The role of the environment in harboring and transmitting multidrug-resistant organisms has become clearer due to a series of publications linking environmental contamination with increased risk of hospital-associated infections. The incidence of antimicrobial resistance is also increasing, leading to higher morbidity and mortality associated with hospital-associated infections. The purpose of this review is to evaluate the evidence supporting the existing methods of environmental control of organisms: environmental disinfection, contact precautions, and hand hygiene. These methods have been routinely employed, but transmission of multidrug-resistant organisms continues to occur in healthcare facilities throughout the country and worldwide. Several new technologies have entered the healthcare market that have the potential to close this gap and enhance the containment of multidrugresistant organisms: improved chemical disinfection, environmental monitoring, molecular epidemiology, self-cleaning surfaces, and automated disinfection systems. A review of the existing literature regarding these interventions is provided. Overall, the role of the environment is still underestimated and new techniques may be required to mitigate the role that environmental transmission plays in acquisition of multidrug-resistant organisms.

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.

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Objective Prolonged survival of SARS-CoV-2 on environmental surfaces and personal protective equipment may lead to these surfaces transmitting disease to others. This article reports the effectiveness of a pulsed xenon ultraviolet disinfection system in reducing the load of SARS-CoV-2 on hard surfaces and N95 respirators. Methods Chamber slides and N95 respirator material were directly inoculated with SARS-CoV-2 and exposed to different durations of pulsed xenon ultraviolet disinfection. Results For hard surfaces, disinfection for 1, 2, and 5 minutes resulted in 3·53 Log10, >4·54 Log10, and >4·12 Log10 reductions in viral load, respectively. For N95 respirators, disinfection for 5 minutes resulted in >4·79 Log10 reduction in viral load. We found that pulsed xenon ultraviolet significantly reduces SARS-CoV-2 on hard surfaces and N95 respirators. Conclusion With the potential to rapidly disinfectant environmental surfaces and N95 respirators, pulsed xenon ultraviolet devices are a promising technology for the reduction of environmental and personal protective equipment bioburden and to enhance both healthcare worker and patient safety by reducing the risk of exposure to SARS-CoV-2.