Photos of the TRU-D Total Room Disinfector courtesy of Lehigh Valley Hospital.
The latest weapon against hospital superbugs is a disinfecting robot that zaps germs with powerful beams of ultraviolet light. These high-tech machines resemble R2D2 of Star Wars fame, but they’re more like a terminator for deadly pathogens, such as MRSA and C. difficile.
Germ-zapping robots, such as the TRU-D Total Room Disinfector or the Xenex system, cost up to $100,000 apiece, but studies show that they’re up to 20 times more effective than the standard hospital sanitizing methods.
Superbugs are notoriously tough to eradicate with conventional techniques. For example, C. difficile spores can survive for up to five months in a hospital room—and are becoming increasingly resistant to such disinfectants as bleach and alcohol.
Every year, 1.7 million Americans are stricken with healthcare-acquired infections, which now rank as the fourth leading cause of death in the US.
More than 100 American medical centers have purchased the futuristic UV machines in the past year. An additional 24 US hospitals now use another type of robot made by Bioquell that blasts bacteria and viruses with concentrated hydrogen peroxide vapor.
Both types of robots provide an additional layer of protection for patients, says Terry Burger, MBA, RN, director of infection control & prevention at Lehigh Valley Health Network. “When we had isolated disease clusters in our burn unit and ICU, disinfecting the rooms with TRU-D halted both outbreaks.”
Lehigh Valley, which has more than 1,000 beds, now owns four TRU-D machines, which are used to disinfect the medical center’s operating rooms and patient rooms that were previously occupied by people with C. difficile.
“C. difficile is an extremely hardy microorganism that’s usually associated with antibiotic use and causes severe diarrhea or in some cases, a life-threatening condition called toxic megacolon,” says Burger. “C. difficile has replaced MRSA as the superbug everyone is worried about.”
Rates of this superbug, which kills 14,000 Americans a year, have hit an all-time high, according to the CDC.
When patients stay in hospital rooms decontaminated by the Bioquel robot, their risk for catching a multi-drug resistant infection dropped by 64 percent, compared to patients whose rooms were sanitized with standard techniques, according to a new study by Johns Hopkins infection-control researchers published in Clinical Infectious Diseases.
Rates of the superbug VRE (vancomycin-resistant enterococci)—gram-negative bacteria that are resistant to many common antibiotics and can cause pneumonia, bloodstream infection, abdominal abscesses, or heart valve infection—fell by an astonishing 80 percent when the vaporizing robot was used.
In the 30-month study, conducted in six high-risk units of a 994-bed hospital, the researchers compared rates of superbug infections in patients whose rooms were previously occupied by people known to be colonized with multi-drug resistant organisms, such as C. difficile, MRSA, and VRE.
Other research reports that on average, hospital crews only clean 34 percent of high-touch surfaces (such as bed rails, TV remotes, and bed tables) in a hospital room between patients. If the previous occupant of the room had a superbug infection, the next patient’s risk for catching one quadruples.
The Bioquell system involves two robots, using a tag team approach. The first sprays an unoccupied room with concentrated hydrogen peroxide vapor, a powerful disinfectant. Because the vapor can be harmful if it’s inhaled or swallowed, a second robot then sprays a solution that causes hydrogen peroxide to break down into harmless water and oxygen molecules.
“The robot is like a fogging machine and the vapor penetrates nooks and crannies that conventional cleaning can’t reach,” says Mark Rupp, MD, medical director, department of infection control and epidemiology at the University of Nebraska Medical Center.
“The downside of using hydrogen peroxide vapor is that the room has to be sealed off when the machine is in use, and the treatment takes two to three hours,” adds Dr. Rupp, who emphasizes that flashy technology is just one element of battling superbugs. Such basics as hand hygiene remain crucial.
Robots like TRU-D and Xenex work like strobe lights, bathing hospital rooms with intense pulses of ultraviolet light. The UV either kills germs outright or it scrambles their DNA so they can’t reproduce. Like the vaporizing machines, UV robots must be used in a vacant room.
UV treatment has proven particularly effective against C. difficile. In just 15 minutes, the Xenex eradicated 95 percent of C. difficile spores in contaminated patient rooms, compared to a 75 percent success rate when bleach (the standard disinfectant) was used, according to a 2012 study by MD Anderson Cancer Center.
A similar 2012 pilot study at Duke reported that the TRU-D robot reduces levels of VRE by 98 percent in hospital rooms previously occupied by patients infected with that superbug. For rooms used by patients with C. difficile, the UV treatment cut level of that microorganism by more than 90 percent.
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