Abstract
BackgroundThe near-patient environment is often heavily contaminated, yet the decontamination of near-patient surfaces and equipment is often poor. The Nanoclave Cabinet produces large amounts of ultraviolet-C (UV-C) radiation (53 W/m2) and is designed to rapidly disinfect individual items of clinical equipment. Controlled laboratory studies were conducted to assess its ability to eradicate a range of potential pathogens including Clostridium difficile spores and Adenovirus from different types of surface.MethodsEach test surface was inoculated with known levels of vegetative bacteria (106 cfu/cm2), C. difficile spores (102-106 cfu/cm2) or Adenovirus (109 viral genomes), placed in the Nanoclave Cabinet and exposed for up to 6 minutes to the UV-C light source. Survival of bacterial contaminants was determined via conventional cultivation techniques. Degradation of viral DNA was determined via PCR. Results were compared to the number of colonies or level of DNA recovered from non-exposed control surfaces. Experiments were repeated to incorporate organic soils and to compare the efficacy of the Nanoclave Cabinet to that of antimicrobial wipes.ResultsAfter exposing 8 common non-critical patient care items to two 30-second UV-C irradiation cycles, bacterial numbers on 40 of 51 target sites were consistently reduced to below detectable levels (≥ 4.7 log10 reduction). Bacterial load was reduced but still persisted on other sites. Objects that proved difficult to disinfect using the Nanoclave Cabinet (e.g. blood pressure cuff) were also difficult to disinfect using antimicrobial wipes. The efficacy of the Nanoclave Cabinet was not affected by the presence of organic soils. Clostridium difficile spores were more resistant to UV-C irradiation than vegetative bacteria. However, two 60-second irradiation cycles were sufficient to reduce the number of surface-associated spores from 103 cfu/cm2 to below detectable levels. A 3 log10 reduction in detectable Adenovirus DNA was achieved within 3 minutes; after 6 minutes, viral DNA was undetectable.ConclusionThe results of this study suggest that the Nanoclave Cabinet can provide rapid and effective disinfection of some patient-related equipment. However, laboratory studies do not necessarily replicate ‘in-use’ conditions and further tests are required to assess the usability, acceptability and relative performance of the Nanoclave Cabinet when used in situ.
Highlights
The near-patient environment is often heavily contaminated, yet the decontamination of near-patient surfaces and equipment is often poor
* Correspondence: ginny.moore@uclh.nhs.uk 1Clinical Microbiology and Virology, University College London Hospitals NHS Foundation Trust, London, UK 4Department of Microbiology, UCLH Environmental Research Group, Royal Free Hampstead NHS Trust, London NW3 2QG, UK Full list of author information is available at the end of the article. Important nosocomial pathogens such as methicillinresistant Staphylococcus aureus, Clostridium difficile and vancomycin-resistant enterococci are often present on inanimate surfaces within the local environment of infected patients [1,2,3]
The Nanoclave Cabinet effectively reduced the numbers of a range of potential pathogens including Clostridium difficile spores and Adenovirus from most, but not all, test surfaces and patient-care items
Summary
The near-patient environment is often heavily contaminated, yet the decontamination of near-patient surfaces and equipment is often poor. Experiments were repeated to incorporate organic soils and to compare the efficacy of the Nanoclave Cabinet to that of antimicrobial wipes. Important nosocomial pathogens such as methicillinresistant Staphylococcus aureus, Clostridium difficile and vancomycin-resistant enterococci are often present on inanimate surfaces within the local environment of infected patients [1,2,3]. Many of these surfaces (e.g. blood-pressure cuffs, bed rails, bedside furniture) only come into contact with a patient’s intact skin – a highly effective barrier against microbes. Inadequate cleaning allows microbial contaminants to survive and persist on environmental surfaces and whilst non-critical surfaces pose little direct risk to patients [4], they can act as a source from which healthcare workers can contaminate their hands and may serve as vectors for cross-transmission
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