References

Anderson DJ, Knelson LP, Moehring RW Implementation lessons learned from the benefits of enhanced terminal room (BETR) disinfection study: process and perceptions of enhanced disinfection with ultraviolet disinfection devices. Infect Control Hosp Epidemiol. 2018; 39:(2)157-163 https://doi.org/10.1017/ice.2017.268

Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022; 399:(10325)629-655 https://doi.org/10.1016/S0140-6736(21)02724-0

Armellino D, Walsh TJ, Petraitis V, Kowalski W. Assessment of focused multivector ultraviolet disinfection with shadowless delivery using 5-point multisided sampling of patient care equipment without manual-chemical disinfection. Am J Infect Control. 2019; 47:(4)409-414 https://doi.org/10.1016/j.ajic.2018.09.019

Bache SE, Maclean M, MacGregor SJ Clinical studies of the High-Intensity Narrow-Spectrum light Environmental Decontamination System (HINS-light EDS), for continuous disinfection in the burn unit inpatient and outpatient settings. Burns. 2012; 38:(1)69-76 https://doi.org/10.1016/j.burns.2011.03.008

Bache SE, Maclean M, Gettinby G, Anderson JG, MacGregor SJ, Taggart I. Universal decontamination of hospital surfaces in an occupied inpatient room with a continuous 405 nm light source. J Hosp Infect. 2018; 98:(1)67-73 https://doi.org/10.1016/j.jhin.2017.07.010

Beal A, Mahida N, Staniforth K, Vaughan N, Clarke M, Boswell T. First UK trial of Xenex PX-UV, an automated ultraviolet room decontamination device in a clinical haematology and bone marrow transplantation unit. J Hosp Infect. 2016; 93:(2)164-168 https://doi.org/10.1016/j.jhin.2016.03.016

Bhardwaj SK, Singh H, Deep A UVC-based photoinactivation as an efficient tool to control the transmission of coronaviruses. Sci Total Environ. 2021; 792 https://doi.org/10.1016/j.scitotenv.2021.148548

Birru M, Mengistu M, Siraj M Magnitude, diversity, and antibiograms of bacteria isolated from patient-care equipment and inanimate objects of selected wards in Arba Minch General Hospital, Southern Ethiopia. Res Rep Trop Med. 2021; 12:39-49 https://doi.org/10.2147/RRTM.S301215

Blanchard DM, Resendiz M, Lustik MB, West GF. Limited impact of an ultraviolet disinfection intervention on hygienic behaviors of nursing staff in a military hospital. Infect Control Hosp Epidemiol. 2022; 43:(6)797-799 https://doi.org/10.1017/ice.2021.118

Borji S, Rostamian M, Kadivarian S Prevalence of Clostridoides difficile contamination in the healthcare environment and instruments: a systematic review and meta-analysis. Germs. 2022; 12:(3)361-371

Brite J, McMillen T, Robilotti E Effectiveness of ultraviolet disinfection in reducing hospital-acquired Clostridium difficile and vancomycin-resistant Enterococcus on a bone marrow transplant unit. Infect Control Hosp Epidemiol. 2018; 39:(11)1301-1306 https://doi.org/10.1017/ice.2018.215

Cabral J, Ag R. Blue light disinfection in hospital infection control: advantages, drawbacks, and pitfalls. Antibiotics (Basel). 2019; 8:(2) https://doi.org/10.3390/antibiotics8020058

Casini B, Tuvo B, Cristina ML Evaluation of an ultraviolet C (UVC) light-emitting device for disinfection of high touch surfaces in hospital critical areas. Int J Environ Res Public Health. 2019; 16:(19) https://doi.org/10.3390/ijerph16193572

Casini B, Tuvo B, Scarpaci M Implementation of an environmental cleaning protocol in hospital critical areas using a UV-C disinfection robot. Int J Environ Res Public Health. 2023; 20:(5) https://doi.org/10.3390/ijerph20054284

Centers for Disease Control and Prevention. Guidelines for environmental infection control in health-care facilities 2003. 2003. https://tinyurl.com/4ufek3vf (accessed 22 August 2023)

Dippenaar R, Smith J. Impact of pulsed xenon ultraviolet disinfection on surface contamination in a hospital facility's expressed human milk feed preparation area. BMC Infect Dis. 2018; 18:(1) https://doi.org/10.1186/s12879-018-2997-9

Duke University. Medical Center Library & Archives. Evidence-based practice: PICO. 2023. https://guides.mclibrary.duke.edu/ebm/pico (accessed 22 August 2023)

Durango-Giraldo G, Cardona A, Zapata JF, Santa JF, Buitrago-Sierra R. Titanium dioxide modified with silver by two methods for bactericidal applications. Heliyon. 2019; 5:(5) https://doi.org/10.1016/j.heliyon.2019.e01608

European Centre for Disease Prevention and Control. Assessing the health burden of infections with antibiotic-resistant bacteria in the EU/EEA, 2016-2020. 2022. https://tinyurl.com/nu7mmzsf (accessed 22 August 2023)

Gostine A, Gostine D, Donohue C, Carlstrom L. Evaluating the effectiveness of ultraviolet-C lamps for reducing keyboard contamination in the intensive care unit: A longitudinal analysis. Am J Infect Control. 2016; 44:(10)1089-1094 https://doi.org/10.1016/j.ajic.2016.06.012

Green C, Pamplin JC, Chafin KN, Murray CK, Yun HC. Pulsed-xenon ultraviolet light disinfection in a burn unit: impact on environmental bioburden, multidrug-resistant organism acquisition and healthcare associated infections. Burns. 2017; 43:(2)388-396 https://doi.org/10.1016/j.burns.2016.08.027

Hu ZT, Chen Y, Fei YF An overview of nanomaterial-based novel disinfection technologies for harmful microorganisms: mechanism, synthesis, devices and application. Sci Total Environ. 2022; 837 https://doi.org/10.1016/j.scitotenv.2022.155720

Kitagawa H, Mori M, Hara T, Kashiyama S, Shigemoto N, Ohge H. Effectiveness of pulsed xenon ultraviolet disinfection for Clostridioides (Clostridium) difficile surface contamination in a Japanese hospital. Am J Infect Control. 2021; 49:(1)55-58 https://doi.org/10.1016/j.ajic.2020.05.032

Knottnerus A, Tugwell P. STROBE—A checklist to STrengthen the Reporting of OBservational studies in Epidemiology. J Clin Epidemiol. 2008; 61:(4) https://doi.org/10.1016/j.jclinepi.2007.11.006

Linam WM, Trivedi KK, Schaffzin JK. Don't just do it – conducting and publishing improvement science in infection prevention and antibiotic stewardship. Antimicrob Steward Healthc Epidemiol. 2022; 2:(1) https://doi.org/10.1017/ash.2021.259

Lucciola M, Vivian M. West Gordon. Breaking the chain of infection: ultraviolet light to disinfect hospital keyboards. Medsurg Nursing. 2022; 31:(3)145-164

Maclean M, McKenzie K, Anderson JG, Gettinby G, MacGregor SJ. 405 nm light technology for the inactivation of pathogens and its potential role for environmental disinfection and infection control. J Hosp Infect. 2014; 88:(1)1-11 https://doi.org/10.1016/j.jhin.2014.06.004

Medioli F, Bacca E, Faltoni M Is it possible to eradicate carbapenem-resistant Acinetobacter baumannii (CRAB) from endemic hospitals?. Antibiotics (Basel). 2022; 11:(8) https://doi.org/10.3390/antibiotics11081015

Morikane K, Suzuki S, Yoshioka J, Yakuwa J, Nakane M, Nemoto K. Clinical and microbiological effect of pulsed xenon ultraviolet disinfection to reduce multidrug-resistant organisms in the intensive care unit in a Japanese hospital: a before-after study. BMC Infect Dis. 2020; 20:(1) https://doi.org/10.1186/s12879-020-4805-6

Nagaraja A, Visintainer P, Haas JP, Menz J, Wormser GP, Montecalvo MA. Clostridium difficile infections before and during use of ultraviolet disinfection. Am J Infect Control. 2015; 43:(9)940-945 https://doi.org/10.1016/j.ajic.2015.05.003

Pereira AR, Braga DFO, Vassal M, Gomes IB, Simões M. Ultraviolet C irradiation: a promising approach for the disinfection of public spaces?. Sci Total Environ. 2023; 879 https://doi.org/10.1016/j.scitotenv.2023.163007

Quinn MM, Henneberger PK Cleaning and disinfecting environmental surfaces in health care: toward an integrated framework for infection and occupational illness prevention. Am J Infect Control. 2015; 43:(5)424-34 https://doi.org/10.1016/j.ajic.2015.01.029

Rangel K, Cabral FO, Lechuga GC, Villas-Bôas MHS, Midlej V, De-Simone SG. Effectiveness evaluation of a UV-C-Photoinactivator against selected ESKAPE-E pathogens. Int J Environ Res Public Health. 2022; 19:(24) https://doi.org/10.3390/ijerph192416559

Sampathkumar P, Folkert C, Barth JE A trial of pulsed xenon ultraviolet disinfection to reduce Clostridioides difficile infection. Am J Infect Control. 2019; 47:(4)406-408 https://doi.org/10.1016/j.ajic.2018.09.018

Sathitakorn O, Jantarathaneewat K, Weber DJ, Apisarnthanarak P, Rutjanawech S, Apisarnthanarak A. Efficacy of environmental cleaning protocol featuring real-time feedback with and without PX-UV in reducing the contamination of Gram-negative microorganisms on high-touch surfaces in four intensive care units in Thailand. Antibiotics (Basel). 2023; 12:(3) https://doi.org/10.3390/antibiotics12030438

Schaffzin JK, Wilhite AW, Li Z, Finney D, Ankrum AL, Moore R. Maximizing efficiency in a high occupancy setting to utilize ultraviolet disinfection for isolation rooms. Am J Infect Control. 2020; 48:(8)903-909 https://doi.org/10.1016/j.ajic.2020.05.004

Shahida S, Islam A, Dey B, Islam F, Venkatesh K, Goodman A. Hospital acquired infections in low and middle income countries: root cause analysis and the development of infection control practices in Bangladesh. Open Journal of Obstetrics and Gynecology. 2016; 6:(1)28-39 https://doi.org/10.4236/ojog.2016.61004

Shea BJ, Reeves BC, Wells G AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017; 358 https://doi.org/10.1136/bmj.j4008

Suetens C, Latour K, Kärki T Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. Euro Surveill. 2018; 23:(46) https://doi.org/10.2807/1560-7917.ES.2018.23.46.1800516

Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals, 2016-2017. 2023. https://tinyurl.com/2kmyuj5w (accessed 22 August 2023)

Torraco RJ. Writing integrative reviews of the literature: methods and purpose. International Journal of Adult Vocational Education and Technology. 2016; 7:(3)62-70 https://doi.org/10.4018/IJAVET.2016070106

Van den Brink R. The end of an antibiotic era. Bacteria's triumph over a universal remedy.New York (NY): Springer; 2021

van der Starre CM, Cremers-Pijpers SAJ, van Rossum C, Bowles EC, Tostmann A. The in situ efficacy of whole room disinfection devices: a literature review with practical recommendations for implementation. Antimicrob Resist Infect Control. 2022; 11:(1) https://doi.org/10.1186/s13756-022-01183-y

Vianna PG, Dale CR, Simmons S, Stibich M, Licitra CM. Impact of pulsed xenon ultraviolet light on hospital-acquired infection rates in a community hospital. Am J Infect Control. 2016; 44:(3)299-303 https://doi.org/10.1016/j.ajic.2015.10.009

Villacis JE, Lopez M, Passey D Efficacy of pulsed-xenon ultraviolet light for disinfection of high-touch surfaces in an Ecuadorian hospital. BMC Infect Dis. 2019; 19:(1) https://doi.org/10.1186/s12879-019-4200-3

Whittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs. 2005; 52:(5)546-553 https://doi.org/10.1111/j.1365-2648.2005.03621.x

Wang N, Shi C, Kang X. Design of a disinfection and epidemic prevention robot based on fuzzy QFD and the ARIZ algorithm. Sustainability. 2022; 14:(24) https://doi.org/10.3390/su142416341

Wong T, Woznow T, Petrie M Postdischarge decontamination of MRSA, VRE, and Clostridium difficile isolation rooms using 2 commercially available automated ultraviolet-C–emitting devices. Am J Infect Control. 2016; 44:(4)416-420 https://doi.org/10.1016/j.ajic.2015.10.016

Zeber JE, Pfeiffer C, Baddley JW Effect of pulsed xenon ultraviolet room disinfection devices on microbial counts for methicillin-resistant Staphylococcus aureus and aerobic bacterial colonies. Am J Infect Control. 2018; 46:(6)668-673 https://doi.org/10.1016/j.ajic.2018.02.001

Infection Prevention

Using photon disinfection technologies for reducing bioburden in hospitals

21 September 2023
Focus
02 September 2023
Volume 32 · Issue 17

Abstract

Background:

Environmental cleaning and disinfection is the basis of the prevention of healthcare-acquired infections (HAIs).

Aim:

This study aimed to describe photon disinfection technologies (PDTs), report their impact on inactivating micro-organisms and preventing HAIs and to create recommendations for their implementation in hospital settings.

Methods:

An integrated literature review was completed to evaluate and report the impact of PDTs in hospital settings. The quality of 23 articles were assessed, their contents analysed and results reported according to the PICOT model.

Findings:

The microbiological impact of the PDT varied by micro-organism, settings and according to the used devices. It was crucial that environmental cleaning was completed before the disinfection.

Conclusion:

The implementation of PDT in the hospital setting requires inquiry from the viewpoints of microbiological, environmental, occupational, technical and human safety. To enhance the safe implementation of PDTs, the construction and use of evidence-based global standards for PDT are crucial.

Environmental cleaning and disinfection measures are the basis for clinical improvements in infection prevention and control (IPC), preventing harm to patients and others from healthcare-acquired infections (HAIs) and infections with multidrug-resistant organisms (MDROs) (Linam et al, 2022).

According to Suetens et al (2018) and the European Centre for Disease Prevention and Control (ECDC) (Suetens, 2023), in Europe the adjusted prevalence of patients with at least one HAI was estimated at 6.5%, that is 3.8 million patients with at least one HAI, and 4.5 million infection episodes in 2016–2017. In England, the HAI prevalence was 6.4%, in Northern Ireland 6.1%, in Scotland 4.3% and in Wales 5.7%. Of all the 19 624 HAIs reported by the ECDC, the most frequent were respiratory tract infections (pneumonia) at 21.4%, urinary tract infections (18.9%), surgical site infections (18.4%), bloodstream infections (10.8%) and gastrointestinal infections (8.9%). Clostridioides difficile infections accounted for 54.6% of the latter and 4.9% of all HAIs. The IPC measures that prevent microbial spreading during outbreaks will vary, dependent on the setting and structural characteristics of the particular clinical area (Medioli et al, 2022). The selection of effective environmental and other IPC measures against the spreading of microbial agents in hospital settings is difficult due to low quality or lack of controlled and microbial agent-specific intervention studies (Medioli et al, 2022). The implementation of environmental IPC measures involves balanced ecological, economic and non-harmful choices (Pereira et al, 2023). This study aimed to analyse photon disinfection technologies (PDTs) for IPC in healthcare settings. The study objectives were to:

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Infection prevention and control
Photon disinfection technology
Ultraviolet light
Blue light
Hospital-acquired infection