Table 1.
Characteristics of the studies included in the meta-analysis
| References | Study design and country | Hospital type (No. of beds) | Study period and comparisons | Outcomes |
|---|---|---|---|---|
| Rock [22] | Cluster-randomised crossover trial USA |
Academic medical facility (1059) Cancer and solid organ transplant in-patient units |
Phase 1: 12 months and 15 days Washout: 5 weeks Phase 2: 12 months and 15 days UV-C + standard environmental cleaning versus standard environmental cleaning |
Vancomycin-resistant enterococcal infection (VRE): IRR 0.98 (95% CI; 0.78, 1.22) Clostridioides difficile (CD) infection: IRR 1.43 (95% CI; 0.93, 2.21) |
| McMullen [23] | Before–after USA |
Acute care community hospital (472) | Pre-intervention: 12 months Post-intervention: 21 months Pre-intervention: Standard daily manual disinfection protocol Intervention: manual disinfection protocol along with UV-C-based disinfection |
CD infection: IRR 1.34 (95% CI; 0.84, 2.15) |
| Anderson [24] | Cluster-randomised crossover trial USA |
Nine hospitals representing multiple types (tertiary, community, Veterans Affairs) |
Each strategy used at every study hospital for four consecutive 7-month study periods. Each study period consisted of a 1-month wash-in period followed by a 6-month period of data collection Three strategies for enhanced terminal disinfection tested against the standard terminal disinfection Comparison of interest for this review: UV-C + standard quaternary ammonium disinfectant (bleach for C. difficile) versus standard quaternary ammonium disinfectant (bleach for C. difficile) |
VRE infection: IRR 0.46 (95% CI; 0.26, 0.82) CD infection: IRR 0.96 (95% CI; 0.61, 1.52) Methicillin-resistant staphylococcal infection (MRSA): IRR 0.73 (95% CI; 0.51, 1.04) |
| Abosi [25] | Before–after USA |
Academic medical centre (811) | 9 months UV-C + sporicidal agent (bleach wipes) versus sporicidal agent (bleach wipes) |
CD infection: IRR 1.05 (95% CI; 0.70, 1.58) |
| Steele [26] | Before–after USA |
Academic children hospital (364) Paediatric haematology–oncology unit |
Pre-intervention: 42 months Post-intervention: 18 months Pre-intervention: manual disinfection protocol along with UV-C-based disinfection. Post-intervention: standard daily manual disinfection protocol |
CD infection: IRR 0.38 (95% CI; 0.24, 0.61) |
| Napolitano [27] | Before–after USA |
Community hospital (420) All patient rooms, hospital-wide |
6 months Continuously monitored and frequently UV-C treatment; incidence of infection before and after the intervention period compared |
CD infection: IRR 0.54 (95% CI; 0.03, 10.58) VRE infection: IRR 0.88 (95% CI; 0.05, 15.36) |
| Pegues [28] | Quasi-experimental with interrupted time series USA |
Academic tertiary care hospital (789) Haematology–oncology units |
Pre-intervention: 12 months Post-intervention: 12 months Incidence rates of C. difficile infection compared between the baseline and intervention period |
CD infection: IRR 0.75 (95% CI; 0.43, 1.30) |
| Goto [29] | Quasi-experimental USA |
Veterans’ Health Administration (VHA) hospitals | Pre-intervention: standard disinfection protocol Intervention: enhanced terminal room cleaning with ultraviolet C (UV-C) |
Hospital-onset Gram-negative rod infection: IRR 0.81 (95% CI: 0.66, 0.97) |
| Schaffzin [30] | Before–after USA |
Large paediatric referral facility (449) | Pre-intervention: standard disinfection protocol (hydrogen peroxide or bleach) Intervention: enhanced cleaning with ultraviolet C (UV-C) |
Hospital-onset Gram-negative rod infection: IRR 2.12 (95% CI: 0.32, 14.2) |