Cone Health System, Greensboro, NC

Cone Health recently announced a dramatic reduction in healthcare-acquired infection (HAIs) rates after implementing an infection prevention program which includes Xenex room disinfection systems.

Cone Health saw 0 MRSA cases in its intensive care units, and the total number of HAIs decreased 42% during the time period studied. HAIs caused by deadly superbugs such as MRSA, Clostridium difficile (C. diff) and Acinetobacter are the 4th leading cause of death in the United States.

Cone Health compared HAI data from the first and second quarters of 2010 to the same period in 2011. Using data from its MRSA screening program, an aggressive approach to HAI prevention was developed. Intervention methods included:

• A new “Step Up. Scrub Up.” campaign to renew the organization’s emphasis on consistent hand hygiene for everyone.
• Room-cleaning was supplemented with Xenex’s automated room disinfection system.
• MRSA surveillance testing was expanded from three units to patients in all ICUs, step-down units, high risk and pre-surgical areas.
• Additional infection prevention professionals were added and/or promoted to new roles.
• An electronic data mining system provided real-time data on whether a patient had MRSA so that measures could be taken to prevent spreading it.

Xenex Customer, Case Study #2

Cooley Dickinson Hospital, Northhampton, MA

In America’s hospitals, approximately 1 in 20 patients will contract a healthcare-associated infection (HAI). At Cooley Dickinson Hospital last year, 1 in 129 patients got an HAI. Now, those better odds of avoiding an infection at Cooley Dickinson have improved even further, as the hospital has documented a groundbreaking 82% drop in one type of infection, Clostridium difficile (C. diff).

The 82% drop in the incidence of C. diff occurred following adoption in January of room cleaning with portable UV light, an added step among many CDH already takes to eliminate infections, reports Levin. Cooley Dickinson Hospital was the first hospital in the Northeast to use the Xenex PX-UV Disinfection System.

Cooley Dickinson had a strong infection prevention program in place before adding the UV disinfection, and the program — which includes best-practice room cleaning and proper hand hygiene — was already lowering infection rates, Levin says. But a bug like C. diff requires a stronger weapon than the tools they had in place.

Specific rates of C. diff infections are not available, but the Centers for Disease Control and Prevention (CDC) tracked a nearly twofold increase in C. diff infections from 1996 to 2003. Two statewide studies in Oregon and Massachusetts found C. diff infections increasing at an even faster pace. The C. diff. pathogen can be found in the community and can be transmitted when a patient is in any care facility, including a hospital or a nursing home.

What makes C. diff especially virulent is that the organism can make spores, which are like seeds with a hard shell. Even strong hospital cleaning products can’t penetrate the shell, Levin said. Subsequently, C. diff can live in an environment for months. In one study, C. diff disease was found on 49% of surfaces in hospital rooms housing a patient with the infection and on 29% of surfaces in rooms with a patient who carries the germ but has no symptoms, according to a March 2011 report in Infection Control and Hospital Epidemiology.

C. diff is a bacterium that causes inflammation of the colon. According to the CDC, the elderly and people who have other illnesses or conditions requiring prolonged use of antibiotics are at greater risk of acquiring this disease.

Xenex Customer, Case Study #3

MD Anderson Cancer Center, Houston, TX

Hospital room floors, walls, tray tables, sinks, telephones and handrails can be sanctuaries for infection-causing bacteria and pathogens, but a study at The University of Texas MD Anderson Cancer Center has found that a device that pulses xenon ultraviolet light significantly reduces the number of bacteria  even after the housekeeping staff does its most thorough cleaning possible.

Published online in March 2011 in Infection Control and Hospital Epidemiology, the study found that the ultraviolet device reduced contamination found on 75 surfaces in 12 inpatient rooms and eliminated a type of bacteria known as VRE, or Vancomycin-Resistant Enterococci, an organism which is resistant to a wide range of antibiotics. The study was conducted in a number of patient rooms, including many in MD Anderson’s Stem Cell Transplant Unit where it is vital that the area stay disinfected and free of these multi-drug resistant organisms (MDROs) because of the immuno-compromised patients treated there.

For the study, MD Anderson incorporated the device into its bed turnover process that begins once a patient is discharged from the hospital. The housekeeper thoroughly cleans the room, wheels the device into the room and remotely turns it on after stepping into the hallway and closing the room door. When turned on, the unit’s small lamp emits flashes of xenon ultra-violet light like a strobe. The cleaning process takes less than 10 minutes, reaching surfaces that are difficult for a housekeeper to reach and where bacteria or pathogens can linger. Developed by Xenex Healthcare Services in Austin, the Xenex PX-UV device – which is about the size of a vacuum cleaner – can be moved to disinfect the immediate patient bed area, the adjoining bathroom and guest sitting area.

Outside laboratory specialists took surface swabs before the housekeeper cleaned the room, after the room was scrubbed down and then again after using the device. With more than 230 samples taken, researchers found the device further reduced contamination even after a thorough room cleaning by the housekeeping staff. According to the study, researchers “found significantly lower heterotrophic plate counts (HPC) and VRE” after using the device.

Roy F. Chemaly, M.D., M.P.H., associate professor in the Department of Infectious Diseases, Infection Control and Employee Health, led the study, and said the device can help reduce the number of bacteria – VRE in this study – in patient rooms which may help prevent the spread of VRE to an incoming patient.

Chemaly said that in addition to a study looking at infection rates among patients whose rooms have been disinfected with the Xenex device, future research may explore use of the device in the Critical Care Unit or on floors where there may be sudden outbreaks of a particular infection.