Postdischarge decontamination of MRSA, VRE, and Clostridium difficile isolation rooms using 2 commercially available automated ultraviolet-C-emitting devices

Am J Infect Control. 2016 Apr 1;44(4):416-20. doi: 10.1016/j.ajic.2015.10.016. Epub 2015 Dec 9.

Abstract

Background: Two ultraviolet-C (UVC)-emitting devices were evaluated for effectiveness in reducing methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile (CD).

Methods: Six surfaces in rooms previously occupied by patients with MRSA, VRE, or CD were cultured before and after cleaning and after UVC disinfection. In a parallel laboratory study, MRSA and VRE suspended in trypticase soy broth were inoculated onto stainless steel carriers in triplicate, placed in challenging room areas, subjected to UVC, and subcultured to detect growth.

Results: Sixty-one rooms and 360 surfaces were assessed. Before cleaning, MRSA was found in 34.4%, VRE was found in 29.5%, and CD was found in 31.8% of rooms. Cleaning reduced MRSA-, VRE-, and CD-contaminated rooms to 27.9%, 29.5%, and 22.7%, respectively (not statistically significant). UVC disinfection further reduced MRSA-, VRE-, and CD-contaminated rooms to 3.3% (P = .0003), 4.9% (P = .0003), and 0% (P = .0736), respectively. Surface colony counts (excluding floors) decreased from 88.0 to 19.6 colony forming units (CFU) (P < .0001) after manual cleaning; UVC disinfection further reduced it to 1.3 CFU (P = .0013). In a multivariable model of the carrier study, the odds of detecting growth in broth suspensions after UVC disinfection were 7 times higher with 1 machine (odds ratio, 6.96; 95% confidence interval, 3.79-13.4) for a given organism, surface, and concentration.

Conclusions: UVC devices are effective adjuncts to manual cleaning but vary in their ability to disinfect high concentrations of organisms in the presence of protein.

Keywords: Clostridium difficile; Environmental cleaning; Methicillin-resistant Staphylococcus aureus; Ultraviolet; Ultraviolet-C; Vancomycin-resistant enterococci.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clostridioides difficile / isolation & purification
  • Clostridioides difficile / radiation effects*
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Disinfection / methods*
  • Environmental Microbiology*
  • Gram-Positive Bacterial Infections / microbiology
  • Gram-Positive Bacterial Infections / prevention & control
  • Humans
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Methicillin-Resistant Staphylococcus aureus / radiation effects*
  • Patient Isolation
  • Prospective Studies
  • Ultraviolet Rays*
  • Vancomycin-Resistant Enterococci / isolation & purification
  • Vancomycin-Resistant Enterococci / radiation effects*