Evaluation of an automated ultraviolet radiation device for decontamination of Clostridium difficile and other healthcare-associated pathogens in hospital rooms.
BACKGROUND
Environmental surfaces play an important role in transmission of healthcare-associated pathogens. There is a need for new disinfection methods that are effective against Clostridium difficile spores, but also safe, rapid, and automated.


METHODS
The Tru-D Rapid Room Disinfection device is a mobile, fully-automated room decontamination technology that utilizes ultraviolet-C irradiation to kill pathogens. We examined the efficacy of environmental disinfection using the Tru-D device in the laboratory and in rooms of hospitalized patients. Cultures for C. difficile, methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus (VRE) were collected from commonly touched surfaces before and after use of Tru-D.


RESULTS
On inoculated surfaces, application of Tru-D at a reflected dose of 22,000 microWs/cm(2) for approximately 45 minutes consistently reduced recovery of C. difficile spores and MRSA by >2-3 log10 colony forming units (CFU)/cm2 and of VRE by >3-4 log10 CFU/cm(2). Similar killing of MRSA and VRE was achieved in approximately 20 minutes at a reflected dose of 12,000 microWs/cm(2), but killing of C. difficile spores was reduced. Disinfection of hospital rooms with Tru-D reduced the frequency of positive MRSA and VRE cultures by 93% and of C. difficile cultures by 80%. After routine hospital cleaning of the rooms of MRSA carriers, 18% of sites under the edges of bedside tables (i.e., a frequently touched site not easily amenable to manual application of disinfectant) were contaminated with MRSA, versus 0% after Tru-D (P < 0.001). The system required <5 minutes to set up and did not require continuous monitoring.


CONCLUSIONS
The Tru-D Rapid Room Disinfection device is a novel, automated, and efficient environmental disinfection technology that significantly reduces C. difficile, VRE and MRSA contamination on commonly touched hospital surfaces.
Nerandzic
Michelle M
MM
Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, Ohio, USA.
Cadnum
Jennifer L
JL
Pultz
Michael J
MJ
Donskey
Curtis J
CJ
D001331:Automation; D016360:Clostridioides difficile / Q000187:drug effects* / Q000302:isolation & purification; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control; D003666:Decontamination / Q000379:methods*; D016983:Enterococcus / Q000187:drug effects* / Q000302:isolation & purification; D004783:Environmental Microbiology; D006761:Hospitals; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D050296:Microbial Viability / Q000528:radiation effects; D014466:Ultraviolet Rays