Table 5.
Clinical trials using ultraviolet or hydrogen peroxide devices for terminal room disinfection to reduce health care–associated infections
| Author, Year | Design | Setting | Modality Tested | Pathogens | Outcome (HAI) | Assessment of HH Compliance | Assessment of EVS Cleaning | Other HAI Prevention Initiatives |
|---|---|---|---|---|---|---|---|---|
| Boyce, 2008 | Before-after (CDI high incidence wards) | Community hospital | HPV (Bioquell) | CDI | 2.28–1.28 per 1000 Pt-days (P = .047) | No | No | NA |
| Cooper, 2011 | Before-after (2 cycles) | Hospitals | HPV (NS) | CDI | Decreased cases (incidence NS) | No | No | Yes |
| Levin, 2013 | Before-after | Community hospital | UV-PX, Xenex | CDI | 9.46–4.45 per 10,000 Pt-days (P = .01) | No | No | Yes |
| Passaretti, 2013 | Prospective cohort (comparison of MDRO acquisition; admitted to rooms with or without HPV decontamination) | Academic center | HPV (Bioquell) | MRSA VRE CDI MDRO-all |
2.3–1.2 (P = .30) 7.2–2.4 (P<.01) 2.4–1.0 (P=.19) 12.6–6.2 per 1000 Pt-days (P<.01) |
No | No | No |
| Manian, 2013 | Before-after | Community hospital | HPV (Bioquell) | CDI | 0.88–0.55 cases per 1000 Pt-days (P<.0001) | Yes | No | No |
| Hass, 2014 | Before-after | Academic center | UV-PX, Xenex | CDI MRSA VRE MDRO-GNB Total |
0.79–0.65 per 1000 Pt-days (P = .02) 0.45–0.33 per 1000 Pt-days (P=.007) 0.90–0.73 per 1000 Pt-days (P = .002) 0.52–0.42 per 1000 Pt-days (P = .04) 2.67–2.14 per 1000 Pt-days (P<.001) |
No | Yes | Yes |
| Mitchell, 2014 | Before-after | Acute care hospital | Dry hydrogen peroxide vapor (Nocospray, New Work City, NY) | MRSA (colonization and infection) | 9.0–5.3 per 10,000 Pt-days (P<.001) | Yes | No | Yes |
| Miller, 2015 | Before-after | Urban hospital | UV-PX, Xenex | CDI | 23.3–8.3 per 10,000 Pt-days (P = .02) | No | No | Yes |
| Nagaraja, 2015 | Before-after | Academic center | UV-PX, Xenex | CDI | 1.06–0.83 per 1000 Pt-days (P = .06) | No | No | No |
| Pegues, 2015 | Before-after | Academic center | UV-C (Optimum) | CDI | 30.34–22.85 per 10,000 Pt-days (IRR = 0.49, 95% CI 0.26–0.94, P = .03) | Yes | Yes | No |
| Anderson, 2015 | RCT | 9 Hospitals | UV-C (Tru-D) | MRSA, VRE, CDI | 51.3–33.9 per 10,000 Pt-days (P = .036) | Yes | Yes | No |
Abbreviations: CDI, Clostridium difficile infections; CI, confidence interval; EVS, environmental service; GNB, gram-negative bacteria; HH, hand hygiene; IRR, incidence rate ratio; MDRO, multidrug-resistant organism; NA, not applicable; NS, not stated; Pt, patient; RCT, randomized controlled trial; UV-PX, ultraviolet light, pulsed xenon device.
Adapted from Weber DJ, Rutala WA, Anderson DJ, et al. Effectiveness of UV devices and hydrogen peroxide systems for terminal room decontamination: focus on clinical trials. Am J Infect Control 2016;44(5 Suppl):e77–84.