1715. Reducing Clostridium difficile Infection among Hematology-Oncology Patients Using Ultraviolet Germicidal Irradiation for Terminal Room Disinfection
Session: Poster Abstract Session: Infection Prevention: Cleaning and Disinfection
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • IDWeek2015_1715_PEGUES.pdf (5.1 MB)
  • Background: We evaluated the impact of terminal room 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. 

    Methods: We conducted a 12-month evaluation of UVGI on three adult hematology-oncology units with a total of 75 private and 7 semiprivate rooms in a 695-bed tertiary care hospital. Rooms of patients with CDI or on contact precautions were targeted for UVGI on discharge using an electronic patient flow system. Following terminal room cleaning, UVGI (Optimum-UV, Clorox Healthcare) was deployed for two 8-minute cycles on either side of the patient bed with the bathroom door left open. Two UVGI units and no additional Environmental Service personnel or resources were utilized for this evaluation. Rates of healthcare onset CDI were compared for the baseline period (Jan.-Dec. 2013) and intervention period (Feb. 2014-Jan. 2015) on study units and non-study units using rate ratios and 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 21.1% (542/2569) of all patient discharges on the three study units. Rates of CDI declined 25% on the study units and increased 16% on non-study units during the intervention vs. baseline period (Table).

     

    Baseline                                               (Jan-Dec 2013)

    Intervention                                           (Feb 2014-Jan 2015)

     

     

    Unit

    Pt. Days

    CDI cases

    CDI Rate*

    Pt. Days

    CDI cases

    CDI Rate

    Rate Ratio   (95% CI)

    Rate Difference

    Study Units

    28672

    87

    30.34

    28884

    66

    22.85

    0.75 

    (0.55-1.04)

    -7.49

    Non-Study Units

    187282

    108

    5.77

    189093

    127

    6.71

    1.16 

    (0.91-1.51)

    0. 96

    *CDI rate per 10,000 patient days

    There was a significant association between UVGI and decline in CDI incidence (incidence rate ratio [IRR] 0.49; 95% CI, 0.26-0.94; P=0.03) on the study units but not on the non-study units (IRR = 0.63, 95% CI: 0.38-1.06, P=0.08). The impact of UVGI use on average weekly room clean time and turn-around time on the three study units was negligible compared to the baseline period.

    Conclusion: Targeted deployment of UVGI to high-risk discharge rooms resulted in a substantial reduction of CDI incidence without adversely impacting room turn around.

    David Pegues, MD, FIDSA, FSHEA, Healthcare Epidemiology, Infection Prevention and Control, Hospital of the University of Pennsylvania, Philadelphia, PA, Cheryl Gilmar, MS, MT, CIC, Infection Prevention and Control, Hospital of the University of Pennsylvania, Philadelphia, PA, Mary Denno, MSN, RN, Nursing Department, Hospital of the University of Pennsylvania, Philadelphia, PA, Steven Gaynes, BS, Environmental Services, Hospital of the University of Pennsylvania, Philadelphia, PA and CDC Prevention Epicenters Program

    Disclosures:

    D. Pegues, None

    C. Gilmar, None

    M. Denno, None

    S. Gaynes, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.