1706. Ultraviolet Light for Terminal Disinfection of Neonatal Incubators
Session: Poster Abstract Session: Role of the Healthcare Environment in HAIs
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • UVC Incubators ID week 2013 poster_FINAL.pdf (400.9 kB)
  • Background:  Neonatal incubators are challenging to clean thoroughly.  We performed a validation study to determine whether ultraviolet light (UV-C), used in addition to manufacturer-recommended manual cleaning, reduced bacterial contamination of neonatal incubators.

    Methods:   After neonates were discharged or transferred, their incubators were held for the study.  We sampled 20 incubators at 3 separate times: prior to manual cleaning; after manual cleaning; and after UV-C disinfection (EDU, Lumalier). Four standardized high touch surfaces were selected for each sample.  Aides cleaning the incubators were blinded to the locations being sampled. Each site was sampled using a pre-moistened swab, and cultures were performed using broth enrichment followed by selective media to isolate Gram-positive and Gram-negative organisms. 

    Results: Of 80 sites (4 x 20 incubators), bacterial growth was found in 62 (77.5%) sites prior to manual cleaning, 40 (50.0%) sites after manual cleaning (36% relative reduction), and 12 (15.0%) sites after UV-C (70% relative reduction compared manual cleaning, p < 0.001).  The most common single organism was coagulase-negative Staphylococci (CoNS).  Excluding CoNS and common skin flora, 29 (36.3%) had pathogens identified before manual cleaning, with a mean of 1.3 pathogens (range, 1-3) among those with any pathogenic growth. This decreased to 3 pathogens (methicillin-resistant S. aureus, Acinetobacter and Enterococcus species) after manual cleaning (3.8% of sites), a 90% relative reduction, and to 1 pathogen (Enterococcus) after UV-C (1.3% of sites), a 67% relative reduction compared to manual cleaning alone (p = 0.6). The UV-C disinfection added approximately 1 hour to the terminal cleaning process.

    Conclusion: This small validation study demonstrated that using UV-C for terminal disinfection further reduced bacterial growth on newborn incubators compared to manual cleaning alone, which may reduce the risk of acquisition for the next neonate. The inability of UV-C to penetrate the incubators’ clear acrylic material required a lengthy process with multiple cycles to disinfect both sides.  Formal cost-effectiveness analysis is needed. The importance of effective manual cleaning as a first step should not be overlooked.

    Michelle Power, BSMT (ASCP)1, Sarojini Misra, MS, SM (ASCP), SM (AAM)1, Jason Funyak1, Bonnie Chavez, BSN, RNC-NIC1, John Stefano, MD1,2, Deborah Tuttle, MD1 and Marci Drees, MD, MS1,3, (1)Christiana Care Health System, Newark, DE, (2)Pediatrics, Jefferson Medical College, Philadelphia, PA, (3)Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA

    Disclosures:

    M. Power, None

    S. Misra, None

    J. Funyak, None

    B. Chavez, None

    J. Stefano, None

    D. Tuttle, None

    M. Drees, Lumalier: Investigator, Lumalier lent the EDU machine used for this research and provided technical expertise, but did not provide financial or any other support of this project.

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.