Abstract
BackgroundHealthcare-acquired infections with methicillin-resistant Staphylococcus aureus (MRSA) are a significant cause of increased mortality, morbidity and additional health care costs in United States. Surface decontamination technologies that utilize pulsed xenon ultraviolet light (PPX-UV) may be effective at reducing microbial burden. The purpose of this study was to compare standard manual room-cleaning to PPX-UV disinfection technology for MRSA and bacterial heterotrophic plate counts (HPC) on high-touch surfaces in patient rooms.MethodsRooms vacated by patients that had a MRSA-positive polymerase chain reaction or culture during the current hospitalization and at least a 2-day stay were studied. 20 rooms were then treated according to one of two protocols: standard manual cleaning or PPX-UV. This study evaluated the reduction of MRSA and HPC taken from five high-touch surfaces in rooms vacated by MRSA-positive patients, as a function of cleaning by standard manual methods vs a PPX-UV area disinfection device.ResultsColony counts in 20 rooms (10 per arm) prior to cleaning varied by cleaning protocol: for HPC, manual (mean = 255, median = 278, q1-q3 132–304) vs PPX-UV (mean = 449, median = 365, q1-q3 332–530), and for MRSA, manual (mean = 127; median = 28.5; q1-q3 8–143) vs PPX-UV (mean = 108; median = 123; q1-q3 14–183). PPX-UV was superior to manual cleaning for MRSA (adjusted incident rate ratio [IRR] = 7; 95% CI <1-41) and for HPC (IRR = 13; 95% CI 4–48).ConclusionPPX-UV technology appears to be superior to manual cleaning alone for MRSA and HPC. Incorporating 15 minutes of PPX-UV exposure time to current hospital room cleaning practice can improve the overall cleanliness of patient rooms with respect to selected micro-organisms.
Highlights
Healthcare-acquired infections with methicillin-resistant Staphylococcus aureus (MRSA) are a significant cause of increased mortality, morbidity and additional health care costs in United States
All patients undergo nasal swab at admission, transfer and discharge; these samples are tested for MRSA by polymerase chain reaction (PCR) or culture as a routine process of care according to institutional policy
Colony counts in 20 rooms (10 per arm) prior to cleaning varied by cleaning protocol: for heterotrophic plate counts (HPC), manual vs Portable pulsed xenon ultraviolet (PPX-UV), and for MRSA, manual vs PPX-UV
Summary
Healthcare-acquired infections with methicillin-resistant Staphylococcus aureus (MRSA) are a significant cause of increased mortality, morbidity and additional health care costs in United States. The purpose of this study was to compare standard manual room-cleaning to PPX-UV disinfection technology for MRSA and bacterial heterotrophic plate counts (HPC) on high-touch surfaces in patient rooms. Healthcare-acquired infection (HAI) with methicillinresistant Staphylococcus aureus (MRSA) is a significant cause of mortality and morbidity in the United States accounting for up to $9.7 billion annually in additional health care costs, and €44.0 million annually in Europe [1,2]. In a 2009 review of environmental cleaning studies, Dancer concluded that high-touch surfaces present one of the biggest risks of MRSA acquisition for patients, providing a source of direct infection to patients and of indirect infection via healthcare workers [7]. Manual cleaning with approved disinfectants is the current standard of disinfection in most countries including the United States, and this requires supervision with constant reinforcement and education of environmental management service (EMS) staff to maintain effectiveness [9]
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