Abstract

BackgroundPrevention of superficial surgical wound infections from drug-resistant bacteria such as methicillin resistant Staphylococcus aureus (MRSA) currently present major health care challenges. The majority of surgical site infections (SSI) are believed to be caused by airborne transmission of bacteria alighting onto the wound during surgical procedures. We have previously shown that far-ultraviolet C light in the wavelength range of 207–222 nm is significantly harmful to bacteria, but without damaging mammalian cells and tissues. It is important that the lamp be fitted with a filter to remove light emitted at wavelengths longer than 230 nm which are harmful.AimsUsing a hairless mouse model of infection of superficial wounds, here we tested the hypothesis that 222-nm light kills MRSA alighting onto a superficial skin incisions as efficiently as typical germicidal light (254 nm), but without inducing skin damage.MethodsTo simulate the scenario wherein incisions are infected during surgical procedures as pathogens in the room alight on a wound, MRSA was spread on a defined area of the mouse dorsal skin; the infected skin was then exposed to UVC light (222 nm or 254 nm) followed by a superficial incision within the defined area, which was immediately sutured. Two and seven days post procedure, bactericidal efficacy was measured as MRSA colony formation unit (CFU) per gram of harvested skin whereas fixed samples were used to assess skin damage measured in terms of epidermal thickness and DNA photodamage.ResultsIn the circumstance of superficial incisions infected with bacteria alighting onto the wound, 222-nm light showed the same bactericidal properties of 254-nm light but without the associated skin damage.ConclusionsBeing safe for patient and hospital staff, our results suggested that far-UVC light (222 nm) might be a convenient approach to prevent transmission of drug-resistant infectious agents in the clinical setting.

Highlights

  • The majority of surgical site infection (SSI) are believed to be caused by airborne transmission of bacteria alighting onto the wound [1, 2]

  • Two and seven days post procedure, bactericidal efficacy was measured as methicillin resistant Staphylococcus aureus (MRSA) colony formation unit (CFU) per gram of harvested skin whereas fixed samples were used to assess skin damage measured in terms of epidermal thickness and DNA photodamage

  • Being safe for patient and hospital staff, our results suggested that far-UVC light (222 nm) might be a convenient approach to prevent transmission of drug-resistant infectious agents in the clinical setting

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Summary

Introduction

The majority of surgical site infection (SSI) are believed to be caused by airborne transmission of bacteria alighting onto the wound [1, 2]. Evidence for the dominance of the airborne route comes from correlations between the density of airborne bacteria and postoperative sepsis rates [2, 3]; proof for the impact of airborne bacteria alighting directly on the surgical wound comes, for example, from studies of conventional ultraviolet (UV) lamps directed over the surgical site [1], and from wound-directed filtered airflow studies [4]. Because of the prevalence of the airborne bacteria route, UV exposure during surgery has long been considered as a potential modality for reducing SSI. There have been multiple clinical studies, starting as far back as 1940 [5, 6], demonstrating that UV exposure of the wound during surgery results in markedly decreased SSI rates.

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