Evaluation of a hand-held far-ultraviolet radiation device for decontamination of Clostridium difficile and other healthcare-associated pathogens

<p>Abstract</p> <p>Background</p> <p>Environmental surfaces play an important role in transmission of healthcare-associated pathogens. There is a need for new disinfection methods that are effective against <it>Clostridium difficile</it> spores, but also safe and rapid. The Sterilray™ Disinfection Wand device is a hand-held room decontamination technology that utilizes far-ultraviolet radiation (185-230 nm) to kill pathogens.</p> <p>Methods</p> <p>We examined the efficacy of disinfection using the Sterilray device in the laboratory, in rooms of hospitalized patients, and on surfaces outside of patient rooms (i.e. keyboards and portable medical equipment). Cultures for <it>C. difficile</it>, methicillin-resistant <it>Staphylococcus aureus</it> (MRSA), and vancomycin-resistant <it>Enterococcus</it> (VRE) were collected from commonly-touched surfaces before and after use of the Sterilray device.</p> <p>Results</p> <p>On inoculated surfaces in the laboratory, application of the Sterilray device at a radiant dose of 100 mJ/cm² for ~ 5 seconds consistently reduced recovery of <it>C. difficile</it> spores by 4.4 CFU log₁₀, MRSA by 5.4 log₁₀CFU and of VRE by 6.9 log₁₀CFU. A >3 log₁₀ reduction of MRSA and VRE was achieved in ~2 seconds at a lower radiant dose, but killing of <it>C. difficile</it> spores was significantly reduced. On keyboards and portable medical equipment that were inoculated with <it>C. difficile</it> spores, application of the Sterilray device at a radiant dose of 100���mJ/cm² for ~ 5 seconds reduced contamination by 3.2 log₁₀CFU. However, the presence of organic material reduced the lethal effect of the far-UV radiation. In hospital rooms that were not pre-cleaned, disinfection with the Sterilray device significantly reduced the frequency of positive <it>C. difficile</it> and MRSA cultures (<it>P</it> =0.007).</p> <p>Conclusions</p> <p>The Sterilray™ Disinfection Wand is a novel environmental disinfection technology that rapidly kills <it>C. difficile</it> spores and other healthcare-associated pathogens on surfaces. However, the presence of organic matter reduces the efficacy of far-UV radiation, possibly explaining the more modest results observed on surfaces in hospital rooms that were not pre-cleaned.</p

Best practice in healthcare environment decontamination

There is now strong evidence that surface contamination is linked to healthcare-associated infections (HCAIs). Cleaning and disinfection should be sufficient to decrease the microbial bioburden from surfaces in healthcare settings, and, overall, help in decreasing infections. It is, however, not necessarily the case. Evidence suggests that there is a link between educational interventions and a reduction in infections. To improve the overall efficacy and appropriate usage of disinfectants, manufacturers need to engage with the end users in providing clear claim information and product usage instructions. This review provides a clear analysis of the scientific evidence supporting the role of surfaces in HCAIs and the role of education in decreasing such infections. It also examines the debate opposing the use of cleaning versus disinfection in healthcare settings