Understanding ultraviolet light surface decontamination in hospital rooms: A primer

Boyce, John M.; Donskey, Curtis J.

doi:10.1017/ice.2019.161

Cited by 59 publications

(67 citation statements)

References 45 publications

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“…Second, we applied the test organisms in a liquid suspension directly onto the surface of the N95 respirators and spread them over a relatively small surface area with a loop. We cannot exclude the possibility that the technologies would have been more effective if the inoculum was spread out over a larger surface area; spreading of an organism inoculum over a larger surface area has been shown to increase the efficacy of UV-C light [14][15]. It has also been suggested that the method of deposition may influence results, and that methods that more closely mimic droplet and aerosol deposition on respirators should be used [6].…”

Section: Discussionmentioning

confidence: 99%

“…The high-level disinfection cabinet generates submicron droplets of aerosolized peracetic acid and hydrogen peroxide and has been shown to be very effective in eliminating microorganisms from hard surfaces in patient rooms and on portable equipment [12][13]. We hypothesized that the disinfection cabinet would be very effective while UV-C light might have reduced efficacy in contrast to previous reports that evaluated microorganism reductions on steel disk carriers or hard surfaces in healthcare settings [14][15]. Soft, irregular surfaces may present a challenge for UV-C decontamination due to the potential for areas of shadowing and absorption of organisms into sites with reduced delivery of UV-C [16].…”

Section: Introductionmentioning

confidence: 95%

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Effectiveness of Ultraviolet-C Light and a High-Level Disinfection Cabinet for Decontamination of N95 Respirators

Cadnum

Redmond

et al. 2020

PAI

104

150

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Background: Shortages of personal protective equipment (PPE) including N95 respirators are an urgent concern in the setting of the global COVID-19 pandemic. Decontamination of PPE could be useful to maintain adequate supplies, but there is uncertainty regarding the efficacy of decontamination technologies.Correction: This is a corrected version of this article. The original version of this article contained data for an additional ultraviolet light device that has been removed from the corrected version as the device tested is no longer manufactured or supported by the manufacturer. The authors have offered to collaborate with the manufacturer to complete additional testing with a current version of the technology. Methods:A modification of the American Society for Testing and Materials standard quantitative carrier disk test method (ASTM E-2197-11) was used to examine the effectiveness of 3 methods, including ultraviolet-C (UV-C) light, a high-level disinfection cabinet that generates aerosolized peracetic acid and hydrogen peroxide, and dry heat at 70°C for 30 minutes. We assessed the decontamination of 3 commercial N95 respirators inoculated with methicillin-resistant Staphylococcus aureus (MRSA) and bacteriophages MS2 and Phi6; the latter is an enveloped RNA virus used as a surrogate for coronaviruses. Three and 6 log 10 reductions on respirators were considered effective for decontamination and disinfection, respectively. Results: UV-C administered as a 1-minute cycle in a UV-C box or a 30-minute cycle by a room decontamination device reduced contamination but did not meet criteria for decontamination of the viruses from all sites on the N95s. The high-level disinfection cabinet was effective for decontamination of the N95s and achieved disinfection with an extended 31-minute cycle. Dry heat at 70°C for 30 minutes was not effective for decontamination of the bacteriophages. Conclusions:UV-C could be useful to reduce contamination on N95 respirators. However, the UV-C technologies studied did not meet pre-established criteria for decontamination under the test conditions used. The high-level disinfection cabinet was more effective and met criteria for disinfection with an extended cycle.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Effectiveness of Ultraviolet-C Light and a High-Level Disinfection Cabinet for Decontamination of N95 Respirators

Cadnum

Redmond

et al. 2020

PAI

104

150

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“…In conclusion, UV-C disinfection can be efficacious in hyperbaric chambers by reducing the levels of clinically relevant bacteria by at least 3 log 10 , but individual UV-C devices should be tested and optimized internally while also recognizing that similar efficacy may not be achieved with certain pathogens such as C. difficile. 2…”

Section: Discussionmentioning

confidence: 99%

Efficacy of UV-C disinfection in hyperbaric chambers

Warren

Masker

Brown

et al. 2020

Infect. Control Hosp. Epidemiol.

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“…Although some studies have reported doses of UVC that yield 3 log 10 reductions of specific pathogens using low-pressure mercury lamps UVC devices, data regarding spectrophotometrically determined doses of 200–320 nm light emitted by pulsed xenon lamps are lacking [21].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an Ultraviolet C (UVC) Light-Emitting Device for Disinfection of High Touch Surfaces in Hospital Critical Areas

Casini

Tuvo

Cristina

et al. 2019

IJERPH

163

134

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Implementation of environmental cleaning and disinfection has been shown to reduce the incidences of healthcare-associated infections. The effect of an enhanced strategy for terminal room disinfection, applying the pulsed xenon-based ultraviolet light no-touch disinfection systems (PX-UVC) after the current standard operating protocol (SOP) was evaluated. In a teaching hospital, the effectiveness in reducing the total bacterial count (TBC) and in eliminating high-concern microorganisms was assessed on five high-touch surfaces in different critical areas, immediately pre- and post-cleaning and disinfection procedures (345 sampling sites). PX-UVC showed only 18% (15/85) of positive samples after treatment compared to 63% (72/115) after SOP. The effectiveness of PX-UVC was also observed in the absence of manual cleaning and application of a chemical disinfectant. According to the hygienic standards proposed by the Italian Workers Compensation Authority, 9 of 80 (11%) surfaces in operating rooms showed TBC ≥15 CFU/24 cm2 after the SOP, while all samples were compliant applying the SOP plus PX-UVC disinfection. Clostridium difficile (CD) spores and Klebsiella pneumoniae (KPC) were isolated only after the SOP. The implementation of the standard cleaning and disinfection procedure with the integration of the PX-UVC treatment had effective results in both the reduction of hygiene failures and in control environmental contamination by high-concern microorganisms.

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Understanding ultraviolet light surface decontamination in hospital rooms: A primer

Cited by 59 publications

References 45 publications

Effectiveness of Ultraviolet-C Light and a High-Level Disinfection Cabinet for Decontamination of N95 Respirators

Effectiveness of Ultraviolet-C Light and a High-Level Disinfection Cabinet for Decontamination of N95 Respirators

Efficacy of UV-C disinfection in hyperbaric chambers

Evaluation of an Ultraviolet C (UVC) Light-Emitting Device for Disinfection of High Touch Surfaces in Hospital Critical Areas

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