Healthcare Hygiene magazine January 2020 | Page 33
if three UV-C units were purchased
and three environmental services
staff were hired to transport and
The rationale for
operate the unit, the first year’s cost
would be approximately $405,000
rigorous manual
(covering equipment and personnel)
cleaning/disinfection and the second year’s cost would
be approximately $150,000 (staff
before the use
only). If the UV-C reduced HAIs for
of ultraviolet-C
patients on Contact Precautions
(approximately 20 percent of
(UV-C) technology
patients) by 10 percent to 30 percent
is that organic
as demonstrated in a randomized
material can interfere trial, 8 the number of infections
prevented in a 900-bed hospital
with disinfection
with an infection rate of about
technologies,
4 per 1,000 patient days would be
approximately 18-55 per year. If
including UV-C.
each HAI cost $24,000 on average, 14
the hospital would need to prevent
only 23 HAIs in the first two years
to cover the acquisition and operational costs of the UV-C
program for two years. If the hospital prevented 10 percent
of infections per year (18 per year) for two years, the cost
savings would be $309,000. If 30 percent of infections were
prevented per year (55 per year) for two years, the cost
savings would be $2,085,000. In an independent analysis,
Pegues, et al. calculated a cost savings for C. difficile of
$348,528 to $1,537,000 per fiscal year. 15
HHM What is the next frontier for this technology
in terms of the clinical/cleaning challenges that can
be addressed?
WR: While “no- touch” technologies are effective, they
have limits as they require rooms without people. Also,
surfaces in patients’ rooms can rapidly become re-contam-
inated and may be persistently contaminated despite room
cleaning/disinfection. 16 The hands of healthcare providers can
become colonized by touching contaminated environmental
surfaces and patient-care equipment and can transfer
pathogens by inadequate hand hygiene or inappropriate
glove use. Since routine disinfection of room surfaces is
frequently inadequate, continuous room decontamination
methods are being evaluated. This technology is intended
is to make surfaces hygienically clean (not sterile), and
free of pathogens in sufficient numbers to prevent human
disease. The technologies include: visible light disinfection
(high-intensity narrow-spectrum light); 17 low-concentration
hydrogen peroxide; 18 continuously active disinfectant; 16 and
self-disinfection surfaces (e.g., copper). 19 These methods are
under active investigation and need to be assessed for their
ability to reduce HAIs. 16-20
References:
1. Rutala WA, Gergen MF, Weber DJ. Room decontamination with UV
radiation. Infect Control Hosp Epidemiol 2010;31:1025-9.
www.healthcarehygienemagazine.com • january 2020
Q
& A
2. Cadnum JL, Tomas ME, Sankar T, Jencson A, Mathew I, Kundrapu
S, Donskey CJ. Effect of variation in test methods on performance of
ultraviolet-C radiation room decontamination. Infect Control Hosp Epidemiol.
2016;37:555-560.
3. Jinadatha C, Villamaria FC, Ganachari-Mallappa N, et al. Can pulsed
xenon ultraviolet light systems disinfect aerobic bacteria in the absence of
manual disinfection? Am J Infect Control 2015;43:415-7.
4. Rutala WA, Weber DJ. Best practices for disinfection of noncritical
environmental surfaces and equipment in health care facilities: A bundle
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5. Rutala WA, Weber DJ. Disinfectants used for environmental disinfection
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systems. Current Opinions Infect Dis. 2016;29:424-431.
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Boyce JM. Effectiveness of UV devices and hydrogen peroxide systems for
terminal room decontamination: Focus on clinical trials. Am J Infect Control
2016;44:e77-e84.
8. Anderson D, Chen LF, Weber DJ, Moehring RW, Lewis SS, Triplett
P, Blocker M, Becherer P, Schwab JC, Knelson LP, Lokhnygina Y, Rutala
WA, Sexton DJ, and CDC Prevention Epicenter Program. The benefits of
enhanced terminal room (BETR) disinfection study: A cluster randomized,
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Program. Enhanced disinfection leads to a reduction in microbial contamination
and a reduction in patient infection and colonization. Infect Control Hosp
Epidemiol. 2018;39:1118-1121.
10. Donskey CJ. Does improving surface cleaning and disinfection reduce
healthcare-associated infections? Am J Infect Control. 2016;41:S12-S19.
11. Rutala WA, Weber DJ, Gergen MF, Tande BM, Sickbert-Bennett EE.
Does coating all room surfaces with an ultraviolet-light C nanoreflective
coating improve decontamination compared to coating only the walls? Infect
Control Hosp Epidemiol. 2014;35:323-325.
12. Cadnum JL, Jencson AL, Gestrich SA, Livingston SH, Karaman BA,
Benner KJ, Wilson BM, Donskey CJ. A comparison of the efficacy of multiple
ultraviolet light room decontamination devices in a radiology procedure room.
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13. Institute for Healthcare Improvement (IHI). What zero looks like: Eliminat-
ing Hospital-acquired infections. http://www.ihi.org/resources/Pages/Improve-
mentStories/WhatZeroLooksLikeEliminatingHospitalAcquiredInfections.aspx
14. Zimlichman E, Henderson D, Tamir, Franz C, Song P, Yamin CK,
Keohan C, Denham CR, Bates DW. Health care-associated Infections” A
meta-analysis of costs and financial impact on the US health care system.
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ultraviolet germicidal irradiation for no-touch terminal room disinfection
on Clostridium difficile infection incidence among heamatology-oncology
patients. Infect Control Hosp Epidemiol 2017;38:39-44
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disinfectant against healthcare pathogens. Infect Control Hosp Epidemiol.
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17. Rutala WA, Kanamori H, Gergen MF, Sickbert-Bennett EE, Sexton DJ,
Anderson DJ, Laux J, Weber DJ, CDC Prevention Epicenters Program. 2018.
Antimicrobial activity of a continuous visible light disinfection system. Infect
Control Hospi Epidemiol 39:1250-1253
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DJ, Sexton DJ, Weber DJ, CDC Prevention Epicenters Program. Evaluation
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19. Salgado CD1, Sepkowitz KA, John JF, Cantey JR, Attaway HH, Freeman
KD, Sharpe PA, Michels HT, Schmidt MG. Copper surfaces reduce the rate of
healthcare-acquired infections in the intensive care unit Infect Control Hosp
Epidemiol. 2013;34:479-86
20. Weber DJ, Rutala WA, Sickbert-Bennett EE, Kanamori H, Anderson
D, CDC Prevention Epicenters Program. Continuous Room Decontamination
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