Use of Ultraviolet Irradiation in Addition to Commonly Used Hospital Disinfectants or Cleaners Further Reduces the Bioburden on High-Touch Surfaces

Abstract

Background The reduction in microbial bioburden achieved by terminal disinfection in a hospital may vary considerably by type of disinfectant or cleaner and by environmental service (EVS) personnel. This study estimated whether supplemental ultraviolet (UV) irradiation after disinfection or cleaning reduced bioburden and whether the supplemental effect persisted after adjusting for disinfectant or cleaner type and EVS personnel. Methods Environmental samples for aerobic bacterial colonies (ABC) and methicillin-resistant Staphylococcus aureus (MRSA) were obtained from 5 high-touch surfaces in patient rooms at 3 time points: before manual cleaning, after manual cleaning using 1 of 3 disinfectants or 1 cleaner, and after UV irradiation. Results For ABC, the model-estimated mean (95% uncertainty interval) counts were 56% (48%–63%) lower for postmanual + UV compared with manual clean alone, and for MRSA they were 93% (62%–99%) lower for postmanual + UV vs manual clean alone. Conclusions Although UV supplementation provides incremental benefit in bioburden reduction across all cleaners or disinfectants tested, it provides the greatest benefit when supplementing cleaners or disinfectants with the lowest disinfection properties. UV irradiation provides additional bioburden reduction to manual cleaning or disinfection, even when accounting for variability introduced by different disinfectants and EVS personnel.

COVID-19 outbreak: Should dental and medical practices consider uv-c technology to enhance disinfection on surfaces? – A systematic review

“…Finally, 12 studies fulfilled the eligibility and we included them for qualitative analyses [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , no extra articles were found in references or other sources. Each phase of the selection study is summarized in Figure 1 .…”

“…Five of these studies were controlled before-after trials [24] , [25] , [26] , [27] , [28] , assessing CFU counts and log reduction provided by the addition of UV-C disinfection (308 samples) compared to manual cleaning alone or another no-touch method (299 samples). Seven studies were uncontrolled before-after [29] , [30] , [31] , [32] , [33] , [34] , [35] , assessing the additional CFU count reduction provided by UV-C intervention (5,112 samples) versus manual cleaning alone (5,152 samples). Data extracted from each study are detailed in Table 1 .…”

“…The UV-C interventions were performed with different devices; 9 studies used the Pulsed Xenon Ultraviolet Light (PX-UV) (Xenex Disinfection Systems, San Antonio, TX, USA) varying from two to five 5-min cycles (depending on if the room had a bathroom) [ [24] , [25] , [26] , [27] , [29] , [30] , [31] , 33 , 34 ]. The PX-UV device emits both UV-B (315-280 nm) and the full UV-C spectrum (280-100 nm) at a pulsed frequency of >60 Hz.…”

“…Both touch and non-touch disinfecting methods demonstrated a significant reduction in CFU counts of overall pathogens. When MRDOs were positive in samples, 3 studies reported a ≥ 2-log reduction: 5-log (99.999%) [34] and 6-log (99.9999%) [ 30 , 31 ] reduction after UV-C intervention in addition to manual cleaning with chlorine-based disinfectants and QAC. Only in 2 studies, manual cleaning without non-touch intervention reported a 1-log (90%) reduction using SH 10% and HP with peracetic acid [ 27 , 30 ].…”

“…When MRDOs were positive in samples, 3 studies reported a ≥ 2-log reduction: 5-log (99.999%) [34] and 6-log (99.9999%) [ 30 , 31 ] reduction after UV-C intervention in addition to manual cleaning with chlorine-based disinfectants and QAC. Only in 2 studies, manual cleaning without non-touch intervention reported a 1-log (90%) reduction using SH 10% and HP with peracetic acid [ 27 , 30 ]. In studies in which C. Difficile was found positive in samples, no methods reported more than 0-log (< 90%) reduction.…”