A Randomized Trial of a UV-C Device vs. an Electrostatic Sprayer as a Finishing Step in Healthcare Settings

Authors

Matthew Carlisle BS, William A. Rutala PhD, Jennifer L. Cadnum BS, Brigid M. Wilson PhD, Abhishek Deshpande MD, PhD, and Curtis J. Donskey MD

Download the full article here.

Overview

Dr. Curtis Donskey and his research group at the Louis Stokes Cleveland VA Medical Center conducted a randomized trial evaluating an UV-C decontamination device compared with Clorox Healthcare® Spore¹⁰ Defense™ Cleaner Disinfectant applied using the Clorox® Total 360® electrostatic sprayer as a finishing step. Standardized cultures were taken from high-touch surfaces and the floor after completion of manual cleaning and disinfection by environmental services personnel. Pathogens examined included: C. difficile, vancomycin-resistant Enterococcus (VRE), and methicillin-resistant Staphylococcus aureus (MRSA).

Key Findings

• Clorox Healthcare® Spore¹⁰ Defense™ Cleaner Disinfectant delivered via the Total 360® electrostatic sprayer and UV-C light were similarly effective in reducing residual contamination on floors and high-touch surfaces (P<0.01). 
• The Total 360® electrostatic sprayer required less total time until the room was ready to be occupied by another patient than the UV-C device (P=0.007) and the average operating time for the electrostatic sprayer was only 8.2 minutes.
• Personnel using the electrostatic sprayer device considered it relatively easy to use in comparison to the UV-C device.

Methods

After completion of manual cleaning and disinfection by the environmental services (EVS) personnel at the Cleveland VA Medical Center, 40 non-Clostridioides difficile infection (CDI) hospital rooms were randomized to either UV-C or Clorox Healthcare® Spore¹⁰ Defense™ Cleaner Disinfectant applied using the Clorox® Total 360® electrostatic system. Research personnel operated both the UV-C device and the Total 360® system. EVS personnel were not made aware of the study.

The UV-C device was operated for 5 minutes on each side of the bed and in the bathroom. The Clorox Healthcare® Spore¹⁰ Defense™ Cleaner Disinfectant applied using the Clorox® Total 360® electrostatic system was sprayed on all room and bathroom high-touch surfaces and the entire surface area of the floor. Surfaces were allowed to air dry. Enough disinfectant was applied to remain visibly wet for 2 minutes or longer. In alignment with manufacturers, instructions for use (IFU), the patient rooms were unoccupied during use.

Before and after use of the UV-C or Clorox Healthcare® Spore¹⁰ Defense™ Cleaner Disinfectant applied using the Clorox® Total 360® electrostatic system, standardized cultures were collected from high-touch surfaces (bedrail, bedside table, call button, telephone, toilet seat, and bathroom handrail) and from areas on the patient room floor and bathroom floor. Pathogens examined included C. difficile, vancomycin-resistant Enterococcus (VRE), and methicillin-resistant Staphylococcus aureus (MRSA).

Conclusions

This study demonstrated that high-touch surfaces and floors in patient rooms were frequently contaminated with healthcare-associated pathogens after manual cleaning and disinfection. Clorox Healthcare® Spore¹⁰ Defense™ Cleaner Disinfectant applied using the Clorox® Total 360® electrostatic sprayer provided an effective and efficient option as an adjunct finishing step compared to manual cleaning and disinfection and required less overall time until the room was ready to be occupied by another patient than the UV-C device.

Download a pdf version of this study here.

References

Carlisle, M., Rutala, W., Cadnum, J., Wilson, B., Deshpande, A., & Donskey, C. (2022). A randomized trial of ultraviolet-C (UV-C) light versus sodium hypochlorite delivered by an electrostatic sprayer for adjunctive decontamination of hospital rooms. Infection Control & Hospital Epidemiology, 1-4. doi:10.1017/ice.2022.132