Journal article
Effectiveness of Ultraviolet-C Disinfection on Hospital-Onset Gram-Negative Rod Bloodstream Infection: A Nationwide Stepped-Wedge Time-Series Analysis
Clinical infectious diseases, Vol.76(2), pp.291-298
01/15/2023
DOI: 10.1093/cid/ciac776
Abstract
Background
The effectiveness of enhanced terminal room cleaning with ultraviolet C (UV-C) disinfection in reducing gram-negative rod (GNR) infections has not been well evaluated. We assessed the association of implementation of UV-C disinfection systems with incidence rates of hospital-onset (HO) GNR bloodstream infection (BSI).
Methods
We obtained information regarding UV-C use and the timing of implementation through a survey of all Veterans Health Administration (VHA) hospitals providing inpatient acute care. Episodes of HO-GNR BSI were identified between January 2010 and December 2018. Bed days of care (BDOC) was used as the denominator. Over-dispersed Poisson regression models were fitted with hospital-specific random intercept, UV-C disinfection use for each month, baseline trend, and seasonality as explanatory variables. Hospitals without UV-C use were also included to the analysis as a nonequivalent concurrent control group.
Results
Among 128 VHA hospitals, 120 provided complete survey responses with 40 reporting implementations of UV-C systems. We identified 13 383 episodes of HO-GNR BSI and 24 141 378 BDOC. UV-C use was associated with a lower incidence rate of HO-GNR BSI (incidence rate ratio: 0.813; 95% confidence interval: .656–.969; P = .009). There was wide variability in the effect size of UV-C disinfection use among hospitals.
Conclusions
In this large quasi-experimental analysis within the VHA System, enhanced terminal room cleaning with UV-C disinfection was associated with an approximately 19% lower incidence of HO-GNR BSI, with wide variability in effectiveness among hospitals. Further studies are needed to identify the optimal implementation strategy to maximize the effectiveness of UV-C disinfection technology.
Details
- Title: Subtitle
- Effectiveness of Ultraviolet-C Disinfection on Hospital-Onset Gram-Negative Rod Bloodstream Infection: A Nationwide Stepped-Wedge Time-Series Analysis
- Creators
- Michihiko Goto - Iowa City VA Health Care SystemShinya Hasegawa - University of IowaErin C Balkenende - Iowa City VA Health Care SystemGosia S Clore - University of IowaNasia Safdar - University of Wisconsin–MadisonEli N Perencevich - Iowa City VA Health Care System
- Resource Type
- Journal article
- Publication Details
- Clinical infectious diseases, Vol.76(2), pp.291-298
- DOI
- 10.1093/cid/ciac776
- ISSN
- 1058-4838
- eISSN
- 1537-6591
- Grant note
- DOI: 10.13039/100000133, name: Agency for Healthcare Research and Quality, award: K08HS027472; DOI: 10.13039/100000030, name: US Centers for Disease Control and Prevention; name: US Department of Veterans Affairs Health Services Research & Development; DOI: 10.13039/100007181, name: Quality Enhancement Research Initiative, award: 15–269
- Language
- English
- Electronic publication date
- 09/17/2022
- Date published
- 01/15/2023
- Academic Unit
- Epidemiology; General Internal Medicine; Infectious Diseases; Internal Medicine
- Record Identifier
- 9984296992402771
Metrics
8 Record Views