reduced by UV-C light disinfection when used in patients’ rooms daily and at time of discharge.</description><subject>Major</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNp9kE1LAzEQhoMotlZP_oGcvMhqsvnY5CKUWj-gUij2ashmk23Kdrdssgv-e1dbBC8ehhlmnnmZeQG4xugOI0nujS-G0LmQ_ASMMSNZwpnEp0ONmEioIGIELkLYIoSxQOwcjAjlhAtGxuBjXcVW976pbExmcOHLTYTzXledjr6poQ5wWmy72kT46IOvnTU__djAld01vYVvXRV90XZlsrLBh6jrCJdtqWsfduESnDldBXt1zBOwfpq_z16SxfL5dTZdJIYIGYd7HckxNSLHjGtuJJMu4ywlOccZkrzInEOOptYKmUuqscVFijJcYE5pJh2ZgIeD7r7Ld7Ywth6-qtS-9TvdfqpGe_V3UvuNKpteSYpSLvAgcHsQMG0TQmvd7y5G6ttmNdisjjYP9M2Bbrr9v-AXBh9_Kg</recordid><startdate>20220824</startdate><enddate>20220824</enddate><creator>Rock, Clare</creator><creator>Hsu, Yea Jen</creator><creator>Curless, Melanie S</creator><creator>Carroll, Karen C</creator><creator>Ross Howard, Tracy</creator><creator>Carson, Kathryn A</creator><creator>Cummings, Stephanie</creator><creator>Anderson, Michael</creator><creator>Milstone, Aaron M</creator><creator>Maragakis, Lisa L</creator><general>Oxford University Press</general><scope>TOX</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20220824</creationdate><title>Ultraviolet-C Light Evaluation as Adjunct Disinfection to Remove Multidrug-Resistant Organisms</title><author>Rock, Clare ; Hsu, Yea Jen ; Curless, Melanie S ; Carroll, Karen C ; Ross Howard, Tracy ; Carson, Kathryn A ; Cummings, Stephanie ; Anderson, Michael ; Milstone, Aaron M ; Maragakis, Lisa L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-65f3b14c8b156a6c959f76523b617096d7ff0f42ee89b94a1e1d2071d164479f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Major</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rock, Clare</creatorcontrib><creatorcontrib>Hsu, Yea Jen</creatorcontrib><creatorcontrib>Curless, Melanie S</creatorcontrib><creatorcontrib>Carroll, Karen C</creatorcontrib><creatorcontrib>Ross Howard, Tracy</creatorcontrib><creatorcontrib>Carson, Kathryn A</creatorcontrib><creatorcontrib>Cummings, Stephanie</creatorcontrib><creatorcontrib>Anderson, Michael</creatorcontrib><creatorcontrib>Milstone, Aaron M</creatorcontrib><creatorcontrib>Maragakis, Lisa L</creatorcontrib><collection>Access via Oxford University Press (Open Access Collection)</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rock, Clare</au><au>Hsu, Yea Jen</au><au>Curless, Melanie S</au><au>Carroll, Karen C</au><au>Ross Howard, Tracy</au><au>Carson, Kathryn A</au><au>Cummings, Stephanie</au><au>Anderson, Michael</au><au>Milstone, Aaron M</au><au>Maragakis, Lisa L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultraviolet-C Light Evaluation as Adjunct Disinfection to Remove Multidrug-Resistant Organisms</atitle><jtitle>Clinical infectious diseases</jtitle><date>2022-08-24</date><risdate>2022</risdate><volume>75</volume><issue>1</issue><spage>35</spage><epage>40</epage><pages>35-40</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><abstract>Abstract Background Our objective was to determine if the addition of ultraviolet-C (UV-C) light to daily and discharge patient room cleaning reduces healthcare-associated infection rates of vancomycin-resistant enterococci (VRE) and Clostridioides difficile in immunocompromised adults. Methods We performed a cluster randomized crossover control trial in 4 cancer and 1 solid organ transplant in-patient units at the Johns Hopkins Hospital, Baltimore, Maryland. For study year 1, each unit was randomized to intervention of UV-C light plus standard environmental cleaning or control of standard environmental cleaning, followed by a 5-week washout period. In study year 2, units switched assignments. The outcomes were healthcare-associated rates of VRE or C. difficile. Statistical inference used a two-stage approach recommended for cluster-randomized trials with &lt;15 clusters/arm. Results In total, 302 new VRE infections were observed during 45787 at risk patient-days. The incidence in control and intervention groups was 6.68 and 6.52 per 1000 patient-days respectively; the unadjusted incidence rate ratio (IRR) was 0.98 (95% confidence interval [CI], .78 − 1.22; P = .54). There were 84 new C. difficile infections observed during 26118 at risk patient-days. The incidence in control and intervention periods was 2.64 and 3.78 per 1000 patient-days respectively; the unadjusted IRR was 1.43 (95% CI, .93 − 2.21; P = .98). Conclusions When used daily and at post discharge in addition to standard environmental cleaning, UV-C disinfection did not reduce VRE or C. difficile infection rates in cancer and solid organ transplant units. In this cluster cross-over randomized trial in 5 in-patient cancer/transplant units neither Clostridioides difficilenor vancomycin-resistant enterococci (VRE) transmission rates were reduced by UV-C light disinfection when used in patients’ rooms daily and at time of discharge.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>34636853</pmid><doi>10.1093/cid/ciab896</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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title Ultraviolet-C Light Evaluation as Adjunct Disinfection to Remove Multidrug-Resistant Organisms
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