342. The Use of Portable Pulsed Xenon Ultraviolet Light (PPX-UV) after Terminal Cleaning Was Associated with a Dramatic Decrease in the Hospital-associated Clostridium difficile Infection (HA-CDI) Rate in a Community Hospital
Session: Poster Abstract Session: Clostridium difficile - Epidemiology, Diagnosis, Treatment, and Prevention
Friday, October 21, 2011
Room: Poster Hall B1
  • Dr Joanne Levin presentation 2011 CDH v3 with disclaimer.pdf (1.1 MB)
  • Background: 

    Clostridium difficile is a major cause of antibiotic associated colitis. The total incidence of CDI as well as severe or fatal CDI has increased dramatically in the past decade. In our hospital, CDI remained a concerning clinical issue, with significant morbidity and mortality, despite following SHEA guidelines , including the use of chorine-based agents for terminal cleaning, contact precautions for the duration of the hospital stay, and the use of soap and water for hand hygiene, along with enhanced education and implementation of competency evaluations for our environmental services workers. Several studies have highlighted the role of environmental contamination in the development of HA- CDI. We sought to determine if using PPX-UV after routine terminal cleaning would decrease CDI in our hospitalized population.


    During January 2011, the use of 2 PPX-UV devices to disinfect patient rooms was phased in. Rooms and bathrooms were terminally cleaned as usual with a chlorine-based product, followed by the use of PPX-UV, usually for three 7-minute exposures (once in the bathroom, twice in the bed room). The overall room turn-over time was extended by about 15 minutes. When a device was not being used for terminal cleaning, it was also used in the operating suite, emergency department and other areas. Surveillance for HA-CDI (hospital-onset plus community onset) using SHEA definitions continued as per routine. No other significant new infection prevention interventions were instituted during this time.


    During the first quarter of 2011, 2 HA-CDI cases were found for a rate of 2.23/10,000 patient days (pd).  This compares favorably with the rate of 9.5/ 10,000 pd for all of 2010 (p-value = 0.014). Since CDI rates tended to be higher in Quarter 1 (Q1), we also compared Q1 data for the previous 3 years. The combined Q1 rate for 2008-2010 was 12.28/ 10,000 pd. There was a 75% decline in hospital-associated CDI in Q1 2011 compared with all of 2010 and an 81% decline compared to the combined Q1 data for the previous 3 years (p-value =0.003).

    Conclusion: The use of  PPX- UV after terminal cleaning is highly effective in preventing hospital-associated CDI.

    Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

    Joanne Levin, MD1, Christine Parrish, MSN, RN, CIC1, Linda Riley, RN, MEd, CIC1 and Daniel English, MHCIMA2, (1)Infection Prevention, Cooley Dickinson Hospital, Northampton, MA, (2)Environmental Services, Cooley Dickinson Hospital, Northampton, MA


    J. Levin, None

    C. Parrish, None

    L. Riley, None

    D. English, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.