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Effectiveness of pulsed xenon ultraviolet disinfection for Clostridioides (Clostridium) difficile surface contamination in a Japanese hospital

  • Hiroki Kitagawa
    Correspondence
    Address correspondence to Hiroki Kitagawa, MD, Department of Surgery, Graduate School of Biochemical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima 734-8551, Japan.
    Affiliations
    Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan

    Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan

    Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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  • Minako Mori
    Affiliations
    Department of Infection Control, Hiroshima University Hospital, Hiroshima, Japan

    Department of Nursing, Hiroshima University Hospital, Hiroshima, Japan
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  • Toshinori Hara
    Affiliations
    Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan

    Section of Clinical Laboratory, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
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  • Seiya Kashiyama
    Affiliations
    Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan

    Section of Clinical Laboratory, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
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  • Norifumi Shigemoto
    Affiliations
    Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan

    Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan

    Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Translational Research Center, Hiroshima University, Hiroshima, Japan
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  • Hiroki Ohge
    Affiliations
    Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan

    Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
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      Highlights

      • We evaluated the efficacy of manual bleach cleaning vs PX-UV for C. difficile.
      • Bleach cleaning and PX-UV disinfection reduced C. difficile-positive samples.
      • Bleach cleaning and PX-UV disinfection reduced C. difficile CFU counts.
      • PX-UV and nonbleach cleaning effectively reduces C. difficile contamination.

      Background

      Contaminated environmental surfaces are important sources of transmission for healthcare-associated pathogens, including Clostridioides (Clostridium) difficile. The effectiveness of manual bleach cleaning and pulsed xenon ultraviolet (PX-UV) disinfection on C. difficile contamination of hospital room high-touch surfaces in Japan was evaluated.

      Methods

      The environmental surfaces of 20 C. difficile infection (CDI) isolation rooms were sampled immediately after CDI patients were discharged or transferred. High-touch surfaces were sampled before and after either bleach cleaning or PX-UV disinfection in addition to nonbleach cleaning. Changes in the number of C. difficile-positive samples and bacterial counts for each cleaning method were assessed.

      Results

      Overall, 286 samples were collected (bleach cleaning, 144 samples; PX-UV disinfection, 142 samples). Before cleaning, the positive rates of C. difficile were 27.8% and 31.0% in bleach cleaning and PX-UV disinfection, respectively. Both bleach cleaning and PX-UV disinfection significantly reduced overall C. difficile-positive samples (P = .018 and P = .002, respectively) and C. difficile colony-forming unit counts (P = .002 and P = .001, respectively).

      Conclusions

      PX-UV disinfection in addition to manual nonbleach cleaning effectively reduces C. difficile contamination from high-touch surfaces. Further studies are warranted to evaluate the effect of PX-UV disinfection on CDI rates in Japanese hospitals.

      Key Words

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