UV Light Decontamination Technology With Manual Cleaning Decreases CREs in a Hospital Setting

Ultraviolent (UV) room decontamination technology paired with manual cleaning protocols decrease the transmission of carbapenem-resistant Enterobacterales (CRE) in a hospital setting according to a recent study by the Wits University Donald Gordon Medical Centre (WDGMC) in Johannesburg, South Africa. The study, “The novel application and effect of an ultraviolet light decontamination strategy on the health care acquisition of CRE in a hospital setting,” was recently published in The Journal of Hospital Infection.

The team of investigators at WDGMC, a 210-bed hospital and the first private teaching hospital in South Africa, demonstrated a 23% reduction in CRE transmission with the sustained use of a UV room decontamination device (UVDI-360 Room Sanitizer, provided by United States-based manufacturer UVDI and eHealthGroup Infection Control) as an add-on to standard cleaning, including the use of bleach and quaternary ammonium disinfectants following a 26-month study. The investigation included broad UV room decontamination across five high-risk patient units, including transplant, oncology, critical care, and gastrointestinal surgery rooms, during a 12-month period. There was a 12-month baseline and a 2-month wash-in period before the trial began.

The study “demonstrates that if you use UV in combination with traditional manual cleaning—it must be used in combination—that we can actually reduce health care [infection] acquisition,” said Warren Lowman, MBBCh; MMed (Wits); FC Path (SA), and leading author, to Infection Control Today® (ICT®) in an exclusive interview. “This is the top tier of what you really want to show…that we actually demonstrate that we can reduce the health care acquisition of infections with this particular group of organisms, which are the CREs. Most of the literature to date has demonstrated the effect around other difficult and troublesome organisms in the health care setting, specifically like Clostridioides difficile (C difficile), vancomycin-resistant Enterococcus (VRE), and methicillin-resistant Staphylococcus aureus (MRSA), but its impact on CRE has not really been demonstrated. And I think that's what our study aimed to do, and that is what we have demonstrated.”

Warren Lowman, MBBCh; MMed (Wits); FC Path (SA)

The impetus of the study came from looking at incidence density rates and then at admission prevalence rates. The investigators noticed that “as [the] admission prevalence of multi-drug resistant organisms (MRIs) increases, so the rates of HAIs increase, which is intuitive. You're getting a higher burden of patients coming in carrying these organisms, the opportunities for spread are there,” Lowman said.

However, in order to stop the spread of HAIs with higher admission rates, “it's actually getting that technology in place [and] being used when the risk is highest. We know that patients with multi-drug resistant organisms [who] spend time in the environment that the environment gets heavily colonized and contaminated with the bugs,” said Lowman.

Overall, he explained, in order to have a successful investigation and result, the important thing is that “it's like as in most things with infection prevention and control, it's how you implement it.”