513. Effectiveness of Pulsed Xenon Ultraviolet Light Disinfection System to Decrease Clostridium difficile Infections at the South Texas Veterans Health Care System

Abstract

Background Clostridium difficile is the leading pathogen implicated in healthcare-associated infections. C. difficile spores can survive for months on surfaces, allowing for transmission between patients; thus, environmental disinfection is a cornerstone for C. difficile infection (CDI) prevention. Pulsed xenon ultraviolet (PX-UV) light disinfection effectively eliminates C. difficile spores from surfaces and can be used as an adjunct to manual cleaning; however, few studies have evaluated the effects of this technology on healthcare facility-onset CDI (HO-CDI) rates. The objective of this study was to compare HO-CDI rates prior to and post-implementation of PX-UV disinfection in an acute care hospital.MethodsThis was a quasi-experimental study in the South Texas Veterans Health Care System (STVHCS), San Antonio, Texas from 2011 to 2018. The PX-UV system was implemented beginning January 1, 2013. HO-CDI rates were calculated as CDI cases per 10,000 patient-days. Rates were compared between the pre-PX-UV period (2011–2012) and post-PX-UV period (2013–2018) using the conditional maximum likelihood estimate of rate ratio. The association between number of beds cleaned and HO-CDI incidence was evaluated using Pearson correlation.ResultsDuring the 2-year preintervention period, the HO-CDI rate was 9.09 per 10,000 patient-days compared with 9.44 per 10,000 patient days in the postintervention period (RR 1.038; 95% CI 0.817 – 1.328) (P = 0.7703). HO-CDI rates peaked in 2015 (13.60 per 10,000) and declined steadily thereafter through 2018 (6.86 per 10,000). There was not a significant correlation between number of beds cleaned and HO-CDI incidence (R=0.3713; 95% CI −0.0597–0.6856; P = 0.0889).ConclusionPX-UV disinfection did not significantly reduce HO-CDI rates in the first 5 years of use; however, more recent data demonstrate HO-CDI rates lower than that of the preintervention period.Disclosures All authors: No reported disclosures.