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


Authors: Brite, J.; McMillen, T.; Robilotti, E.; Sun, J.; Chow, H. Y.; Stell, F.; Seo, S. K.; McKenna, D.; Eagan, J.; Montecalvo, M.; Chen, D.; Sepkowitz, K.; Kamboj, M.
Article Title: Effectiveness of ultraviolet disinfection in reducing hospital-acquired Clostridium difficile and vancomycin-resistant Enterococcus on a bone marrow transplant unit
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. © 2018 by The Society for Healthcare Epidemiology of America. All rights reserved.
Keywords: adult; controlled study; major clinical study; nonhuman; ultraviolet radiation; incidence; cancer center; tertiary health care; vancomycin resistant enterococcus; bone marrow transplantation; disinfection; cleaning; recipient; human; male; female; article; peptoclostridium difficile
Journal Title: Infection Control and Hospital Epidemiology
Volume: 39
Issue: 11
ISSN: 0899-823X
Publisher: The Society for Healthcare Epidemiology of America  
Date Published: 2018-11-01
Start Page: 1301
End Page: 1306
Language: English
DOI: 10.1017/ice.2018.215
PUBMED: 30226124
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 November 2018 -- Source: Scopus
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MSK Authors
  1. Kent A Sepkowitz
    270 Sepkowitz
  2. Susan Seo
    87 Seo
  3. Mini Kamboj
    101 Kamboj
  4. Janet A Eagan
    38 Eagan
  5. Janet Yuan Sun
    8 Sun
  6. Frederic G Stell
    2 Stell
  7. Jennifer   Brite
    7 Brite
  8. Hoi Yan Chow
    4 Chow