Improving the cleaning and disinfection of high-touch surfaces is one of the core components of reducing healthcare-associated infections. The effectiveness of an enhanced protocol applying UV-C irradiation for terminal room disinfection between two successive patients was evaluated. Twenty high-touch surfaces in different critical areas were sampled according to ISO -, both immediately pre- and post-cleaning and disinfection standard operating protocol (SOP) and after UV-C disinfection ( sampling sites in each condition, in total). Dosimeters were applied at the sites to assess the dose emitted. A total of .% (/) of the sampling sites tested after SOP were positive, whereas only .% (/) were positive after UV-C. According to the national hygienic standards for health-care setting, .% (/) resulted in being non-compliant after SOP and only .% (/) were non-compliant after UV-C disinfection. Operation theaters was the setting that resulted in being less compliant with the standard limit ( colony-forming unit/ cm
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.
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 [
Although the dose measurement system used in our study (FastCheck Mediland, Taoyuan City , Taiwan) is semi-quantitative, it allowed us to detect if the dose reached adequate values for disinfection and to repeat the application when the value was not satisfactory. However, each dose value exceeded the expected value. This demonstrates that the device was positioned correctly in order to avoid shadow areas, although it was necessary to properly place furniture and equipment to improve the irradiation of all surfaces. In the study conducted by Wong et al., the R-D Rapid Disinfector system (Steriliz, Rochester, NY, USA) was used in a tertiary care hospital to evaluate the incremental benefit of UV-C disinfection in isolation rooms after the discharge of infected patients. The employed robot used four detached sensors to directly measure the UV-C light [
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 [