title: Clostridium difficile infections before and during use of ultraviolet disinfection.
abstract: We previously reported a significant decrease in hospital-acquired (HA) Clostridium difficile infection (CDI) coincident with the introduction of pulsed xenon ultraviolet light for room disinfection (UVD). The purpose of this study was to evaluate CDI cases in greater detail to understand the effect of UVD.
  
  
  
  CDI rates (HA and community acquired [CA]), CDI patient length of stay, room occupancy, and number of days between a CDI case in a room and an HA CDI case in the same room were studied for the first year of UVD compared with the 1-year period pre-UVD.
  
  
  
  Compared with pre-UVD, during UVD, HA CDI was 22% less (P = .06). There was a 70% decrease for the adult intensive care units (ICUs) (P < .001), where the percentage of room discharges with UVD was greater (P < .001). During UVD, CA CDI increased by 18%, and length of stay of all CDI cases was lower because of the greater proportion of CA CDI. No significant difference was found in days to HA CDI in rooms with a prior CDI occupant.
  
  
  
  These data suggest that UVD contributed to a reduction in ICU-acquired CDI where UVD was used for a larger proportion of discharges. Evaluation of UVD should include data for hospitalized CA CDI cases because these cases may impact the HA CDI rate.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, NY.
authors.forename: Aarathi
authors.initials: A
authors.lastname: Nagaraja
authors.affiliation: Tufts University School of Medicine, Division of Academic Affairs, Baystate Medical Center, Springfield, MA.
authors.forename: Paul
authors.initials: P
authors.lastname: Visintainer
authors.affiliation: Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, NY; Department of Infection Prevention and Control, Westchester Medical Center, Valhalla, NY.
authors.forename: Janet P
authors.initials: JP
authors.lastname: Haas
authors.affiliation: Department of Performance Management, Westchester Medical Center, Valhalla, NY.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Menz
authors.affiliation: Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, NY.
authors.forename: Gary P
authors.initials: GP
authors.lastname: Wormser
authors.affiliation: Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, NY. Electronic address: marisa_montecalvo@nymc.edu.
authors.forename: Marisa A
authors.initials: MA
authors.lastname: Montecalvo
mesh_terms: D016360:Clostridioides difficile / Q000528:radiation effects*; D003015:Clostridium Infections / Q000517:prevention & control*; D003428:Cross Infection / Q000517:prevention & control*; D004203:Disinfection / Q000379:methods*; D006801:Humans; D014466:Ultraviolet Rays; D014978:Xenon
chemical_list: D014978:Xenon
keywords: Clostridium difficile; Hospital acquired; Ultraviolet disinfection