The role of the environment, particularly of high-touch surfaces in the patients room (e.g., bedrails, over-bed tables, and call-buttons) and reusable care equipment that is moved between rooms, has been demonstrated to be fundamental in the transmission of healthcare-related infections. Together with standard precautions and the application of good practices in invasive procedures, environmental cleaning and disinfection represents one of the three pillars of infection risk prevention in healthcare settings.
In our study, we evaluated the efficacy of the UV-C treatment only on the reduction in mesophilic growth that mainly represents human contamination, but not on specific pathogens of interest; however, the reduction was very significant, suggesting that this system can easily eliminate pathogens as well. We have previously demonstrated that the adoption of an automated UV-C-disinfection robot in the enhancement of SOP in high-risk settings was successful in reducing pathogens on high-touch surfaces, improving the patients safety [
Our study has some limitations. Firstly, the non-homogeneous sampling for all of the settings, where a greater number of analyses were dedicated to the OTs rather than the ICUs or patient rooms: it was not always possible to proceed with the UV-C treatment at the patient discharge because trained personnel were limited and not always available. This problem underlines the importance of having dedicated personnel identifiable as that of the outsourced cleaning company. The use of new technologies could in fact be included in outsourcing contracts as an improvement action in the event of non-compliance in the cleaning service. These personnel could be adequately trained not only on the cleaning protocols to be adopted but also on infection control issues.
Hospitalized patients security in intensive care units should be ensured using protective devices, which may be evaluated for human security during UV-C emission at specific dosages and times. Considering the lack of literature data about these possible strategies, the use of a UV-C robot in the presence of persons still represents a critical issue that may be taken into account for the development of safe and effective technologies.
Among the appliable strategies for the improvement of cleaning and disinfection practices are the use of new materials and/or disinfectants, the training and audit of operators, and the use of new automated technologies, which are becoming increasingly important. In particular, no-touch disinfection technologies have the great advantage of not being dependent on the operator, ensuring process repeatability. Furthermore, their effectiveness has been demonstrated even on sites that are difficult to reach with manual intervention. Their use complements but does not replace ordinary cleaning and disinfection protocols. In the past few years, ultraviolet disinfection systems have been widely investigated and used as a way to improve standard cleaning protocols. Currently, ultraviolet devices are automated in order to guarantee process repeatability and reduce human errors. The application of UV devices as an addition to traditional environmental cleaning has become increasingly common due to their effectiveness in reducing the environmental microbial burden in a shorter time compared to other technologies using chemical products [