title: Impact of pulsed xenon ultraviolet light on hospital-acquired infection rates in a community hospital.
abstract: BACKGROUND
  The role of contaminated environments in the spread of hospital-associated infections has been well documented. This study reports the impact of a pulsed xenon ultraviolet no-touch disinfection system on infection rates in a community care facility.
  
  
  METHODS
  This study was conducted in a community hospital in Southern Florida. Beginning November 2012, a pulsed xenon ultraviolet disinfection system was implemented as an adjunct to traditional cleaning methods on discharge of select rooms. The technology uses a xenon flashlamp to generate germicidal light that damages the DNA of organisms in the hospital environment. The device was implemented in the intensive care unit (ICU), with a goal of using the pulsed xenon ultraviolet system for disinfecting all discharges and transfers after standard cleaning and prior to occupation of the room by the next patient. For all non-ICU discharges and transfers, the pulsed xenon ultraviolet system was only used for Clostridium difficile rooms. Infection data were collected for methicillin-resistant Staphylococcus aureus, C difficile, and vancomycin-resistant Enterococci (VRE). The intervention period was compared with baseline using a 2-sample Wilcoxon rank-sum test.
  
  
  RESULTS
  In non-ICU areas, a significant reduction was found for C difficile. There was a nonsignificant decrease in VRE and a significant increase in methicillin-resistant S aureus. In the ICU, all infections were reduced, but only VRE was significant. This may be because of the increased role that environment plays in the transmission of this pathogen. Overall, there were 36 fewer infections in the whole facility and 16 fewer infections in the ICU during the intervention period than would have been expected based on baseline data.
  
  
  CONCLUSIONS
  Implementation of pulsed xenon ultraviolet disinfection is associated with significant decreases in facility-wide and ICU infection rates. These outcomes suggest that enhanced environmental disinfection plays a role in the risk mitigation of hospital-acquired infections.
authors.affiliation: University of Central Florida College of Medicine, Orlando, FL.
authors.forename: Pedro G
authors.initials: PG
authors.lastname: Vianna
authors.affiliation: Xenex Disinfection Services, LLC, San Antonio, TX.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Dale
authors.affiliation: Xenex Disinfection Services, LLC, San Antonio, TX. Electronic address: sarah.simmons@xenex.com.
authors.forename: Sarah
authors.initials: S
authors.lastname: Simmons
authors.affiliation: Xenex Disinfection Services, LLC, San Antonio, TX.
authors.forename: Mark
authors.initials: M
authors.lastname: Stibich
authors.affiliation: University of Central Florida College of Medicine, Orlando, FL; Orlando Health, Longwood, FL.
authors.forename: Carmelo M
authors.initials: CM
authors.lastname: Licitra
mesh_terms: D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control*; D004203:Disinfection / Q000379:methods*; D005431:Florida / Q000453:epidemiology; D006764:Hospitals, Community; D006801:Humans; D015995:Prevalence; D014466:Ultraviolet Rays; D014978:Xenon
chemical_list: D014978:Xenon
keywords: Clostridium difficile infection; Environmental hygiene; Hospital-acquired infection; Intensive care unit; Methicillin-resistant Staphylococcus aureus; No-touch disinfection; Pulsed xenon ultraviolet disinfection