Infection Control & Hospital Epidemiology (2019), 40, 158–163 doi:10.1017/ice.2018.296
Original Article
A comparison of the efficacy of multiple ultraviolet light room decontamination devices in a radiology procedure room
Jennifer L. Cadnum BS1, Annette L. Jencson CIC1, Scott A. Gestrich MD1, Scott H. Livingston BS1, Boris A. Karaman MD2, Kevin J. Benner BS3, Brigid M. Wilson PhD4 and Curtis J. Donskey MD4,5 1Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, 2Radiology Department, Louis Stokes Cleveland VA Medical Center, Cleveland,
Ohio, 3Current, Powered by GE, Cleveland, Ohio, 4Geriatric Research, Education and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio and 5Case Western Reserve University School of Medicine, Cleveland, Ohio
Abstract
Objective: To evaluate the efficacy of multiple ultraviolet (UV) light decontamination devices in a radiology procedure room. Design: Laboratory evaluation. Methods: We compared the efficacy of 8 UV decontamination devices with a 4-minute UV exposure time in reducing recovery of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Clostridium difficile spores on steel disk carriers placed at 5 sites on a computed tomography patient table. Analysis of variance was used to compare reductions for the different devices. A spectrometer was used to obtain irradiance measurements for the devices. Results: Four standard vertical tower low-pressure mercury devices achieved 2 log10CFU or greater reductions in VRE and MRSA and ~1 log10CFU reductions in C. difficile spores, whereas a pulsed-xenon device resulted in less reduction in the pathogens (P<.001). In comparison to the vertical tower low-pressure mercury devices, equal or greater reductions in the pathogens were achieved by 3 nonstandard low-pressure mercury devices that included either adjustable bulbs that could be oriented directly over the exam table, a robotic base allowing movement along the side of the table during operation, or 3 vertical towers operated simultaneously. The low- pressure mercury devices produced primarily UV-C light, whereas the pulsed-xenon device produced primarily UV-A and UV-B light. The time required to move the devices from the corner of the room and set up for operation varied from 18 to 59 seconds. Conclusions: Many currently available UV devices could provide an effective and efficient adjunct to manual cleaning and disinfection in radiology procedure rooms.
(Received 16 August 2018; accepted 11 October 2018)
Ultraviolet (UV)light roomdecontaminationdevices are increasingly used as an adjunct to standard cleaning and disinfection in healthcare facilities. These devices are effective in killing a wide range of pathogens, including Clostridium difficile spores, and they have been shown to reduce the burden of pathogens on surfaces.1–5 Several quasi-experimental studies have reported reductions in healthcare-associated infections with the use of UV devices in patient rooms.6 Moreover, in a recent cluster-randomized trial, enhanced terminal room disinfection with UV in a subset of high- risk rooms reduced acquisition of targeted pathogens and was associated with reductions in hospital-wide incidence of C. difficile infection (CDI) and vancomycin-resistant enterococci (VRE).7–9 There is increasing interest in expanding the use of UV devices
to areas outside of patient rooms. Ultraviolet devices designed specifically to decontaminate items such as keyboards, touchsc- reens, and cell phones have been shown to be effective.10–12 Room decontamination devices have also been used to decrease
Author for correspondence: Curtis J. Donskey, Geriatric Research, Education and
Clinical Center 1110W, Louis Stokes Cleveland VA Medical Center, 10701 East Boulevard, Cleveland, Ohio 44106. E-mail:
Curtis.Donskey@
va.gov
Cite this article: Cadnum JL, et al. (2019). A comparison of the efficacy of multiple
ultraviolet light room decontamination devices in a radiology procedure room. Infection Control & Hospital Epidemiology 2019, 40, 158–163. doi: 10.1017/ice.2018.296
contamination in operating rooms.13,14 Radiology departments are another area where room decontamination devices could potentially be used. Numerous patients, including many of those colonized or infected with multidrug-resistant pathogens, pass through radiology procedure rooms each day.15 In a recent study involving spatial and temporal mapping of patient movement, passing through a computed tomography scanner in the emer- gency department after a patient with CDI was associated with increased risk of developing CDI.16 Given that patients typically contact only a central procedure table, it is plausible that pro- viding a short cycle focusing primarily on contacted areas might be beneficial. Because our radiology department was planning to purchase UV devices as an adjunct to standard cleaning, we evaluated the efficacy of multiple UV room decontamination devices in a radiology procedure room.
Methods
Point-prevalence survey of environmental contamination in a radiology department
We conducted a point-prevalence culture survey of frequently touched surfaces in the radiology department at the Cleveland VA
This work is classified, for copyright purposes, as a work of the U.S. Government and is not subject to copyright protection within the United States.
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