Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T20:36:17.706Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of Ultraviolet Germicidal Irradiation for No-Touch Terminal Room Disinfection on Clostridium difficile Infection Incidence Among Hematology-Oncology Patients

Published online by Cambridge University Press:  06 October 2016

David A. Pegues ,
Jennifer Han ,
Cheryl Gilmar ,
Brooke McDonnell  and
Steven Gaynes
David A. Pegues*
Affiliation:
Division of Infectious Diseases, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania Department of Healthcare Epidemiology, Infection Prevention and Control, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Jennifer Han
Affiliation:
Division of Infectious Diseases, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania Department of Healthcare Epidemiology, Infection Prevention and Control, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Cheryl Gilmar
Affiliation:
Department of Healthcare Epidemiology, Infection Prevention and Control, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Brooke McDonnell
Affiliation:
Operations Improvement, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Steven Gaynes
Affiliation:
Department of Environmental Services, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
*
Address correspondence to David Pegues, MD, Ground Founders, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 ([email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

OBJECTIVE

To evaluate the impact of no-touch terminal room no-touch disinfection using ultraviolet wavelength C germicidal irradiation (UVGI) on C. difficile infection (CDI) rates on inpatient units with persistently high rates of CDI despite infection control measures.

DESIGN

Interrupted time-series analysis with a comparison arm.

SETTING

3 adult hematology-oncology units in a large, tertiary-care hospital.

METHODS

We conducted a 12-month prospective valuation of UVGI. Rooms of patients with CDI or on contact precautions were targeted for UVGI upon discharge using an electronic patient flow system. Incidence rates of healthcare-onset CDI were compared for the baseline period (January 2013–December 2013) and intervention period (February 2014–January 2015) on study units and non–study units using a mixed-effects Poisson regression model with random effects for unit and time in months.

RESULTS

During a 52-week intervention period, UVGI was deployed for 542 of 2,569 of all patient discharges (21.1%) on the 3 study units. The CDI rate declined 25% on study units and increased 16% on non-study units during the intervention compared to the baseline period. We detected a significant association between UVGI and decrease in CDI incidence (incidence rate ratio [IRR], 0.49; 95% confidence interval [CI], 0.26–0.94; P=.03) on the study units but not on the non-study units. The impact of UVGI use on average room-cleaning time and turnaround time was negligible compared to the baseline period.

CONCLUSIONS

Targeted deployment of UVGI to rooms of high-risk patients at discharge resulted in a substantial reduction of CDI incidence without adversely impacting room turnaround.

Infect Control Hosp Epidemiol 2016;1–6

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 1 , January 2017 , pp. 39 - 44
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

PREVIOUS PRESENTATION: Presented in part at IDWeek, San Diego, California, October 10, 2015.

References

REFERENCES

1. Dubberke, ER, Carling, P, Carrico, R, et al. Strategies to prevent Clostridium difficile infections in acute care hospitals: 2014 Update. Infect Control Hosp Epidemiol 2014;35:628–645.CrossRefGoogle ScholarPubMed
2. Shaughnessy, MK, Micielli, RL, DePestel, DD, et al. Evaluation of hospital room assignment and acquisition of Clostridium difficile infection. Infect Control Hosp Epidemiol 2011;32:201–206.CrossRefGoogle ScholarPubMed
3. Rutala, WA, Weber, DJ. Disinfectants used for environmental disinfection and new room decontamination technology. Am J Infect Control 2013;41:S36–S41.Google Scholar
4. Weber, DJ, Rutala, WA, Anderson, DJ, Chen, LF, Sickbert-Bennett, EE, Boyce, JM. Effectiveness of ultraviolet devices and hydrogen peroxide systems for terminal room decontamination: focus on clinical trials. Am J Infect Control 2016;44:e77–e84.CrossRefGoogle ScholarPubMed
5. Butler, M, Olson, A, Drekonja, D, et al. Early Diagnosis, Prevention, and Treatment of Clostridium difficile: Update. Rockville, MD: Agency for Healthcare Research and Quality (US); 2016.Google Scholar
6. Centers for Disease Control and Prevention/National Healthcare Safety Network. Surveillance definitions for specific types of infections. Centers for Disease Control and Prevention website.http://www.cdc.gov/nhsn/pdfs/pscmanual/17pscnosinfdef_current.pdf. Published 2016. Accessed May 11, 2016.Google Scholar
7. Leas, BF, Sullivan, N, Han, JH, Pegues, DA, Kaczmarek, JL, Umscheid, CA. Environmental Cleaning for the Prevention of Healthcare-Associated Infections. Rockville, MD: Agency for Healthcare Research and Quality (US); 2015.Google ScholarPubMed
8. Anderson, D, Chen, LF, Weber, DJ, et al. The BETR-disinfection study. Abstract 1280. Abstract presented at IDWeek, San Diego, CA, October 7–11, 2015.Google Scholar
9. Cadnum, JL, Tomas, ME, Sankar, T, et al. Effect of variation in test methods on performance of ultraviolet-c radiation room decontamination. Infect Control Hosp Epidemiol 2016;37:555–560.Google Scholar
10. Rutala, WA, Gergen, MF, Tande, BM, Weber, DJ. Room decontamination using an ultraviolet-C device with short ultraviolet exposure time. Infect Control Hosp Epidemiol 2014;35:1070–1072.CrossRefGoogle ScholarPubMed
11. Anderson, DJ, Gergen, MF, Smathers, E, et al. Decontamination of targeted pathogens from patient rooms using an automated ultraviolet-C-emitting device. Infect Control Hosp Epidemiol 2013;34:466–471.Google Scholar
12. Gabriel, L, Mathiot, AB. Hospitalization stay and costs attributable to Clostridium difficile infection: a critical review. J Hosp Infect 2014;88:12–21.Google Scholar