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

Green, Caroline; Pamplin, Jeremy; Chafin, Kristine N.; Murray, Clinton K.; Yun, Heather C.

doi:10.1016/j.burns.2016.08.027

Cited by 33 publications

(72 citation statements)

References 35 publications

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“…But the incidence of HAI with the MDRO were not change. The reason was possibly because of under-powering due to the low incidence of HAI overall, or the intervention that focus on terminal cleaning and disinfection may be insufficient to reduce the incidence of HAI with the MDRO [20,21]. We showed that there was a significant (27.8%) reduction of VRE carriage rate, that was similar to other studies [22][23][24].…”

Section: Discussionsupporting

confidence: 86%

Implementation of human factors engineering approach to improve environmental cleaning and disinfection in a medical center

Hung

Chang

Cheng

et al. 2020

Antimicrob Resist Infect Control

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Background: Inadequate hospital cleaning may contribute to cross-transmission of pathogens. It is important to implement effective cleaning for the safe hospital environment. We conducted a three-phase study using human factors engineering (HFE) approach to enhance environmental cleanliness.Methods: This study was conducted using a prospective interventional trial, and 28 (33.3%) of 84 wards in a medical center were sampled. The three-phases included pre-intervention analysis (Phase 1), implementing interventions by HFE principles (Phase 2), and programmatic analysis (Phase 3). The evaluations of terminal cleaning and disinfection were performed using the fluorescent marker, the adenosine triphosphate bioluminescence assay, and the aerobic colony count method simultaneously in all phases. Effective terminal cleaning and disinfection was qualified with the aggregate outcome of the same 10 high-touch surfaces per room. A score for each high-touch surface was recorded, with 0 denoting a fail and 10 denoting a pass by the benchmark of the evaluation method, and the total terminal cleaning and disinfection score (TCD score) was a score out of 100.Results: In each phase, 840 high-touch surfaces were collected from 84 rooms after terminal cleaning and disinfection. After the interventions, the TCD score by the three evaluation methods all showed significant improved. The carriage incidence of multidrug-resistant organism (MDRO) decreased significantly from 4.1 per 1000 patient-days to 3.6 per 1000 patient-days (P = .03). Conclusion:The HFE approach can improve the thoroughness and the effectiveness of terminal cleaning and disinfection, and resulted in a reduction of patient carriage of MDRO at hospitals. Larger studies are necessary to establish whether such efforts of cleanliness can reduce the incidence of healthcare-associated infection.

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Section: Discussionsupporting

confidence: 86%

Implementation of human factors engineering approach to improve environmental cleaning and disinfection in a medical center

Hung

Chang

Cheng

et al. 2020

Antimicrob Resist Infect Control

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“…The 2017 SHEA/IDSA guidelines also highlight the role of terminal room cleaning with a sporicidal agent, with consideration of daily sporicidal room cleaning in hyperendemic settings . So‐called no‐touch disinfection technologies showed promise in several studies to reduce C. difficile spores and CDI incidence, and, recently, the use of ultraviolet light disinfection of rooms induced a prolonged CDI‐free interval in a burn ICU . Unfortunately, the available analyses for these automated methodologies had significant limitations when the SHEA/IDSA guideline was released, leading the expert panel to conclude that no recommendation could be made regarding their incorporation into a CDI prevention program …”

Section: Prevention Of Transmissionmentioning

confidence: 99%

“…11 So-called no-touch disinfection technologies showed promise in several studies to reduce C. difficile spores and CDI incidence, and, recently, the use of ultraviolet light disinfection of rooms induced a prolonged CDI-free interval in a burn ICU. 17,18 Unfortunately, the available analyses for these automated methodologies had significant limitations when the SHEA/IDSA guideline was released, leading the expert panel to conclude that no recommendation could be made regarding their incorporation into a CDI prevention program. 11 Robust hand hygiene programs should be foundational in every ICU and include objective components such as so-called secret shopper audits (anonymous trained observers who monitor hand hygiene practices), volumebased utilization of hand disinfectants, and routine feedback for ICU staff.…”

Section: Prevention Of Transmissionmentioning

confidence: 99%

Prevention of Clostridium difficile Infection in Critically Ill Adults

et al. 2019

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The incidence and severity of Clostridium difficile infection (CDI) remain high across intensive care units in the United States despite national efforts to decrease this escalating health care burden. Most published literature and guidelines address treatment rather than prevention, yet this approach may be too downstream to limit morbidity and mortality from the disease and its complications. Mechanisms to prevent CDI successfully include reducing modifiable risk factors and minimizing horizontal transmission of C. difficile spores between patients and the health care environment. Because CDI prevention is characterized by a bundled approach, it is difficult to quantify the individual impact of any one element; however, a number of patient‐ and facility‐level strategies can be considered for CDI prevention. Robust hygiene strategies, diagnostic and antimicrobial stewardship, and particular prophylaxis maneuvers such as continuation of oral vancomycin or fidaxomicin in the setting of systemic antibiotics have all demonstrated benefit. The preventive roles of deprescribing acid suppressants, routine use of probiotics, or early fecal microbiota transplantation remain unclear. The focus of this review is to summarize the evidence related to primary and secondary CDI prevention in critically ill adults and provide a concise implementation pathway for clinicians and policymakers.

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“…Pulsed xenon ultraviolet (PX-UV) is proven as an effective tool for disinfection of pathogens in various hospital settings, including wards [2][3][4][5][6], operating rooms [7], surgical sites [8,9], nursing rooms [10], human milk feeding rooms [11], and burns units [12]; and this disinfectant effect also applies to clinical laboratories and blood sampling rooms in China [13,14]. However, the effectiveness of PX-UV in disinfection of a hospital animal laboratory is unstudied.…”

Section: Introductionsmentioning

confidence: 99%

Portable pulsed xenon ultraviolet light disinfection in a teaching hospital animal laboratory in China

Wang

Qiao

et al. 2020

Journal of Photochemistry and Photobiology B: Biology

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

Cited by 33 publications

References 35 publications

Implementation of human factors engineering approach to improve environmental cleaning and disinfection in a medical center

Implementation of human factors engineering approach to improve environmental cleaning and disinfection in a medical center

Prevention of Clostridium difficile Infection in Critically Ill Adults

Portable pulsed xenon ultraviolet light disinfection in a teaching hospital animal laboratory in China

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