Duke Health researchers have found that a UVC machine use can reduce transmission of harmful superbugs in hospital settings.
Healthcare-associated infections continue to plague hospitals across the country, despite advancements in prevention strategies. In fact, the Centers for Disease Control and Prevention (CDC) reports that about one in 25 hospitals has at least one healthcare-associated infection, “on any given day.” Prevention is becoming increasingly difficult since many of these harmful organisms are developing resistance to currently available antibiotics. However, things may be looking up.
Duke Health researchers have found that a tool may help hospitals make a some headway in the fight against antibiotic-resistant bacteria. The tool in question? A UVC machine, which uses a kind of ultraviolet light to kill harmful bacteria that may remain in patient rooms even after they have been chemically disinfected. The researchers report that these machines can reduce “transmission of four major superbugs by a cumulative 30%.”
Even though some hospitals have already started using UVC machines in combination with “standard chemical disinfection,” there is not much research available on how effective these machines are in eliminating dangerous bacteria.
Therefore, Duke Health researchers decided to conduct a large randomized trial—consisting of over 21,000 patients—comparing the effectiveness of several different cleaning methods on eliminating different pathogens from the environment. The researchers compared quaternary ammonium followed by UV light, subbing chlorine bleach instead of quaternary ammonium without any UV light, and using chlorine bleach followed by UV light.
The study focused on the effectiveness of removing four drug-resistant organisms that are known to plague hospitals the most: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Clostridium difficile, and Acinetobacter.
“These are the top four bad bugs that we’ll see in hospitals. When patients get infections from these organisms they have long hospital stays, often require intensive care, and have basically a major interruption in their lives because of the ill effects of these types of infections,”said lead investigator Deverick J. Anderson, MD, an infectious disease specialist at Duke Health explained in an educational video.
The trial was conducted at nine hospitals over the course of two years, from 2012 to 2014. According to Dr. Anderson, “We had two tertiary care centers, Duke and UNC, a [Veterans Affairs] VA, and six different community hospitals, so it was a good representation of all of the different areas where care is provided.”
These healthcare facilities used a UVC machine, called the Tru-D SmartUVC, to disinfect rooms where patients who had been infected with any of the four “bad bugs” had been treated. The UVC machine “emits UVC light into an empty room, [where] the light bounces and reflects into hard-to-reach areas such as open drawers or cabinet fixtures.” In about thirty minutes’ time, the light works to eliminate harmful bacteria from the room “by disrupting their DNA.”
The results of the study showed that using quaternary ammonium with UV light was the most effective disinfection strategy overall, and was especially successful when it came to preventing MRSA transmission.
When it came to preventing VRE transmission, they found that using chlorine bleach instead of quaternary ammonium “cut transmissions of VRE by more than half.” Even better, the researchers noted that by following the chlorine bleach disinfection with the UV light, they could reduce VRE transmission by a whopping 64%.
Unfortunately, when it came to C. difficile, the researchers found that none of the disinfectant combinations resulted in a significant reduction of incidence. Since there was only one case of Acinetobacter in the trial, the researchers decided to omit it from their analyses.
By cutting the amount of healthcare-associated infections in hospitals, UVC machines could potentially save hospitals a significant amount of money, according to the press release. A potential issue with using the machines is the extra 30 minutes of staff time it would take it turn over a room and make it ready for the next patient that is coming in.
“There is such a push in the hospital environment to turn rooms over that really any amount of added time is viewed as a potential issue. In a large hospital, you might have 100 rooms that are vacated and turned over in one day,” Dr. Anderson explained. To overcome such an obstacle, hospitals would need to consider a number of factors such as: “varied discharge times, the demand for patient rooms, and availability of the machines.”
The hospitals that participated in the trial were able to achieve “90% compliance with the UVC machine using careful planning and communication,” according to Dr. Anderson, which suggests that overcoming these challenges in real-world settings is possible.
In addition to UV light, Dr. Anderson and his team also shared additional methods that hospitals actively use to reduce transmission. “Hand hygiene is a big focus,” he said. “We also use what we call contact precautions where for patients that we know have these pathogens, we’ll wear gowns and gloves, and then discard those gowns and gloves when we’re done caring for that patient so we don’t then carry that organism to the next patient.”
Duke Health plans to take their research a step further by taking a closer look at “day-to-day strategies” that hospital personnel can perform to improve infection control.
Feature Picture Source: Duke Health YouTube Channel.