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 [
These organisms belong to a group of carbapenem-resistant, gram-negative bacteria of national and international concern because of their implication as an emerging cause of severe healthcare-associated infections. In , the World Health Organization published the first global guidelines for the prevention and control of CRE-CRAB-CRPsA in healthcare facilities, which include environmental cleaning and disinfection as a key recommendation.
The UV-C disinfection robot (Mediland Enterprise Corporation, Taoyuan City, Taiwan) uses amalgam lamps (UV lamp NNI / XL Niederdruck VUV Strahler) and protective reflector technology to generate high-energy, broad-spectrum ultraviolet light (UV-C nm). The manufacturer of the lamps declares in the technical data sheet that the lamps have a filter that blocks radiation between nm, eliminating the possibility of producing ozone as a by-product of UV-C radiation. The UV-C device uses min disinfection cycles and multiple positions with minimal distances from high-touch surfaces. Due to the use of high-intensity UV-C radiation, the device must operate in unoccupied rooms. There are multi-motion sensors that shut off the device if any movement is detected inside the room being disinfected or if the door is accidentally opened. When the robot operates in accordance with these procedures, the manufacturer declares that the amalgam lamps produce no ozone gas and leave no toxic residues.
In this hospital, cleaning services were outsourced. According to the contract and the cleaning and disinfection standard operating protocol (SOP), during terminal disinfection, the housekeeping staff applied a chlorine-based detergent, Antisapril Detergent %, Angelini, followed by a chlorine-based disinfectant (Deornet Clor (COSÌ, Forlì-Cesena, Italy), active chlorine mgr/L) on furniture surfaces and electromedical devices.
In that regard, the World Health Organization has reiterated the importance of using this type of disinfection after the adoption of the standard protocol for sanitizing hospital rooms, but, during the COVID- pandemic, the use of UVC radiation was also proposed immediately after the patient has been discharged in order to reduce the risk of the cleaning staff being infected, who can then safely apply the standard protocol [