title: Ultraviolet (UV)-reflective paint with ultraviolet germicidal irradiation (UVGI) improves decontamination of nosocomial bacteria on hospital room surfaces.
abstract: An ultraviolet germicidal irradiation (UVGI) generator (the TORCH, ClorDiSys Solutions, Inc.) was used to compare the disinfection of surface coupons (plastic from a bedrail, stainless steel, and chrome-plated light switch cover) in a hospital room with walls coated with ultraviolet (UV)-reflective paint (Lumacept) or standard paint. Each surface coupon was inoculated with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus faecalis (VRE), placed at 6 different sites within a hospital room coated with UV-reflective paint or standard paint, and treated by 10 min UVC exposure (UVC dose of 0-688 mJ/cm2between sites with standard paint and 0-553 mJ/cm2with UV-reflective paint) in 8 total trials. Aggregated MRSA concentrations on plastic bedrail surface coupons were reduced on average by 3.0 log10(1.8 log10Geometric Standard Deviation [GSD]) with standard paint and 4.3 log10(1.3 log10GSD) with UV-reflective paint (p = 0.0005) with no significant reduction differences between paints on stainless steel and chrome. Average VRE concentrations were reduced by ≥4.9 log10(<1.2 log10GSD) on all surface types with UV-reflective paint and ≤4.1 log10(<1.7 log10GSD) with standard paint (p < 0.05). At 5 aggregated sites directly exposed to UVC light, MRSA concentrations on average were reduced by 5.2 log10(1.4 log10GSD) with standard paint and 5.1 log10(1.2 log10GSD) with UV-reflective paint (p = 0.017) and VRE by 4.4 log10(1.4 log10GSD) with standard paint and 5.3 log10(1.1 log10GSD) with UV-reflective paint (p < 0.0001). At one indirectly exposed site on the opposite side of the hospital bed from the UVGI generator, MRSA concentrations on average were reduced by 1.3 log10(1.7 log10GSD) with standard paint and 4.7 log10(1.3 log10GSD) with UV-reflective paint (p < 0.0001) and VRE by 1.2 log10(1.5 log10GSD) with standard paint and 4.6 log10(1.1 log10GSD) with UV-reflective paint (p < 0.0001). Coating hospital room walls with UV-reflective paint enhanced UVGI disinfection of nosocomial bacteria on various surfaces compared to standard paint, particularly at a surface placement site indirectly exposed to UVC light.
authors.affiliation: a Department of Environmental , Agricultural & Occupational Health, University of Nebraska Medical Center , Omaha , Nebraska.
authors.forename: Katelyn C
authors.initials: KC
authors.lastname: Jelden
authors.affiliation: b Department of Environmental Health , Indiana University School of Public Health , Bloomington , Indiana.
authors.forename: Shawn G
authors.initials: SG
authors.lastname: Gibbs
authors.affiliation: c Department of Internal Medicine, Division of Infectious Diseases , University of Nebraska Medical Center , Omaha , Nebraska.
authors.forename: Philip W
authors.initials: PW
authors.lastname: Smith
authors.affiliation: c Department of Internal Medicine, Division of Infectious Diseases , University of Nebraska Medical Center , Omaha , Nebraska.
authors.forename: Angela L
authors.initials: AL
authors.lastname: Hewlett
authors.affiliation: d Department of Pathology and Microbiology, College of Medicine , University of Nebraska Medical Center , Omaha , Nebraska.|e Nebraska Public Health Laboratory , Omaha , Nebraska.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Iwen
authors.affiliation: f Department of Biostatistics ; University of Nebraska Medical Center , Omaha , Nebraska.
authors.forename: Kendra K
authors.initials: KK
authors.lastname: Schmid
authors.affiliation: a Department of Environmental , Agricultural & Occupational Health, University of Nebraska Medical Center , Omaha , Nebraska.
authors.forename: John J
authors.initials: JJ
authors.lastname: Lowe
mesh_terms: D015169:Colony Count, Microbial; D003428:Cross Infection / Q000517:prevention & control; D004203:Disinfection / Q000295:instrumentation / Q000379:methods*; D004866:Equipment Contamination; D055624:Methicillin-Resistant Staphylococcus aureus / Q000528:radiation effects*; D010150:Paint; D010362:Patients' Rooms; D014466:Ultraviolet Rays; D065507:Vancomycin-Resistant Enterococci / Q000528:radiation effects*
keywords: Environmental decontamination; UV-reflective paint; hospital room; surfaces; ultraviolet germicidal irradiation