Impact of Ultraviolet Germicidal Irradiation for No-Touch Terminal Room Disinfection on Clostridium difficile Infection Incidence Among Hematology-Oncology Patients
Impact of Ultraviolet Germicidal Irradiation for No-Touch Terminal Room Disinfection on Clostridium difficile Infection Incidence Among Hematology-Oncology Patients
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DOI：
10.1017/ice.2016.222
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发表时间：
2017-01-01
影响因子：
4.5
通讯作者：
Gaynes, Steven
中科院分区：
文献类型：
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作者：
Pegues, David A.;Han, Jennifer;Gaynes, Steven
OBJECTIVE.目的评价紫外线C波长照射对无接触终端室无接触消毒对C。尽管采取了感染控制措施，但住院单位的艰难梭菌感染（CDI）率持续较高。使用比较臂中断时间序列分析。设置。3成人血液肿瘤单位在一个大型的，三级保健医院。我们对UVGI进行了为期12个月的前瞻性估值。出院时，使用电子患者流量系统，将CDI或接触预防措施患者的房间作为UVGI的目标。使用混合效应Poisson回归模型比较了基线期（2013年1月至2013年12月）和干预期（2014年2月至2015年1月）研究单位和非研究单位的医疗保健发作CDI的发生率，其中单位和时间为随机效应（以月为单位）。在52周的干预期间，3个研究单位的2，569例出院患者中有542例（21.1%）使用了UVGI。与基线期相比，干预期间研究单位的CDI率下降了25%，非研究单位的CDI率增加了16%。我们在研究单位中检测到UVGI和CDI发病率降低之间的显著相关性（发病率比[IRR]，0.49; 95%置信区间[CI]，0.26-0.94; P= 0.03），但在非研究单位中未检测到。与基线期相比，UVGI使用对平均房间清洁时间和周转时间的影响可以忽略不计。在出院时将UVGI定向部署到高风险患者的房间，导致CDI发生率大幅降低，而不会对房间周转产生不利影响。
OBJECTIVE. To evaluate the impact of no-touch terminal room no-touch disinfection using ultraviolet wavelength C germicidal irradiation (UVGI) on C. difficile infection (CDI) rates on inpatient units with persistently high rates of CDI despite infection control measures.DESIGN. Interrupted time-series analysis with a comparison arm.SETTING. 3 adult hematology-oncology units in a large, tertiary-care hospital.METHODS. We conducted a 12-month prospective valuation of UVGI. Rooms of patients with CDI or on contact precautions were targeted for UVGI upon discharge using an electronic patient flow system. Incidence rates of healthcare-onset CDI were compared for the baseline period (January 2013 December 2013) and intervention period (February 2014 January 2015) on study units and non study units using a mixed-effects Poisson regression model with random effects for unit and time in months.RESULTS. During a 52-week intervention period, UVGI was deployed for 542 of 2,569 of all patient discharges (21.1%) on the 3 study units. The CDI rate declined 25% on study units and increased 16% on non-study units during the intervention compared to the baseline period. We detected a significant association between UVGI and decrease in CDI incidence (incidence rate ratio [IRR], 0.49; 95% confidence interval [CI], 0.26-0.94; P=.03) on the study units but not on the non-study units. The impact of UVGI use on average room-cleaning time and turnaround time was negligible compared to the baseline period.CONCLUSIONS. Targeted deployment of UVGI to rooms of high-risk patients at discharge resulted in a substantial reduction of CDI incidence without adversely impacting room turnaround.