UV light can aid hospitals’ fight of superbugs A new tool -- a type of ultraviolet light called UVC -- could aid hospitals in the ongoing battle to keep drug-resistant bacteria from lingering in patient rooms and causing new infections. Some hospitals have already begun using UVC machines in addition to standard chemical disin- fection to kill potentially dangerous bacteria such as methicillin-resistant Staphylococcus aureus (MRSA), but research on their effectiveness has been preliminary. A large randomized trial led by Duke Health

and published in The Lancet finds use of UVC machines can cut transmission of four major superbugs by a cumulative 30 percent. The find- ing is specific to patients who stay overnight in a room where someone with a known positive culture or infection of a drug-resistant organism had previously been treated. “Some of these germs can live on the envi-

ronment so long that even after a patient with the organism has left the room and it has been cleaned, the next patient in the room could po- tentially be exposed,” said Deverick J. Anderson, M.D., an infectious disease specialist at Duke Health and lead investigator of the trial, which included more than 21,000 patients. The researchers focused on four drug-resistant

organisms: MRSA, vancomycin-resistant entero- cocci (VRE), C. difficile and Acinetobacter. The facilities used a portable UVC machine to

disinfect rooms where patients with the target bacteria had been staying. For about 30 minutes, the machine emits UVC light into an empty room, the light bouncing and reflecting into hard-to- reach areas such as open drawers or between cabinets and fixtures. The light waves kill bacteria by disrupting their DNA. The trial compared standard disinfection with

quaternary ammonium to three other cleaning methods: using quaternary ammonium followed by UV light; using chlorine bleach instead of qua- ternary ammonium and no UV light; and cleaning with bleach and UV light. Overall, the most effective strategy was using

quaternary ammonium followed by UV light. This combination led to the 30 percent decrease in overall transmission and was particularly effective against transmission of MRSA, resulting in a 22 percent reduction in transmission. The researchers found that using chlorine bleach

instead of quaternary ammonium cut transmis- sions of VRE by more than half (57 percent). Adding UV light to the bleach regimen was even more successful, cutting VRE transmission by 64 percent. UVC machines are now being manufactured

by several companies and are priced upwards of $90,000. Results of this study suggest that use of this technology would allow hospitals to better care for their patients by reducing their risks of acquiring these infections, while at the same time reducing their overall costs.

INFECTION PREVENTION Prevention intention

Teamwork, research, and training: Keys to reducing hospital-acquired infections by Susan Cantrell, ELS

Progress,” indicates that rates of hospital- onset Clostridium difficile infection are slow to drop. From a baseline of 1.0 Standard- ized Infection Ratio (SIR) from 2010-2011, the SIR only dropped to .85 by 2016. The report states, “The most recent pace of progress (i.e. 8% from 2015 to 2016) needs to remain steady or increase to meet na- tional prevention goals for hospital-onset CDI in 2020.”


Reduction in rates of some other hospi- tal-acquired infections are being met with greater success. The report states, “After some early lack of progress, there have been steady declines in [catheter-associat- ed urinary tract infections] CAUTIs over the past few years. The gains have been most marked in non-ICU locations, but recent years have seen progress in ICUs as well. Although CAUTIs that include those caused by yeast declined on wards from 2012 through 2014, they failed to decline in ICUs, where they increased and then remained elevated from 2012 through 2014. However, using the more clinically-relevant CAUTI definition that no longer includes yeast, and applying this retrospectively as well as in the new baseline, there have been consistent year- to-year declines in CAUTIs in both ICUs and wards from 2012 through 2016.” The report also bears good news on the CLABSI front. “Hospitals have made significant progress in preventing CLABSIs– nationally, there has been a roughly 50% drop in CLABSIs be- tween 2008 and 2016.” As you explore avenues in reducing infection at your hos- pital, the experiences of some of those who already have success- fully reduced infec- tion in their medical facilities may offer


recent HAI Data Report, “Health- care-associated Infections in the United States, 2006-2016: A Story of

insight and inspiration in how to attack hospital-acquired infections.

Challenging C. diff

Norman Regional Health System South Central OK

The Norman Regional Health System is a multi-campus system serving patients throughout south central Oklahoma. Its acute-care facility, the 219-bed Norman Regional Hospital, offers a full range of services. The 168-bed HealthPlex campus features cardiovascular services, spine and orthopedic surgery, and women’s and children’s services.

Xenex LightStrike Germ-Zapping Robots

Normal Regional’s infection rates were already low. The combined rate of infection for Clostridium difficile (C. diff), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE) was 14.43 per 10,000 patient-days or 31 cases. The motivation to improve at Normal Regional, according to Clyde Brawner, Director, Distribution/ Transportation and Environmental Ser- vices, is, “We believe that one infection is too many.” What they did: In 2016, the hospital partnered with Xenex to deploy four LightStrike Germ-Zapping Robots. “In an innovative shared-risk agreement, Xenex guaranteed Norman Regional leadership that patient infection rates on evaluation units would decrease or they would refund the money the system invested in the robots,” explained Brawner. The LightStrike robots’ germicidal UV light kills bac- teria and viruses in just minutes, disin- fecting high-touch areas and surfaces including bedrails, tray tables, ma- chines, monitors, keyboards, and computers. It can be used in any depart-

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