196. Reducing bioburden in the operating room: manual cleaning and pulsed-xenon ultraviolet light disinfection produces significant reduction in colony forming units

Abstract

BACKGROUND CONTEXT Though techniques for sterilizing surgical tools and supplies have steadily improved, current standards for operating room (OR) disinfection have become antiquated – providing continued convenience for pathogenic organisms and surgical site infections. Pulsed-xenon ultraviolet (PX-UV) disinfection is an opportunity for standardized, touch-free disinfection that may serve as a supplement to manual terminal cleaning. The combination of manual and PX-UV disinfection may provide the greatest reduction in OR bioburden, as measured by colony-forming units (CFUs), and frequency of site contamination. Here, the bioburden and site contamination of ORs following manual cleaning and PX-UV disinfection are explored. PURPOSE Determine impact of manual vs manual and PX-UV disinfection on CFUs in spine operating suites. STUDY DESIGN/SETTING N/A PATIENT SAMPLE N/A OUTCOME MEASURES N/A METHODS Fifteen ORs were sampled at three different time points – before terminal manual cleaning, after terminal manual cleaning, and after PX-UV. For each OR, at each time point, five high-touch surfaces were cultured using a Tryptone Soy Agar touch plate. A total of 225 samples were acquired. Samples were incubated for 24 hours and the number of colony-forming units reported. Distinct colonies were identified. Descriptive statistics and Rank Sum Testing with a Bonferroni correction were used to analyze results. RESULTS There was a 26.8% reduction of CFUs after manual cleaning (p>0.8014) and an 81.0% reduction of CFUs after PX-UV (p = 0.0086). Overall, the combination of manual and PX-UV disinfection resulted in an 86.10% reduction in CFUs (p = 0.004). The frequency of sites with CFUs prior to cleaning was 26.7%. There was no change in frequency of sites with CFUs after manual cleaning. Following PX-UV cleaning, the frequency of sites with CFUs reduced to 8.0%, which is a 70.0% reduction in sites with CFUs. Interestingly, the frequency of sites with an increase in CFUs after manual cleaning was 20.0%. There was no occurrence of an increase in CFUs after PX-UV disinfection. CONCLUSIONS The combination of PX-UV with manual cleaning yields the greatest reduction in OR bioburden as measured by CFUs. Manual cleaning alone resulted in a low reduction of CFUs and no change in the frequency of site contamination. Though some individual sites demonstrated elimination of CFUs following manual cleaning, there were a number of sites that had an increase in CFUs. This may represent cross contamination due to the inconsistent nature of manual terminal cleaning. The use of PX-UV disinfection resulted in a significant reduction in CFUs when compared to both the pre- and postmanual cleaning time points. PX-UV disinfection also yielded a reduction in the frequency of site contamination. This reduction in both bioburden and contaminated sites may contribute to a decreased risk of surgical site infection. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.