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How can we reduce nosocomial infections?

As the world’s governments roll out their plans to prevent the spread of COVID-19 (coronavirus), it is only natural to reflect on our ability to protect ourselves from the various viruses and infections to which we may be exposed. In a period where public gatherings are being banned around the world, people are asked to limit their international travel, and most sports leagues in North America and Europe have suspended their seasons, what can hospitals do? What steps are being taken to ensure that those already debilitated by another disease do not come down with a new virus or infection? How do we protect hospital staff?

Biomed Health
Suzie Dufour
Date  March 2020

Nosocomial infections are defined as infections acquired during treatment at a healthcare facility. These hospital-acquired infections are a major concern for healthcare institutions at any time, and all the more so as the world grapples with a pandemic.

Nosocomial infections are caused mainly by resistant bacteria such as methicillin-resistant (MRSA), vancomycin-resistant enterococcus (VRE), and Clostridium difficile (C. difficile) bacteria. The presence of these bacteria varies depending on region, type and size of facility, and type of care provided. When such multidrug-resistant (MDR) organisms are introduced into the hospital environment, the transmission and persistence of the strain is influenced by factors such as the presence of susceptible patients, the use of antibiotics, and the number of patients already infected with MDR bacteria. (https://www.inspq.qc.ca/infections-nosocomiales) (in French)

Since MDR bacteria are not susceptible to most available antimicrobial agents, having access to and rigorously implementing effective preventive measures is fundamental to protecting patients and healthcare workers. But for such measures to be effective, hospital staff have to apply them meticulously. They must wash their hands properly, use appropriate equipment (mask, gloves), and thoroughly disinfect surfaces.

Canada has had a nosocomial infection surveillance program since 1994. The Canadian Nosocomial Infection Surveillance Program (CNISP) is responsible for collecting data on nosocomial infections and quickly identifying and correcting problematic trends. It helps Canadian hospitals identify the greatest risks and address them as quickly as possible.

In addition to having disastrous human consequences (including death), the massive spread of nosocomial infections also has logistical and financial consequences. For example, when a strain of C. difficile is present, the number of people needing treatment goes up, as does the length of their hospital stay. This fills up beds and makes it difficult to admit others who need care. In a pandemic, a hospital that is not careful about cleaning treatment surfaces and sees people contracting COVID-19 will quickly become overwhelmed and unable to provide care to all those who need it.

Obviously, this all comes at a cost. In 2014 the Canadian Patient Safety Institute estimated the average cost per infected MRSA patient at C$12,216 . That would be equal to C$14,519.10 in 2020. The more infections spread, the harder and more expensive it is to contain them.

To optimize safety, hospitals are looking to technology as a possible way to eliminate potentially dangerous biological agents from healthcare surfaces. One such solution is to use UV LED lamps. Ultraviolet light kills or alters the DNA of microorganisms, thereby preventing them from spreading and infecting people.

In 2014 Centre Hospitalier Universitaire de Québec studied the possibility of acquiring a robot equipped with a UVC radiation lamp to clean its treatment surfaces. After a rigorous study (https://www.chudequebec.ca/getmedia/2f06ce09-2e7e-4877-b515-f7a57d34dfe5/RAP_11_14_Robot_V2.aspx, in French), the hospital ultimately opted not to purchase this device despite the fact that its literature review determined that the use of such lamps would reduce the number of bacteria present on surfaces. It cited the lack of literature proving that the increased efficiency would actually have a significant impact on the risk of nosocomial infections. The hospital decided that the burden of implementing UV LED lamps (human resources, procedural and financial costs) was too high to justify the investment.

What’s more, not many lamps are available, and those that are in use are primarily used to treat water. To give hospitals access to such a device at a reasonable price and help them in their fight against nosocomial infections, developing a safe and viable solution using UV-C rays is worth looking into.

At a time when public health is under threat, we should even be asking ourselves whether such technology could not also be used outside hospitals. Schools and airports could be prime candidates, given the high number of people they serve. Portable devices could be another weapon in the arsenal of those in charge of keeping such places clean.

Far UV-C, which presents certain advantages over UV-C, could also be used. For example, far UV is faster and more effective than UV-C and has a higher absorption rate in bacteria and viruses. It is not harmful to humans since it does not penetrate the eyes or skin.

At INO, it’s our mission to help companies develop viable solutions to important problems such as nosocomial infections. Our structured approach allows us to help our clients bring mature and safe solutions to market as quickly as possible. Our experience with UV rays and our world-leading experts make us an ideal partner in the development of such devices.

If you are interested in learning more about UV rays, nosocomial infections, or any other issues related to the biomedical industry, feel free to contact me.

About the author

Suzie Dufour

Solutions Manager

Solutions Manager since 2019, and part of the INO team since 2015, Suzie has strong expertise in biophotonic, neurophotonic, ophthalmology, biomedical imaging and in vivo experimentation.  As a researcher, she participated in projects related to ophthalmic laser surgery, ophthalmic imaging and sensing, and printable photonics.  She’s the author and co-author of more than 20 peer reviewed journal publications and she’s participated in more than 30 conference scientific presentations.

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