Impact of a pulsed xenon disinfection system on hospital onset Clostridioides difficile infections in 48 hospitals over a 5-year period

Abstract

Abstract Background The role of the environment in hospital acquired infections is well established. We examined the impact on the infection rate for hospital onset Clostridioides difficile (HO-CDI) of an environmental hygiene intervention in 48 hospitals over a 5 year period using a pulsed xenon ultraviolet (PX-UV) disinfection system. Methods Utilization data was collected directly from the automated PX-UV system and uploaded in real time to a database. HO-CDI data was provided by each facility. Data was analyzed at the unit level to determine compliance to disinfection protocols. Final data set included 5 years of data aggregated to the facility level, resulting in a dataset of 48 hospitals and a date range of January 2015–December 2019. Negative binomial regression was used with an offset on patient days to convert infection count data and assess HO-CDI rates vs. intervention compliance rate, total successful disinfection cycles, and total rooms disinfected. The K-Nearest Neighbor (KNN) machine learning algorithm was used to compare intervention compliance and total intervention cycles to presence of infection. Results All regression models depict a statistically significant inverse association between the intervention and HO-CDI rates. The KNN model predicts the presence of infection (or whether an infection will be present or not) with greater than 98% accuracy when considering both intervention compliance and total intervention cycles. Conclusions The findings of this study indicate a strong inverse relationship between the utilization of the pulsed xenon intervention and HO-CDI rates.

Keywords

• C. difficile infection
• Pulsed xenon ultraviolet
• Healthcare associated infections
• Environmental interventions