Universal decontamination of hospital surfaces in an occupied inpatient room with a continuous 405 nm light source

Background Previous work has shown that a ceiling-mounted, 405 nm high-intensity narrow-spectrum light environmental decontamination system (HINS-light EDS) reduces bacterial contamination of environmental surfaces in a burns unit by between 27% and 75%. Examination of the efficacy of the light over extended exposure times and its probable mode of action was performed. Aims Studies were designed to ascertain the correlation between bacterial kill achieved on sampled surface sites around the Burns Unit and both irradiance levels of the 405 nm light, and exposure time. Method Seventy samples were taken using contact agar plates from surfaces within an occupied side room in the burns unit before, during and after a seven day use of the HINS-light EDS. This was repeated in three separate studies. Statistical analysis determined if there was significant decrease in environmental contamination during prolonged periods of HINS-light treatment, and if there was a relationship between irradiance and bacterial kill. Findings A decrease of between 22% and 86% in the mean number of surface bacteria was shown during the use of the HINS-light EDS. When the light ceased to be used, increases of between 78% and 309% occurred. There was no correlation between bacterial kill and irradiance levels at each sampling site but strong correlation between bacterial kill and exposure time. Conclusions Prolonged exposure to the HINS-light EDS causes a cumulative decontamination of the surfaces within a burns unit. The importance of exposure time and possible airborne effect over irradiance levels is emphasised

Late-onset rhabdomyolysis in burn patients in the intensive care unit

Rhabdomyolysis (RML), defined as creatine phosphokinase (CPK) >1000 U/L, is relatively common immediately after a significant burn. Late-onset RML, occurring a week or more after a burn, is less well understood and recognised. All patients admitted to the Intensive Care Unit (ICU) following an acute burn between May 2006 and December 2009 were retrospectively identified. Patients with CPK > 1000 U/L a week or more after their burn had a detailed notes review. Seventy-six patients were admitted during 43 months. Late-onset RML was demonstrated in 7/76 (9%) patients. They had a similar pattern of normal or mildly raised CPK on admission that resolved over the following days, but suddenly increased sharply to over 1000 U/L, a week or more after their burn, usually around day ten. A severe late-onset RML occurred in 5/76 (7%) patients, with a CPK rise of over 5000 U/L, and all required haemodialysis. Potential triggering factors for late-onset RML include sepsis, nephrotoxic drugs and hypophosphataemia. It is important to consider measuring CPK in all patients with the above complications, even after it has previously been observed to be normal, in order to initiate early treatment. (C) 2011 Elsevier Ltd and ISBI. All rights reserve