Implementation and impact of ultraviolet environmental disinfection in an acute care setting

Am J Infect Control. 2014 Jun;42(6):586-90. doi: 10.1016/j.ajic.2013.12.013.


Background: Multiple-drug-resistant organisms (MDROs) and Clostridium difficile (CD) are significant problems in health care. Evidence suggests that these organisms are transmitted to patients by the contaminated environment.

Methods: This is a retrospective study of the implementation of ultraviolet environmental disinfection (UVD) following discharge cleaning of contact precautions rooms and other high-risk areas at Westchester Medical Center, a 643-bed tertiary care academic medical center. Incidence rates of hospital-acquired MDROs plus CD before and during the UVD use were evaluated using rate ratios and piecewise regression.

Results: The average time per UVD was 51 minutes, and machines were in use 30% of available time. UVD was used 11,389 times; 3,833 (34%) of uses were for contact precautions discharges. UVD was completed for 76% of contact precautions discharges. There was a significant 20% decrease in hospital-acquired MDRO plus CD rates during the 22-month UVD period compared with the 30-month pre-UVD period (2.14 cases/1,000 patient-days vs 2.67 cases per 1,000 patient-days, respectively; rate ratio, 0.80; 95% confidence interval: 0.73-0.88, P < .001).

Conclusion: During the time period UVD was in use, there was a significant decrease in overall hospital-acquired MDRO plus CD in spite of missing 24% of opportunities to disinfect contact precautions rooms. This technology was feasible to use in our acute care setting and appeared to have a beneficial effect.

Keywords: Clostridium difficile; Multiple-drug-resistant organisms.

MeSH terms

  • Academic Medical Centers / statistics & numerical data
  • Bacterial Infections / microbiology
  • Bacterial Infections / prevention & control*
  • Cross Infection / microbiology
  • Cross Infection / prevention & control*
  • Disinfection / methods*
  • Disinfection / statistics & numerical data*
  • Drug Resistance, Multiple, Bacterial
  • Humans
  • Patients' Rooms
  • Retrospective Studies
  • Tertiary Care Centers / statistics & numerical data
  • Time Factors
  • Ultraviolet Rays*