New research carried out in the USA has shown that healthcare-related multidrug-resistant organisms (MDRO) were decreased among patients after adding ultraviolet environmental disinfection (UVD) to existing cleaning protocols.
In this retrospective study scientists discovered that the rate of healthcare-related infections caused by MDRO and C. difficile was significantly lower during the 22 months of UVD use compared with the 30-month period before UVD (2.14 cases per 1,000 patient-days vs 2.67 cases, respectively). This dramatic decline in incidence occurred despite missing 24 percent of UVD opportunities.
UVD is a disinfection method that uses ultraviolet light to kill microorganisms in the healthcare setting.
The study analysed 52 months of hospital-acquired MDROs plus C. difficile before and during UVD use. During the pre-UVD period (January 2009-June 2011), the hospital used standard cleaning protocols [sodium hypochlorite (bleach)] to disinfect MDRO patient rooms upon discharge. Once the hospital leased two UVD machines and trained the staff to use them, the second phase began (July 2011-April 2013), during which UVD was added to the cleaning regimen.
In addition to use for contact precaution discharges, UVD was used weekly in the dialysis unit and for all burn unit discharges. UVD could be requested for rooms of long-stay patients or for discharges in units with high prevalence of MDRO or CD.
Under contact precautions, everyone coming into a patient's room is asked to wear a gown and gloves because the patient has a type of infection that can be spread by touching the patient or their environment.
The system was used for 6 minutes in the bathroom and 6 minutes each at two positions in the patient room. On average, UVD added 51 minutes per discharge.
"Use of UVD as an adjunct to routine discharge cleaning of contact precautions rooms was feasible and temporally associated with a significant decrease in hospital-acquired MDRO plus CD in our institution," conclude the authors.
The results of the study were published in the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).
A group up of senior UK scientists including Dame Sally Davies, the chief medical officer, and Professor Jeremy Farrar, director of the Wellcome Trust, told the Royal Society recently that the planet faced the prospect of people dying from routine infections because effective antibiotics no longer existed.
They called for changes to be made to the layout of hospital wards to include greater distances between beds, lower bed occupancy rates, improved staff-patient ratios and large windows capable of being opened.
"We are talking about returning hospital wards to the type we had 100 years ago," said microbiologist Professor Kevin Kerr, of Hull York Medical School.
The crucial point of such "old school" measures is to buy time, added fellow microbiologist Professor Mark Fielder, of Kingston University in Surrey: "We need to hold back the spread of resistant bacteria while finding ways to persuade pharmaceuticals [companies] to improve their output of new generations of antibiotics, for we are facing a future in which there might be no effective antibiotics left on the planet."