Beyond duodenoscope-transmitted infections: Analysis of surface bioburden and UV-C mitigation within a tertiary care endoscopy unit

Am J Infect Control. 2024 Mar;52(3):331-336. doi: 10.1016/j.ajic.2023.09.016. Epub 2023 Sep 28.

Abstract

Background: An inpatient endoscopy unit is a care hub for patients from throughout the hospital and can be the site of health care-associated infections (HAIs). Shared surfaces and other nonmedical devices (keyboards) have been increasingly recognized as sites of pathogen transmission. Beyond standard cleaning of high-touch target areas, we queried whether the addition of automated devices delivering low-intensity doses of ultraviolet (UV)-C radiation could further reduce bioburden in an academic endoscopy unit.

Methods: Bioburden on previously identified high-touch/communal surfaces was measured before and after the installation of automated, low-intensity UV-light emitting devices (UV Angel) that passively monitor and disinfect targeted surfaces with Ultraviolet-C light (UV-C) light.

Results: High-touch sites (keyboards) had a baseline bacterial contamination of >80%, whereas individual procedure rooms and common areas had a >57% contamination rate. Following the implementation of automated UV-C light decontamination, bioburden was reduced on average by >91% at high-touch surfaces and within procedure rooms.

Discussion/conclusions: Nonsterile hubs of patient care could serve as sites of "silent" HAI transmission. We have identified high-touch surfaces within an endoscopy unit that have a high bioburden of bacterial contamination and demonstrated that the installation of passive, automated UV-C light disinfection devices can reduce bioburden significantly, possibly mitigating HAI transmission between patients.

Keywords: Disease transmission; Health care-associated infections; Infection control; Infectious.

MeSH terms

  • Bacteria
  • Cross Infection* / microbiology
  • Cross Infection* / prevention & control
  • Disinfection / methods
  • Duodenoscopes*
  • Endoscopy, Gastrointestinal
  • Hospitals
  • Humans
  • Tertiary Healthcare
  • Ultraviolet Rays