Clostridium difficile infections before and during use of ultraviolet disinfection

Autor(es): Aarathi Nagaraja MD a , Paul Visintainer PhD , Janet P. Haas PhD , Jonathan Menz MBA , Gary P. Wormser MD , Marisa A. Montecalvo MD

Background: 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.

Methods: 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.

Results: Compared with pre-UVD, during UVD, HA CDI was 22% less (P ¼ .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.

Conclusion: 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.