Abstract
BackgroundEnvironmental disinfection with continuously antimicrobial surfaces could offer superior control of surface bioburden. We sought to decide the efficacy of photocatalyst antimicrobial coating in reducing methicillin-resistant Staphylococcus aureus (MRSA) acquisition in high incidence setting.MethodsWe performed prospective cohort study involving patients hospitalized in medical intensive care unit. A titanium dioxide-based photocatalyst was coated on high touch surfaces and walls. Five months of pre-intervention data were compared with five months of post-intervention data. The incidence rates of multidrug-resistant organism acquisition and the rates of hospital-acquired blood stream infection, pneumonia, urinary tract infection, and Clostridium difficile–associated diseases were compared using Cox proportional hazards regression analysis.ResultsIn total, 621 patients were included. There was significant decrease in MRSA acquisition rate after photocatalyst coating (hazard ratio, 0.37; 95% confidence interval, 0.14–0.99; p = 0.04). However, clinical identification of vancomycin-resistant Enterococcus spp. and multidrug-resistant Acinetobacter baumannii did not decrease significantly. The hazard of contracting hospital-acquired pneumonia during the intervention period compared to baseline period was 0.46 (95% confidence interval, 0.23–0.94; p = 0.03).ConclusionsIn conclusion, MRSA rate was significantly reduced after photocatalyst coating. We provide evidence that photocatalyst disinfection can be an adjunctive measure to control MRSA acquisition in high-incidence settings.Trial registrationISRCTN Registry (ISRCTN31972004). Registered retrospectively on November 19, 2018.
Highlights
Environmental disinfection with continuously antimicrobial surfaces could offer superior control of surface bioburden
Patient characteristics In total, 858 patients were admitted to the Intensive care unit (ICU) during the study period
After adjusting for sequential organ failure assessment score, renal function, and length of ICU stay, the hazard of acquiring methicillinresistant Staphylococcus aureus (MRSA) during the intervention vs. baseline period was 0.37
Summary
Environmental disinfection with continuously antimicrobial surfaces could offer superior control of surface bioburden. We sought to decide the efficacy of photocatalyst antimicrobial coating in reducing methicillinresistant Staphylococcus aureus (MRSA) acquisition in high incidence setting. Multidrug-resistant organisms (MDROs), including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp.(VRE), and multidrug-resistant Acinetobacter baumannii (MRAB), have increased in prevalence in many acute and long-term care facilities [1]. Controlling hospital-acquired infections (HAIs) associated with these organisms has become a major challenge [2, 3]. As patient-to-patient spread is a major route of MDRO transmission, hand hygiene and isolation are pivotal infection control measures [4]. Compliance with these measures is low [5]. The Society for Healthcare Epidemiology of America recommends environmental cleaning only with moderate strength [4], Kim et al BMC Infectious Diseases (2018) 18:610 enhanced environmental cleaning can reduce MDRO transmission [7,8,9]
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