Innovative New Technology Attempting to Reduce Hospital Associated Infections

Kenneth Trang

Introduction

Today, the modern American is more likely than ever before to visit a hospital, local doctor, or any healthcare provider. In fact, 83% of Americans (268 million) visited a healthcare professional in 2015 ((Summary Health Statistics: National Health Interview Survey. Centers for Disease Control and Prevention. 2015)). However, while hospitals do have general health benefits, visiting one exposes patients to a new risk: healthcare associated infections (HAIs), also known as nosocomial infections.

Today, these pose a major health issue to patients. With “approximately 4.5 HAIs for every 100 hospital admissions ((Scott, Douglas. The Direct Medical costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. Centers for Disease Control and Prevention. 2009))”, “there were an estimated 722,000 HAIs in U.S. acute care hospitals ((Magill, Shelley; Edwards, Jonathan. Multistate Point-Prevalence Survey of Health Care-Associated Infections. New England Journal of Medicine. 2014))” in 2011— 73,000 of which died.

Although in 2014 there have been significant measures taken to combat HAIs, there still exists large room for improvement, especially in improving the sanitation quality of the healthcare environment.

Background

Currently, there exist many traditional measures for healthcare environmental disinfection, the most direct way to deal with HAIs, ranging from the chemical sterilant glutaraldehyde to disposable disinfectant wipes. However, more revolutionary methods exist as well. Among these, disinfecting lights have shown strong promise as a potent solution to stronger, more efficient environmental disinfection.

The most common disinfection light, UV light functions by causing “damage to nucleic acids.” because the “absorption of UV energy forms new bonds between adjacent nucleotides, creating double bonds or dimers”, which “prevents replication and [causes the] inability to infect ((Introduction to UV Disinfection. TrojanUV. 2017.)).” However, the down side to this is that UV light damages the nucleic acid of both bacteria and humans; thus cannot be used in healthcare settings, and remains only a water disinfection technique.

HINS-Light EDS

So, instead of using UV light, Kenall Manufacturing has utilized a high-intensity narrow spectrum light environmental decontamination system (HINS- Light EDS) in their product Indigo-Clean. This product utilizes a “light fixture that installs easily into the ceiling of any room in the hospital” and can “safely, automatically and continuously kill harmful bacteria, 24/7, in the air and on hard and soft surfaces. ((A Light Fixture That Reduces Harmful Bacteria. Indigo Clean. 2016.)).”

Methodology

HINS-light EDS functions by emitting 405nm light waves which leave the light fixture and reflect off walls in order to reach all areas of the room [see photo below]. Unlike UV light waves, 405nm waves do not rely on gene destruction.  Instead, this light excites “naturally occurring molecules called porphyrins that exist [exclusively] inside bacteria”, consequently producing Reactive Oxygen Species (ROS) inside the cell, “inactivat[ing] the bacteria, [and] preventing it from re-populating the space ((A Light Fixture That Reduces Harmful Bacteria. Indigo Clean. 2016.)).”

Efficacy of Disinfection

In addition, opposed to manual disinfectants, HINS-light EDS works both automatically and continuously, which removes possible human error and allows for constant around the clock cleaning. Furthermore, it effectively kills airborne bacteria which other traditional disinfectants have trouble thoroughly doing so.

Most impressively, although still new to the market, clinical testing has discovered “Indigo-Clean can achieve a continuous 70+ percent reduction of harmful bacteria in the environment.”

At University of Strathclyde in Glasgow, research conducted has discovered that the “use of HINS-light EDS resulted in ?90% reduction of surface bacterial levels and when the room was occupied by an MRSA-infected burns patient, reductions between 56% and 86% were achieved, with the highest reduction (86%) measured following an extended period of HINS-light EDS operation. In an on/off intervention study, surface bacterial levels were reduced by 62% by HINS-light EDS treatment and returned to normal contamination levels two days after the system was switched off. These reductions of staphylococci, including Staphylococcus aureus and meticillin-resistant S. aureus, by HINS-light EDS treatment were greater than the reductions achieved by normal infection control and cleaning activities alone. The findings provide strong evidence that HINS-light EDS, used as a supplementary procedure, can make a significant contribution to bacterial decontamination in clinical environments ((Maclean, M.; Macgregor, JG. Environmental Decontamination of a Hospital Isolation Room Using High-intensity Narrow-spectrum Light. Journal of Hospital Infection. 2010)).”

Only one of many, the research conducted in Glasgow displays the impact HINS-light EDS has on reducing HAIs in a clinical setting. Though widespread use of HINS-light EDS has not yet come to fruition, understanding the beneficial impact they will have on reducing HAIs requires little effort.

Cost-Effectiveness

Although revolutionary in bacterial disinfection, HINS-light EDS also has beneficial cost-effectiveness because HAIs pose a costly financial burden on healthcare facilities due to the extension of care that they bring about. Research has evaluated the total annual cost of HAIs on the American healthcare system to range “from $35.7 billion to $45 billion ((Scott, Douglas. The Direct Medical costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. Centers for Disease Control and Prevention. 2009)).” Assuming that 70 percent of infections are preventable, the same study calculated that thwarting preventable HAIs will save “a high of $25.0 to $31.5 billion ((Scott, Douglas. The Direct Medical costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. Centers for Disease Control and Prevention. 2009))”. However, since researchers conducted this study before Indigo-Clean was released, the definition of preventable HAIs the study used did not yet include the preventable HAIs that HINS-light EDS has made possible to kill as well. Therefore, the economic savings predicted will more than likely exceed that predicted above, saving even more money for the American Healthcare System.      

The Future: Implementation in Hospitals

Due to its short life span on the market, Indigo-Clean remains integrated in only a few hospitals worldwide. However, a future with Indigo-Clean and other HINS-light EDSs approaches quickly. By utilizing the technology, the risk of HAIs will drastically fall, allowing for more lives saved, less stress to patients entering healthcare facilities, and a reduction in healthcare costs nationally.

Implementation beyond Healthcare practices

Ideally, HINS-light EDSs should function in areas beyond just healthcare. Though a world where every room contains HINS-light EDS is excessive, Indigo-Clean in day-cares, nurseries, and nursing homes (where illnesses cause some of the most damage) is more than doable. As high technology normalizes in everyday society, HINS-light EDS can replace traditional disinfectants and allow for a cleaner, safer, and less costly world.

Works Cited:

“A Light Fixture That Reduces Harmful Bacteria”. Indigo Clean. http://www.indigo-clean.com/what-is-it. 2016. Accessed 3 July, 2017.

"Introduction to UV Disinfection”. TrojanUV. http://www.trojanuv.com/uv-basics. Accessed 4 July, 2017.  

Maclean, M., S.j. Macgregor, J.g. Anderson, G.a. Woolsey, J.e. Coia, K. Hamilton, I. Taggart, S.b. Watson, B. Thakker, and G. Gettinby. "Environmental Decontamination of a Hospital Isolation Room Using High-intensity Narrow-spectrum Light." Journal of Hospital Infection 76.3. https://www.ncbi.nlm.nih.gov/pubmed/20864210. 2010. Accessed 2 July, 2017.  

Magill, Shelley S., Jonathan R. Edwards, "Multistate Point-Prevalence Survey of Health Care-Associated Infections." New England Journal of Medicine. 2014. https://www.cdc.gov/hai/surveillance/index.html. Accessed 3 July, 2017.

Scott, R. Douglass. The Direct Medical costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. Centers for Disease Control and Prevention. 2009 https://www.cdc.gov/hai/pdfs/hai/scottcostpaper.pdf.  Accessed 3 July 2017.

"Summary Health Statistics: National Health Interview Survey." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 2015. https://www.cdc.gov/nchs/fastats/physician-visits.htm. Accessed 9 July 2017.

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