Pulsed Xenon Found Less Effective than Continuous UVC

Posted by Tru-D SmartUVC 05.09.16

A recent report comparing various studies on cleaning protocols, including the use of UV disinfection, by researcher John M. Boyce addresses the effectiveness of continuous UV-C as compared to pulsed xenon. According to his findings, one carefully-performed trial which compared the pulsed xenon system with a continuous UV-C light device such as Tru-D SmartUVC found that log10 reductions of pathogens achieved with the pulsed xenon system were lower than with the continuous UV-C light device (Nerandzic, 2015).

Further, Boyce reports that, “While a few studies utilizing the Xenon device reported reductions in C. difficile infection, a more recent 8-month study in a large institution found no significant reduction in C. difficile infection rates hospital-wide or on four units with high C. difficile infection rates” (McMullen, et all 2015).

In contrast, “advantages of the mobile, continuous UV-C light devices include their ease of use, minimal need for special training of environmental services personnel, and unlike hydrogen peroxide vapor systems, the ability to utilize the devices without having to seal room vents or doors,” reports Boyce.

Boyce’s full cumulative comparison on ultraviolet light devices is below. 

Boyce Cumulative Comparison of Ultraviolet Light Devices

Automated mobile ultraviolet light devices that continuously emit UV-C in the range of 254 nm can be placed in patient rooms after patient discharge and terminal cleaning has been performed. A number of these devices can be set to kill vegetative bacteria or to kill spores. These systems often reduce the VRE and MRSA by four or more log10, and C. difficile by 1–3 log10 [1-9]. In one comparative trial, a continuous UV-C light system resulted in lower log reductions than a micro-condensation hydrogen peroxide vapor system [10]. Advantages of the mobile, continuous UV-C light devices include their ease of use, minimal need for special training of environmental services personnel, and unlike hydrogen peroxide vapor systems, the ability to utilize the devices without having to seal room vents or doors. Recently, a prospective, multicenter randomized controlled trial comparing a mobile continuous UV-C light system with standard and other enhanced surface disinfection methods has been completed [11]. Results of the trial should be published in the near future.

A pulsed-xenon device, which does not use mercury bulbs to produce UV light, emits light in the 200–320 nm range. It has been shown to significantly reduce pathogens in patient rooms [12-18]. The manufacturer recommends placing device in 3 locations in a room with 5–7 min cycles (shorter than with some continuous UV-C systems). While a few studies utilizing the device reported reductions in C. difficile infection [13, 18], a more recent 8-month study in a large institution found no significant reduction in C. difficile infection rates hospital-wide or on four units with high C. difficile infection rates [19]. One carefully-performed trial which compared the pulsed-xenon system with a continuous UV-C light device found that log10 reductions of pathogens achieved with the pulsed-xenon system were lower than with the continuous UV-C light device [20]. Additional evaluation of the pulsed-xenon UV system by independent investigators is needed.

Conclusions

In conclusion, manual cleaning and disinfection of environmental surfaces in healthcare facilities (daily and at patient discharge) are essential elements of infection prevention programs. Because many factors make it difficult to achieve high rates of effective disinfection on a routine and sustained basis, continued efforts to improve the quality and consistency of traditional cleaning and disinfection practices are needed. Given the many challenges in achieving desired levels of surface disinfection, adoption of modern technologies is indicated to supplement traditional methods. Further research into the efficacy and cost-effectiveness of newer technologies, and when to best apply them, is needed. As additional data become available, it is likely that newer liquid disinfectants and some no-touch room decontamination systems will be more widely adopted to supplement traditional cleaning and disinfection practices.

References

  1. Nernandzic MM, Cadnum JL, Pultz MJ, Donskey CJ. Evaluation of an automated ultraviolet radiation device for decontamination ofClostridium difficile and other healthcare-associated pathogens in hospital rooms. BMC Infect Dis. 2010;10:197.
  2. Rutala WA, Gergen MF, Weber DJ. Room decontamination with UV radiation. Infect Control Hosp Epidemiol. 2010;31:1025–9.
  3. Boyce JM, Havill NL, Moore BA. Terminal decontamination of patient rooms using an automated mobile UV light unit. Infect Control Hosp Epidemiol. 2011;32:737–42.
  4. Rutala WA, Gergen MF, Tande BM, Weber DJ. Rapid hospital room decontamination using ultraviolet (UV) light with a nanostructured UV-reflective wall coating. Infect Control Hosp Epidemiol. 2013;34:527–9.
  5. Anderson DJ, Gergen MF, Smathers E, Sexton DJ, Chen LF, Weber DJ, et al. Decontamination of targeted pathogens from patient rooms using an automated ultraviolet-C-emitting device. Infect Control Hosp Epidemiol. 2013;34:466–71.
  6. Mahida N, Vaughan N, Boswell T. First UK evaluation of an automated ultraviolet-C room decontamination device (Tru-D). J Hosp Infect. 2013;84:332–5.
  7. Nerandzic MM, Fisher CW, Donskey CJ. Sorting through the wealth of options: comparative evaluation of two ultraviolet disinfection systems. PLoS One. 2014;9:e107444.
  8. Rutala WA, Gergen MF, Tande BM, Weber DJ. Room decontamination using an ultraviolet-C device with short ultraviolet exposure time. Infect Control Hosp Epidemiol. 2014;35:1070–2.
  9. Rutala WA, Weber DJ, Gergen MF, Tande BM, Sickbert-Bennett EE. Does coating all room surfaces with an ultraviolet C light-nanoreflective coating improve decontamination compared with coating only the walls? Infect Control Hosp Epidemiol. 2014;35:323–5.
  10. Havill NL, Moore BA, Boyce JM. Comparison of the microbiological efficacy of hydrogen peroxide vapor and ultraviolet light processes for room decontamination. Infect Control Hosp Epidemiol. 2012;33:507–12.
  11. Anderson DJ, Sexton DJ. Effectiveness of enhanced terminal room disinfection to prevent healthcare-associated infections (HAIs). Clinical Trials.gov identifier: NCT01579370, 2015.
  12. Stibich M, Stachowiak J, Tanner B, Berkheiser M, Moore L, Raad I, et al. Evaluation of a pulsed-xenon ultraviolet room disinfection device for impact on hospital operations and microbial reduction. Infect Control Hosp Epidemiol. 2011;32:286–8.
  13. Levin J, Riley LS, Parrish C, English D, Ahn S. The effect of portable pulsed xenon ultraviolet light after terminal cleaning on hospital-associated Clostridium difficile infection in a community hospital. Am J Infect Control. 2013;41:746–8.
  14. Jinadatha C, Quezada R, Huber TW, Williams JB, Zeber JE, Copeland LA. Evaluation of a pulsed-xenon ultraviolet room disinfection device for impact on contamination levels of methicillin-resistant Staphylococcus aureus. BMC Infect Dis. 2014;14:187.
  15. Ghantoji SS, Stibich M, Stachowiak J, Cantu S, Adachi JA, Raad II, et al. Non-inferiority of pulsed xenon UV light versus bleach for reducing environmental Clostridium difficile contamination on high-touch surfaces in Clostridium difficile infection isolation rooms. J Med Microbiol. 2015;64:191–4.
  16. Sander J, Ladenstein M. Reliability of disinfectant dispensers in hospitals (author’s transl). Dtsch Med Wochenschr. 1974;99:1560–4.
  17. Nagaraja A, Visintainer P, Haas JP, Menz J, Wormser GP, Montecalvo MA. Clostridium difficile infections before and during use of ultraviolet disinfection. Am J Infect Control. 2015;43:940–5.
  18. Miller R, Simmons S, Dale C, Stibich M, Stachowiak J. Utilization and impact of a pulsed-xenon ultraviolet room disinfection system and multidisciplinary care team onClostridium difficile in a long-term acute care facility. Am J Infect Control. 2015;43:1350–3.
  19. McMullen K, Wood H, Buol W, Johnson D, Bradley A, Woeltje K, et al. Impact of a pulsed xenon ultraviolet light (PX-UV) light room disinfection system onClostridium difficile  Presented at IDWeek 2015, abstract 1714, October 10, 2015, San Diego, CA. 2015.
  20. Nerandzic MM, Thota P, Sankar CT, Jencson A, Cadnum JL, Ray AJ, et al. Evaluation of a pulsed xenon ultraviolet disinfection system for reduction of healthcare-associated pathogens in hospital rooms. Infect Control Hosp Epidemiol. 2015;36:192–7.

Click here to read the full abstract.

Posted 05.09.16
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