Ultraviolet-C Light Evaluation as Adjunct Disinfection to Remove Multidrug-Resistant Organisms

Area of Science:

• Infection Control and Hospital Epidemiology
• Environmental Services in Healthcare
• Antimicrobial Resistance

Background:

• Healthcare-associated infections (HAIs) pose a significant threat, particularly to immunocompromised patients.
• Vancomycin-resistant enterococci (VRE) and Clostridioides difficile are common and challenging HAIs.
• Standard environmental cleaning protocols may not be sufficient to eliminate all pathogens.

Purpose of the Study:

• To evaluate the efficacy of adding ultraviolet-C (UV-C) light disinfection to daily and discharge patient room cleaning.
• To determine if this combined approach reduces HAI rates of VRE and C. difficile.
• To assess the impact on immunocompromised adults in cancer and solid organ transplant units.

Main Methods:

• A cluster randomized crossover control trial was conducted in four cancer and one solid organ transplant inpatient units.
• Units were randomized to either standard environmental cleaning or standard cleaning plus UV-C light intervention.
• The study involved a 5-week washout period, with units switching assignments in the second year. Outcomes measured were HAI rates of VRE or C. difficile.

Main Results:

• A total of 302 new VRE infections were observed. The incidence rate ratio (IRR) between control and intervention groups was 0.98 (P=.54).
• There were 84 new C. difficile infections. The IRR between control and intervention periods was 1.43 (P=.98).
• UV-C disinfection, when added to standard cleaning, did not significantly reduce VRE or C. difficile infection rates.

Conclusions:

• The addition of UV-C light disinfection to daily and post-discharge cleaning did not decrease VRE or C. difficile infection rates.
• Current environmental cleaning practices combined with UV-C light were not effective in reducing these specific HAIs in the studied patient populations.
• Further research may be needed to explore alternative or enhanced disinfection strategies for high-risk units.