Pulsed Xenon Found Less Effective than Continuous UVC
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 . 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 . 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 . 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 . Additional evaluation of the pulsed-xenon UV system by independent investigators is needed.
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.
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