Cargando…

1214. Microbiological and Clinical Effectiveness of Pulsed-Xenon Ultraviolet Disinfection of the Patient Room in the ICU

BACKGROUND: Contact precautions do not necessarily control transmission of MDROs as other route of transmission such as patient environment may be significant. No-touch environmental disinfection has been highlighted in the past several years to control transmission of MDROs. The effectiveness of po...

Descripción completa

Detalles Bibliográficos
Autores principales: Morikane, Keita, Suzuki, Shoko, Yoshioka, Jun, Yakuwa, Jun, Nakane, Masaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809068/
http://dx.doi.org/10.1093/ofid/ofz360.1077
_version_ 1783461893848956928
author Morikane, Keita
Suzuki, Shoko
Yoshioka, Jun
Yakuwa, Jun
Nakane, Masaki
author_facet Morikane, Keita
Suzuki, Shoko
Yoshioka, Jun
Yakuwa, Jun
Nakane, Masaki
author_sort Morikane, Keita
collection PubMed
description BACKGROUND: Contact precautions do not necessarily control transmission of MDROs as other route of transmission such as patient environment may be significant. No-touch environmental disinfection has been highlighted in the past several years to control transmission of MDROs. The effectiveness of portable Pulsed Xenon Ultraviolet (PX-UV) device has been examined and demonstrated in US healthcare settings. However, its effectiveness outside the US healthcare setting is seldom reported. METHODS: This study was conducted in the intensive care unit (ICU) of Yamagata University Hospital, a 637-bed tertiary referral hospital. The ICU has six rooms and beds. In the baseline period (August 2016 to January 2018), all rooms were manually cleaned after every patient transfer/discharge. In the intervention period (February 2018 to February 2019), PX-UV disinfection was added after the manual cleaning. In both periods, all patients were screened for MRSA and two drug-resistant Acinetobacter baumannii (2DRA) to detect acquisition of those pathogens in the ICU. For microbiological evaluation, surfaces were selected for sampling by contact plates before/after manual cleaning and after PX-UV. After overnight incubation, colonies on the plates were counted. RESULTS: The incidence of newly acquired MRSA declined over time (1.40 per 1,000 patient-days in the baseline period to 0.95 in the intervention period, relative risk (RR): 0.68, 95% confidence interval (CI): 0.12–3.70). The incidence of newly acquired 2DRA further declined (4.91 to 1.90, RR: 0.39, 95% CI: 0.13–1.18). Notably, no new acquisition of 2DRA was observed since August 2018 for more than 7 months, not only in the ICU but also throughout the hospital. The total count of colonies in the sampling of 140 sites after 17 patient discharges were 3,540 (before manual cleaning), 669 (after manual cleaning, before PX-UV) and 261 (after PX-UV). The percent reduction of microbiological burden by manual cleaning was 81%, but a further 61% reduction was achieved by PX-UV. CONCLUSION: PX-UV is effective in further reducing the microbial burden even after through manual cleaning, which presumably led to termination of transmission of 2DRA in our hospital. The effectiveness of PX-UV in controlling MDROs in the non-US healthcare settings is suggested. DISCLOSURES: All authors: No reported disclosures.
format Online
Article
Text
id pubmed-6809068
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-68090682019-10-28 1214. Microbiological and Clinical Effectiveness of Pulsed-Xenon Ultraviolet Disinfection of the Patient Room in the ICU Morikane, Keita Suzuki, Shoko Yoshioka, Jun Yakuwa, Jun Nakane, Masaki Open Forum Infect Dis Abstracts BACKGROUND: Contact precautions do not necessarily control transmission of MDROs as other route of transmission such as patient environment may be significant. No-touch environmental disinfection has been highlighted in the past several years to control transmission of MDROs. The effectiveness of portable Pulsed Xenon Ultraviolet (PX-UV) device has been examined and demonstrated in US healthcare settings. However, its effectiveness outside the US healthcare setting is seldom reported. METHODS: This study was conducted in the intensive care unit (ICU) of Yamagata University Hospital, a 637-bed tertiary referral hospital. The ICU has six rooms and beds. In the baseline period (August 2016 to January 2018), all rooms were manually cleaned after every patient transfer/discharge. In the intervention period (February 2018 to February 2019), PX-UV disinfection was added after the manual cleaning. In both periods, all patients were screened for MRSA and two drug-resistant Acinetobacter baumannii (2DRA) to detect acquisition of those pathogens in the ICU. For microbiological evaluation, surfaces were selected for sampling by contact plates before/after manual cleaning and after PX-UV. After overnight incubation, colonies on the plates were counted. RESULTS: The incidence of newly acquired MRSA declined over time (1.40 per 1,000 patient-days in the baseline period to 0.95 in the intervention period, relative risk (RR): 0.68, 95% confidence interval (CI): 0.12–3.70). The incidence of newly acquired 2DRA further declined (4.91 to 1.90, RR: 0.39, 95% CI: 0.13–1.18). Notably, no new acquisition of 2DRA was observed since August 2018 for more than 7 months, not only in the ICU but also throughout the hospital. The total count of colonies in the sampling of 140 sites after 17 patient discharges were 3,540 (before manual cleaning), 669 (after manual cleaning, before PX-UV) and 261 (after PX-UV). The percent reduction of microbiological burden by manual cleaning was 81%, but a further 61% reduction was achieved by PX-UV. CONCLUSION: PX-UV is effective in further reducing the microbial burden even after through manual cleaning, which presumably led to termination of transmission of 2DRA in our hospital. The effectiveness of PX-UV in controlling MDROs in the non-US healthcare settings is suggested. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809068/ http://dx.doi.org/10.1093/ofid/ofz360.1077 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Morikane, Keita
Suzuki, Shoko
Yoshioka, Jun
Yakuwa, Jun
Nakane, Masaki
1214. Microbiological and Clinical Effectiveness of Pulsed-Xenon Ultraviolet Disinfection of the Patient Room in the ICU
title 1214. Microbiological and Clinical Effectiveness of Pulsed-Xenon Ultraviolet Disinfection of the Patient Room in the ICU
title_full 1214. Microbiological and Clinical Effectiveness of Pulsed-Xenon Ultraviolet Disinfection of the Patient Room in the ICU
title_fullStr 1214. Microbiological and Clinical Effectiveness of Pulsed-Xenon Ultraviolet Disinfection of the Patient Room in the ICU
title_full_unstemmed 1214. Microbiological and Clinical Effectiveness of Pulsed-Xenon Ultraviolet Disinfection of the Patient Room in the ICU
title_short 1214. Microbiological and Clinical Effectiveness of Pulsed-Xenon Ultraviolet Disinfection of the Patient Room in the ICU
title_sort 1214. microbiological and clinical effectiveness of pulsed-xenon ultraviolet disinfection of the patient room in the icu
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809068/
http://dx.doi.org/10.1093/ofid/ofz360.1077
work_keys_str_mv AT morikanekeita 1214microbiologicalandclinicaleffectivenessofpulsedxenonultravioletdisinfectionofthepatientroomintheicu
AT suzukishoko 1214microbiologicalandclinicaleffectivenessofpulsedxenonultravioletdisinfectionofthepatientroomintheicu
AT yoshiokajun 1214microbiologicalandclinicaleffectivenessofpulsedxenonultravioletdisinfectionofthepatientroomintheicu
AT yakuwajun 1214microbiologicalandclinicaleffectivenessofpulsedxenonultravioletdisinfectionofthepatientroomintheicu
AT nakanemasaki 1214microbiologicalandclinicaleffectivenessofpulsedxenonultravioletdisinfectionofthepatientroomintheicu