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Effectiveness of ultraviolet disinfection in reducing hospital-acquired Clostridium difficile and vancomycin-resistant Enterococcus on a bone marrow transplant unit

Published online by Cambridge University Press:  18 September 2018

Jennifer Brite
Affiliation:
Infection Control, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
Tracy McMillen
Affiliation:
Infection Control, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
Elizabeth Robilotti
Affiliation:
Infection Control, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York Infectious Disease Service, Memorial Sloan Kettering Cancer Center, New York, New York Department of Medicine, Weill Cornell Medical College, New York, New York
Janet Sun
Affiliation:
Infection Control, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
Hoi Yan Chow
Affiliation:
Infection Control, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
Frederic Stell
Affiliation:
Environmental Services, Memorial Sloan Kettering Cancer Center, New York, New York
Susan K. Seo
Affiliation:
Infectious Disease Service, Memorial Sloan Kettering Cancer Center, New York, New York Department of Medicine, Weill Cornell Medical College, New York, New York
Donna McKenna
Affiliation:
Westchester Medical Center, Valhalla, New York
Janet Eagan
Affiliation:
Infection Control, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
Marisa Montecalvo
Affiliation:
Department of Medicine, New York Medical College, Valhalla, New York
Donald Chen
Affiliation:
Department of Medicine, New York Medical College, Valhalla, New York Westchester Medical Center, Valhalla, New York
Kent Sepkowitz
Affiliation:
Infectious Disease Service, Memorial Sloan Kettering Cancer Center, New York, New York Division of Quality and Safety, Memorial Sloan Kettering Cancer Center, New York, New York
Mini Kamboj*
Affiliation:
Infection Control, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York Infectious Disease Service, Memorial Sloan Kettering Cancer Center, New York, New York Department of Medicine, Weill Cornell Medical College, New York, New York
*
Author for correspondence: Mini Kamboj MD, 1275 York Avenue, New York, NY 10065. E-mail: kambojm@mskcc.org

Abstract

Objective

To determine the effectiveness of ultraviolet (UV) environmental disinfection system on rates of hospital-acquired vancomycin-resistant enterococcus (VRE) and Clostridium difficile.

Design

Using active surveillance and an interrupted time-series design, hospital-acquired acquisition of VRE and C. difficile on a bone marrow transplant (BMT) unit were examined before and after implementation of terminal disinfection with UV on all rooms regardless of isolation status of patients. The main outcomes were hospital-based acquisition measured through (1) active surveillance: admission, weekly, and discharge screening for VRE and toxigenic C. difficile (TCD) and (2) clinical surveillance: incidence of VRE and CDI on the unit.

Setting

Bone marrow transplant unit at a tertiary-care cancer center.

Participants

Stem cell transplant (SCT) recipients.

Intervention

Terminal disinfection of all rooms with UV regardless of isolation status of patients.

Results

During the 20-month study period, 579 patients had 704 admissions to the BMT unit, and 2,160 surveillance tests were performed. No change in level or trend in the incidence of VRE (trend incidence rate ratio [IRR], 0.96; 95% confidence interval [CI], 0.81–1.14; level IRR, 1.34; 95% CI, 0.37–1.18) or C. difficile (trend IRR, 1.08; 95% CI, 0.89–1.31; level IRR, 0.51; 95% CI, 0.13–2.11) was observed after the intervention.

Conclusions

Utilization of UV disinfection to supplement routine terminal cleaning of rooms was not effective in reducing hospital-acquired VRE and C. difficile among SCT recipients.

Type
Original Article
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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