WHAT IS THE THREAT?
Airborne and surface germs, bacteria and viruses are becoming a major health problem not only in healthcare facilities but businesses and in homes worldwide. The CDC back in 2013 stated the spread of contagious disease is one of the greatest threats to public health in the 21st century and antibiotic resistant microorganisms pose “a catastrophic threat” to all countries (CDC, 2013).
Microbial reservoirs in the environment are difficult to eliminate, may be resistant to traditional cleaning mechanisms, and can exist on surfaces for up to 7 months (Hota et al. 2004).
Infectious germs are easily spread through the surfaces we touch every day and many studies have shown contaminated environments increase the risk of infections (Weber et al. 2013).
According to the EPA indoor air pollution is often five times and as much as 100 times worse than outdoor and represents a significant health risk. UV-C improves indoor air quality by sterilizing mold, bacteria, viruses, and allergens from the air as it cycles through the central air system.
The US government now specifies that germicidal UV be used in all government buildings. It is also used in government, county, commercial water treatment systems as a chemical-free means of purification.
Room Decontamination with UV Radiation Study:
William A. Rutala, PhD, MPH; Maria F. Gergen, MT (ASCP); David J. Weber, MD, MPH objective.
To determine the effectiveness of a UV-C–emitting device to eliminate clinically important nosocomial pathogens in a contaminated hospital room. methods. This study was carried out in a standard but empty hospital room (phase 1) and in a room previously occupied by a patient with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) infection (phase 2) in an acute care tertiary hospital in North Carolina from January 21 through September 21, 2009. During phase 1, cm Formica sheets contaminated 8 # 8 with approximately 104 –105 organisms of MRSA, VRE, multidrug-resistant (MDR) Acinetobacter baumannii, or Clostridium difficile spores were placed in a hospital room, both in direct line of sight of the UV-C device and behind objects. After timed exposure, the presence of the microbes was assessed. During phase 2, specific sites in rooms that had housed patients with MRSA or VRE infection were sampled before and after UV-C irradiation. After timed exposure, the presence of MRSA and VRE and total colony counts were assessed. results. In our test room, the effectiveness of UV-C radiation in reducing the counts of vegetative bacteria on surfaces was more than 99.9% within 15 minutes, and the reduction in C. difficile spores was 99.8% within 50 minutes. In rooms occupied by patients with MRSA, UV-C irradiation of approximately 15 minutes duration resulted in a decrease in total CFUs per plate (mean, 384 CFUs vs 19 CFUs; P ! .001), in the number of samples positive for MRSA (81 [20.3%] of 400 plates vs 2 [0.5%] of 400 plates; ), and in MRSA counts P ! .001 per MRSA-positive plate (mean, 37 CFUs vs 2 CFUs; ). P ! .001 conclusions. This UV-C device was effective in eliminating vegetative bacteria on contaminated surfaces both in the line of sight and behind objects within approximately 15 minutes and in eliminating C. difficile spores within 50 minutes. Infect Control Hosp Epidemiol 2010; 31(10):1025-1029 From Hospital Epidemiology, University of North Carolina Health Care (all authors), and the Division of Infectious Diseases, University of North Carolina School of Medicine (W.A.R., D.J.W.), Chapel Hill, North Carolina. Received January 28, 2010; accepted April 19, 2010; electronically published August 30, 2010. ! 2010 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2010/3110-0006
DOI: 10.1086/656244
Surface disinfection of noncritical surfaces and equipment is normally performed by manually applying a liquid disinfectant to the surface with a cloth, wipe, or mop. Recent studies have identified substantial opportunities in hospitals to improve the cleaning of frequently touched objects in the patient’s immediate environment.1-3 For example, of 20,646 standardized environmental surfaces (14 types of objects), only 9,910 (48%) were cleaned at terminal room cleaning.3 Epidemiologic studies have shown that patients hospitalized in rooms previously occupied by individuals infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA),4 vancomycin-resistant Enterococcus (VRE),5 or Clostridium difficile6 are at significant risk of acquiring these organisms from contaminated environmental surfaces. These data have inspired the development of room decontamination devices that avoid the problems associated with manual disinfection.7 Devices using UV-C light (wavelength, 254 nm) have also been proposed for room decontamination. One UV-C device uses an array of UV sensors, which determines and targets shadowed areas to deliver a measured dose of UV energy that destroys microorganisms. This unit is fully automated and activated by a hand-held remote control, and the room ventilation does not need to be modified. It measures UV light reflected from the walls, ceiling, floors, or items in the room and calculates the time required to deliver the programmed lethal dose for pathogens.8 After decontamination, it powers down and an audible alarm notifies the operator. The purpose of this article is to summarize our evaluation of the ability of this device to decontaminate rooms that were experimentally or naturally contaminated with epidemiologically important pathogens, such as MRSA, VRE, a multidrug-resistant (MDR) strain of Acinetobacter baumannii, and C. difficile spores. methods
The study was performed at University of North Carolina Health Care, an acute care tertiary hospital in Chapel Hill, North Carolina, during the period January 21 through September 21, 2009. Phase 1: Clinical Translational Research Center A single UV-C device was investigated (Tru-D; Lumalier Corporation). This device delivers a reflected dose of 36,000 mWs/
Airborne and surface germs, bacteria and viruses are becoming a major health problem not only in healthcare facilities but businesses and in homes worldwide. The CDC back in 2013 stated the spread of contagious disease is one of the greatest threats to public health in the 21st century and antibiotic resistant microorganisms pose “a catastrophic threat” to all countries (CDC, 2013).
Microbial reservoirs in the environment are difficult to eliminate, may be resistant to traditional cleaning mechanisms, and can exist on surfaces for up to 7 months (Hota et al. 2004).
Infectious germs are easily spread through the surfaces we touch every day and many studies have shown contaminated environments increase the risk of infections (Weber et al. 2013).
According to the EPA indoor air pollution is often five times and as much as 100 times worse than outdoor and represents a significant health risk. UV-C improves indoor air quality by sterilizing mold, bacteria, viruses, and allergens from the air as it cycles through the central air system.
The US government now specifies that germicidal UV be used in all government buildings. It is also used in government, county, commercial water treatment systems as a chemical-free means of purification.
Room Decontamination with UV Radiation Study:
William A. Rutala, PhD, MPH; Maria F. Gergen, MT (ASCP); David J. Weber, MD, MPH objective.
To determine the effectiveness of a UV-C–emitting device to eliminate clinically important nosocomial pathogens in a contaminated hospital room. methods. This study was carried out in a standard but empty hospital room (phase 1) and in a room previously occupied by a patient with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) infection (phase 2) in an acute care tertiary hospital in North Carolina from January 21 through September 21, 2009. During phase 1, cm Formica sheets contaminated 8 # 8 with approximately 104 –105 organisms of MRSA, VRE, multidrug-resistant (MDR) Acinetobacter baumannii, or Clostridium difficile spores were placed in a hospital room, both in direct line of sight of the UV-C device and behind objects. After timed exposure, the presence of the microbes was assessed. During phase 2, specific sites in rooms that had housed patients with MRSA or VRE infection were sampled before and after UV-C irradiation. After timed exposure, the presence of MRSA and VRE and total colony counts were assessed. results. In our test room, the effectiveness of UV-C radiation in reducing the counts of vegetative bacteria on surfaces was more than 99.9% within 15 minutes, and the reduction in C. difficile spores was 99.8% within 50 minutes. In rooms occupied by patients with MRSA, UV-C irradiation of approximately 15 minutes duration resulted in a decrease in total CFUs per plate (mean, 384 CFUs vs 19 CFUs; P ! .001), in the number of samples positive for MRSA (81 [20.3%] of 400 plates vs 2 [0.5%] of 400 plates; ), and in MRSA counts P ! .001 per MRSA-positive plate (mean, 37 CFUs vs 2 CFUs; ). P ! .001 conclusions. This UV-C device was effective in eliminating vegetative bacteria on contaminated surfaces both in the line of sight and behind objects within approximately 15 minutes and in eliminating C. difficile spores within 50 minutes. Infect Control Hosp Epidemiol 2010; 31(10):1025-1029 From Hospital Epidemiology, University of North Carolina Health Care (all authors), and the Division of Infectious Diseases, University of North Carolina School of Medicine (W.A.R., D.J.W.), Chapel Hill, North Carolina. Received January 28, 2010; accepted April 19, 2010; electronically published August 30, 2010. ! 2010 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2010/3110-0006
DOI: 10.1086/656244
Surface disinfection of noncritical surfaces and equipment is normally performed by manually applying a liquid disinfectant to the surface with a cloth, wipe, or mop. Recent studies have identified substantial opportunities in hospitals to improve the cleaning of frequently touched objects in the patient’s immediate environment.1-3 For example, of 20,646 standardized environmental surfaces (14 types of objects), only 9,910 (48%) were cleaned at terminal room cleaning.3 Epidemiologic studies have shown that patients hospitalized in rooms previously occupied by individuals infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA),4 vancomycin-resistant Enterococcus (VRE),5 or Clostridium difficile6 are at significant risk of acquiring these organisms from contaminated environmental surfaces. These data have inspired the development of room decontamination devices that avoid the problems associated with manual disinfection.7 Devices using UV-C light (wavelength, 254 nm) have also been proposed for room decontamination. One UV-C device uses an array of UV sensors, which determines and targets shadowed areas to deliver a measured dose of UV energy that destroys microorganisms. This unit is fully automated and activated by a hand-held remote control, and the room ventilation does not need to be modified. It measures UV light reflected from the walls, ceiling, floors, or items in the room and calculates the time required to deliver the programmed lethal dose for pathogens.8 After decontamination, it powers down and an audible alarm notifies the operator. The purpose of this article is to summarize our evaluation of the ability of this device to decontaminate rooms that were experimentally or naturally contaminated with epidemiologically important pathogens, such as MRSA, VRE, a multidrug-resistant (MDR) strain of Acinetobacter baumannii, and C. difficile spores. methods
The study was performed at University of North Carolina Health Care, an acute care tertiary hospital in Chapel Hill, North Carolina, during the period January 21 through September 21, 2009. Phase 1: Clinical Translational Research Center A single UV-C device was investigated (Tru-D; Lumalier Corporation). This device delivers a reflected dose of 36,000 mWs/