Abstract
Background
Contact precautions do not necessarily control transmission of MDROs as other route of transmission such as patient environment may be significant. No-touch environmental disinfection has been highlighted in the past several years to control transmission of MDROs. The effectiveness of portable Pulsed Xenon Ultraviolet (PX-UV) device has been examined and demonstrated in US healthcare settings. However, its effectiveness outside the US healthcare setting is seldom reported.
Methods
This study was conducted in the intensive care unit (ICU) of Yamagata University Hospital, a 637-bed tertiary referral hospital. The ICU has six rooms and beds. In the baseline period (August 2016 to January 2018), all rooms were manually cleaned after every patient transfer/discharge. In the intervention period (February 2018 to February 2019), PX-UV disinfection was added after the manual cleaning. In both periods, all patients were screened for MRSA and two drug-resistant Acinetobacter baumannii (2DRA) to detect acquisition of those pathogens in the ICU. For microbiological evaluation, surfaces were selected for sampling by contact plates before/after manual cleaning and after PX-UV. After overnight incubation, colonies on the plates were counted.
Results
The incidence of newly acquired MRSA declined over time (1.40 per 1,000 patient-days in the baseline period to 0.95 in the intervention period, relative risk (RR): 0.68, 95% confidence interval (CI): 0.12–3.70). The incidence of newly acquired 2DRA further declined (4.91 to 1.90, RR: 0.39, 95% CI: 0.13–1.18). Notably, no new acquisition of 2DRA was observed since August 2018 for more than 7 months, not only in the ICU but also throughout the hospital. The total count of colonies in the sampling of 140 sites after 17 patient discharges were 3,540 (before manual cleaning), 669 (after manual cleaning, before PX-UV) and 261 (after PX-UV). The percent reduction of microbiological burden by manual cleaning was 81%, but a further 61% reduction was achieved by PX-UV.
Conclusion
PX-UV is effective in further reducing the microbial burden even after through manual cleaning, which presumably led to termination of transmission of 2DRA in our hospital. The effectiveness of PX-UV in controlling MDROs in the non-US healthcare settings is suggested.
Disclosures
All authors: No reported disclosures.
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