Pulsed Xenon Ultraviolet Disinfection Research Articles

Pulsed-xenon ultraviolet light disinfection in a burn unit: Impact on environmental bioburden, multidrug-resistant organism acquisition and healthcare associated infections

Portable pulsed xenon ultraviolet disinfection (PPX-UVD) may reduce healthcare associated infections (HAI). There is limited data to inform use in burn intensive care units (BICU), where multidrug-resistant organisms (MDRO), especially gram negative rods (GNR), commonly cause disease. We evaluated PPX-UVD effects on environmental bioburden and rates of HAI and MDRO acquisition in a BICU. PPX-UVD was used for 3 months after standard cleaning of patient and operating rooms (ORs). Settle and touch plates in patient rooms and ORs were obtained after standard cleaning, pre-and post-PPX-UVD. HAI and MDRO acquisition were evaluated 1year prior to and for 3 month periods before, during, and after PPX-UVD. 110 touch and settle plates (33 pre- and 30 post-PPX-UVD) were obtained after standard cleaning, pre- and post-PPX-UVD. After PPX-UVD, environmental samples with any growth decreased (48% vs 31%, p=0.02), as did mean colony count/sample (2.8 pre- vs 1.6 post-, p=0.03). The 379 colonies largely represented skin commensals, without identified MDRO. Following PPX-UVD, no changes in device-associated infections, overall MDRO, or MDR GNR were seen, though a prolonged interval without healthcare-associated Clostridium difficile infection was observed. PPX-UVD in a BICU reduced overall environmental bioburden, without a statistically significant impact on HAI or MDRO.

2-107 - A Trial of Pulsed Xenon Ultraviolet Disinfection to Reduce C. Difficile Infection

2-107 - A Trial of Pulsed Xenon Ultraviolet Disinfection to Reduce C. Difficile Infection

Evaluation of a pulsed xenon ultraviolet light device for isolation room disinfection in a United Kingdom hospital

Pathogen transmission from contaminated surfaces can cause hospital-associated infections. Although pulsed xenon ultraviolet (PX-UV) light devices have been shown to decrease hospital room bioburden in the United States, their effectiveness in United Kingdom (UK) hospitals is less understood. Forty isolation rooms at the Queens Hospital (700 beds) in North London, UK, were sampled for aerobic bacteria after patient discharge, after manual cleaning with a hypochlorous acid-troclosene sodium solution, and after PX-UV disinfection. PX-UV device efficacy on known organisms was tested by exposing inoculated agar plates in a nonpatient care area. Turnaround times for device usage were recorded, and a survey of hospital staff for perceptions of the device was undertaken. After PX-UV disinfection, the bacterial contamination measured in colony forming units (CFU) decreased by 78.4%, a 91% reduction from initial bioburden levels prior to terminal cleaning. PX-UV exposure resulted in a 5-log CFU reduction for multidrug-resistant organisms (MDROs) on spiked plates. The average device turnaround time was 1 hour, with minimal impact on patient throughput. Ward staff were enthusiastic about device deployment, and device operators reported physical comfort in usage. PX-UV use decreased bioburden in patient discharge rooms and on agar plates spiked with MDROs. The implementation of the PX-UV device was well received by hospital cleaning and ward staff, with minimal disruption to patient flow.

The microbiological impact of pulsed xenon ultraviolet disinfection on resistant bacteria, bacterial spore and fungi and viruses

Pathogens can persist in the patient care environment and cause the risk of transmission to patients. Pulsed xenon ultraviolet (PX-UV) is increasingly being used to disinfect patient rooms, operating rooms and other areas. Data on the impact of PX-UV on resistant bacteria, bacterial spores, fungi, viruses and the Ebola virus are lacking in the literature. Laboratory data are presented in this paper on the log reductions observed after the exposure of PX-UV to a variety of organisms in a laboratory setting.

Impact of pulsed xenon ultraviolet light on hospital-acquired infection rates in a community hospital

The role of contaminated environments in the spread of hospital-associated infections has been well documented. This study reports the impact of a pulsed xenon ultraviolet no-touch disinfection system on infection rates in a community care facility. This study was conducted in a community hospital in Southern Florida. Beginning November 2012, a pulsed xenon ultraviolet disinfection system was implemented as an adjunct to traditional cleaning methods on discharge of select rooms. The technology uses a xenon flashlamp to generate germicidal light that damages the DNA of organisms in the hospital environment. The device was implemented in the intensive care unit (ICU), with a goal of using the pulsed xenon ultraviolet system for disinfecting all discharges and transfers after standard cleaning and prior to occupation of the room by the next patient. For all non-ICU discharges and transfers, the pulsed xenon ultraviolet system was only used for Clostridium difficile rooms. Infection data were collected for methicillin-resistant Staphylococcus aureus, C difficile, and vancomycin-resistant Enterococci (VRE). The intervention period was compared with baseline using a 2-sample Wilcoxon rank-sum test. In non-ICU areas, a significant reduction was found for C difficile. There was a nonsignificant decrease in VRE and a significant increase in methicillin-resistant S aureus. In the ICU, all infections were reduced, but only VRE was significant. This may be because of the increased role that environment plays in the transmission of this pathogen. Overall, there were 36 fewer infections in the whole facility and 16 fewer infections in the ICU during the intervention period than would have been expected based on baseline data. Implementation of pulsed xenon ultraviolet disinfection is associated with significant decreases in facility-wide and ICU infection rates. These outcomes suggest that enhanced environmental disinfection plays a role in the risk mitigation of hospital-acquired infections.

Influence of a total joint infection control bundle on surgical site infection rates

Quality improvement initiatives combined with pulsed xenon ultraviolet room disinfection were implemented to reduce surgical site infections (SSIs) in patients undergoing total joint procedures. After 12months, knee SSIs were reduced from 4 to 0 (P=.03) and hip SSIs were reduced from 3 to 0 (P=.15) for a combined prevention of 7 SSIs (P=.01) and a savings of $290,990.

Is the pulsed xenon ultraviolet light no-touch disinfection system effective on methicillin-resistant Staphylococcus aureus in the absence of manual cleaning?

Methicillin-resistant Staphylococcus aureus (MRSA) has been shown to survive on ambient surfaces for extended periods of time. Leftover MRSA environmental contamination in a hospital room places future patients at risk. Manual disinfection supplemented by pulsed xenon ultraviolet (PX-UV) light disinfection has been shown to greatly decrease the MRSA bioburden in hospital rooms. However, the effect of PX-UV in the absence of manual disinfection has not been evaluated. Rooms that were previously occupied by a MRSA-positive patient (current colonization or infection) were selected for the study immediately postdischarge. Five high-touch surfaces were sampled, before and after PX-UV disinfection, in each hospital room. The effectiveness of the PX-UV device on the concentration of MRSA was assessed employing a Wilcoxon signed-rank test for all 70 samples with MRSA in 14 rooms, as well as by surface location. The final analysis included 14 rooms. Before PX-UV disinfection there were a total of 393 MRSA colonies isolated from the 5 high-touch surfaces. There were 100 MRSA colonies after disinfection by the PX-UV device and the overall reduction was statistically significant (P < .01). Our study results suggest that PX-UV light effectively reduces MRSA colony counts in the absence of manual disinfection. These findings are important for hospital and environmental services supervisors who plan to adapt new technologies as an adjunct to routine manual disinfection.

Disinfecting personal protective equipment with pulsed xenon ultraviolet as a risk mitigation strategy for health care workers

The doffing of personal protective equipment (PPE) after contamination with pathogens such as Ebola poses a risk to health care workers. Pulsed xenon ultraviolet (PX-UV) disinfection has been used to disinfect surfaces in hospital settings. This study examined the impact of PX-UV disinfection on an Ebola surrogate virus on glass carriers and PPE material to examine the potential benefits of using PX-UV to decontaminate PPE while worn, thereby reducing the pathogen load prior to doffing. Ultraviolet (UV) safety and coverage tests were also conducted. PX-UV exposure resulted in a significant reduction in viral load on glass carriers and PPE materials. Occupational Safety and Health Administration-defined UV exposure limits were not exceeded during PPE disinfection. Predoffing disinfection with PX-UV has potential as an additive measure to the doffing practice guidelines. The PX-UV disinfection should not be considered sterilization; all PPE should still be considered contaminated and doffed and disposed of according to established protocols.

Implementation of innovative pulsed xenon ultraviolet (PX-UV) environmental cleaning in an acute care hospital

It is widely acknowledged that the hospital environment is an important reservoir for many of the pathogenic microbes associated with health care-associated infections (HAIs). Environmental cleaning plays an important role in the prevention and containment of HAIs, in patient safety, and the overall experience of health care facilities. New technologies, such as pulsed xenon ultraviolet (PX-UV) light systems are an innovative development for enhanced cleaning and decontamination of hospital environments. A portable PX-UV disinfection device delivers pulsed UV light to destroy microbial pathogens and spores, and can be used in conjunction with manual environmental cleaning. In addition, this technology facilitates thorough disinfection of hospital rooms in 10–15 minutes. The current study was conducted to evaluate whether the introduction of the PX-UV device had a positive impact on patient satisfaction. Satisfaction was measured using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. In 2011, prior to the introduction of the PX-UV system, patient HCAHPS scores for cleanliness averaged 75.75%. In the first full quarter after enhanced cleaning of the facility was introduced, this improved to 83%. Overall scores for the hospital rose from 76% (first quarter, 2011) to 87.6% (fourth quarter, 2012). As a result of this improvement, the hospital received 1% of at-risk reimbursement from the inpatient prospective payment system as well as additional funding. Cleanliness of the hospital environment is one of the questions included in the HCAHPS survey and one measure of patient satisfaction. After the introduction of the PX-UV system, the score for cleanliness and the overall rating of the hospital rose from below the fiftieth to the ninety-ninth percentile. This improvement in the patient experience was associated with financial benefits to the hospital.

Impact of a multi-hospital intervention utilising screening, hand hygiene education and pulsed xenon ultraviolet (PX-UV) on the rate of hospital associated meticillin resistant Staphylococcus aureus infection

Standard approaches to meticillin resistant Staphylococcus aureus (MRSA) prevention have included hand hygiene and active surveillance. These approaches have shown mixed results. The addition of pulsed xenon ultraviolet (PX-UV) room disinfection for MRSA prevention is a novel approach. This new MRSA prevention method was implemented at an acute care hospital system in Greensboro, NC, USA. An MRSA screening programme was implemented over a six-month period from July 2011 to January 2012 to include all high-risk patients and the majority of surgical patients. A two-week hand hygiene education initiative was implemented in February 2011. The use of PX-UV for terminal cleaning of MRSA patient rooms was also implemented in February 2011. The rates of hospital associated MRSA (HA-MRSA) infections were monitored before and after implementation of all prevention efforts. The HA-MRSA rate decreased at the largest facility in the system by 57%, and for the entire healthcare system by 56% ( p=0.001). The two smaller hospitals saw reductions of 51% and 66%, but the results were not statistically significant ( p=0.1047 and p=0.2263). Implementing a PX-UV device in conjunction with active screening and hand hygiene was associated with a decrease in HA-MRSA rates. Studies on the individual effect of PX-UV on HA-MRSA rates are warranted.

Decreasing Operating Room Contamination of Surfaces and Air with Pulsed Xenon Ultraviolet Disinfection

Compare the bacterial contamination remaining on surfaces and in the air of operating rooms (ORs) before and after standard cleaning and quick cleaning (QC) followed by pulsed xenon ultraviolet disinfection (PX-UVD).

Pulsed Xenon Ultraviolet Disinfection and Patient Satisfaction

and place a “No Entry” sign on the door to deter staff from entering and contaminating the room. If a staff membermust enter the room they are required to wash their hands prior to entering and when leaving the room. All equipment brought into the room must be disinfected prior to entering and any equipment in the room that is touch will be disinfected prior to leaving the room. RESULTS: Prior to implementing the room sealing procedure, of the 125 high-touch surfaces tested for cleanliness, 59 (47%) were not satisfactory. However, after implementing the room sealing procedure there was a significant improvement with not satisfactory results in only 29 (23%) of 128 surfaces tested. LESSON LEARNED: Ensuring every patient is admitted to a clean room does not stop at a visual inspection. Additional measures such as surface testing and sealing cleaned rooms to prevent contamination are essential to ensure we provide the best possible environment for our patients.

Results from a Trial of a Pulsed Xenon Ultraviolet Disinfection Device: Reducing the Burden of Hospital Associated Infections

The role of the environment as a source of hospital associated infections has been explored in numerous studies. Recent efforts to mitigate this risk have focused on enhanced disinfection methods such as ultraviolet light. Pulse xenon ultraviolet (PX-UV) is a novel method for achieving rapid disinfection of the healthcare environment. PX-UV technology was trialed on two units of a large cancer center in the Southeastern US.