title: Effect of Variation in Test Methods on Performance of Ultraviolet-C Radiation Room Decontamination.
abstract: OBJECTIVE
  To determine the effect of variation in test methods on performance of an ultraviolet-C (UV-C) room decontamination device.
  
  
  METHODS
  Laboratory evaluation.
  
  
  METHODS
  We compared the efficacy of 2 UV-C room decontamination devices with low pressure mercury gas bulbs. For 1 of the devices, we evaluated the effect of variation in spreading of the inoculum, carrier orientation relative to the device, type of organic load, type of carrier, height of carrier, and uninterrupted versus interrupted exposures on measured UV-C killing of methicillin-resistant Staphylococcus aureus and Clostridium difficile spores.
  
  
  RESULTS
  The 2 UV-C room decontamination devices achieved similar log10 colony-forming unit reductions in the pathogens with exposure times ranging from 5 to 40 minutes. On steel carriers, spreading of the inoculum over a larger surface area significantly enhanced killing of both pathogens, such that a 10-minute exposure on a 22-mm2 disk resulted in greater than 2 log reduction in C. difficile spores. Orientation of carriers in parallel rather than perpendicular with the UV-C lamps significantly enhanced killing of both pathogens. Different types of organic load also significantly affected measured organism reductions, whereas type of carrier, variation in carrier height, and interrupted exposure cycles did not.
  
  
  CONCLUSIONS
  Variation in test methods can significantly impact measured reductions in pathogens by UV-C devices during experimental testing. Our findings highlight the need for standardized laboratory methods for testing the efficacy of UV-C devices and for evaluations of the efficacy of short UV-C exposure times in real-world settings.
authors.affiliation: 1Research Service,Cleveland Veterans Affairs Medical Center,Cleveland,Ohio.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Cadnum
authors.affiliation: 1Research Service,Cleveland Veterans Affairs Medical Center,Cleveland,Ohio.
authors.forename: Myreen E
authors.initials: ME
authors.lastname: Tomas
authors.affiliation: 1Research Service,Cleveland Veterans Affairs Medical Center,Cleveland,Ohio.
authors.forename: Thriveen
authors.initials: T
authors.lastname: Sankar
authors.affiliation: 1Research Service,Cleveland Veterans Affairs Medical Center,Cleveland,Ohio.
authors.forename: Annette
authors.initials: A
authors.lastname: Jencson
authors.affiliation: 2Case Western Reserve University School of Medicine,Cleveland,Ohio.
authors.forename: J Itty
authors.initials: JI
authors.lastname: Mathew
authors.affiliation: 2Case Western Reserve University School of Medicine,Cleveland,Ohio.
authors.forename: Sirisha
authors.initials: S
authors.lastname: Kundrapu
authors.affiliation: 2Case Western Reserve University School of Medicine,Cleveland,Ohio.
authors.forename: Curtis J
authors.initials: CJ
authors.lastname: Donskey
mesh_terms: D016360:Clostridioides difficile / Q000528:radiation effects*; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000517:prevention & control*; D003666:Decontamination / Q000379:methods*; D004761:Enterocolitis, Pseudomembranous / Q000517:prevention & control*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000528:radiation effects*; D010362:Patients' Rooms; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013997:Time Factors; D014466:Ultraviolet Rays