Background Environmental disinfection is essential for reducing spread of healthcare associated infections (HAIs). Previous studies report conflicting results regarding the effects of ultraviolet light (UV) in reducing infections. This trial evaluated the impact of adding pulsed xenon UV (PX-UV) to standard terminal cleaning in reducing environmentally-implicated HAIs (eiHAIs). Methods The LAMP trial was conducted in 2 hospitals (15 inpatient wards) utilizing a cluster randomized controlled, double-blinded, interventional crossover trial comparing standard terminal cleaning followed by either pulsed xenon ultraviolet (PX-UV) disinfection (intervention arm) or sham disinfection (control arm). The primary outcome was incidence of eiHAIs from clinical microbiology tests on the 4th day of stay or later or within 3 days after discharge from the study unit. EiHAIs included clinical cultures positive for vancomycin-resistant enterococci (VRE), extended spectrum beta-lactamase-producing Escherichia coli or Klebsiella pneumonia, methicillin-resistant Staphylococcus aureus (MRSA), and Acinetobacter baumannii, and stool PCR positive for Clostridiodes difficile. Findings Between May 18, 2017 to Jan 7, 2020, 25,732 patients were included, with an incidence of 601 eiHAI and 180,954 patient days. There was no difference in the rate of eiHAIs in the intervention and sham arms (3.49 vs 3.17 infections/1000 patient days respectively, RR 1.10 CI (0.94, 1.29, p= 0.23)). Study results were similar when stratified by eiHAI type, hospital, and unit type. Conclusion The LAMP study failed to demonstrate an effect of the addition of UV light disinfection following terminal cleaning on reductions in rates of eiHAIs. Further investigations targeting hospital environmental surfaces and the role of no touch technology to reduce HAIs are needed.

中文翻译：

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使用脉冲氙气 (LAMP) 研究降低多重耐药菌 (MDRO) 的获得：一项整群随机对照、双盲、介入性交叉试验

背景 环境消毒对于减少医疗保健相关感染 (HAI) 的传播至关重要。先前的研究报告了关于紫外线 (UV) 在减少感染方面的作用的相互矛盾的结果。该试验评估了在标准码头清洁中添加脉冲氙紫外线 (PX-UV) 对减少环境相关 HAI (eiHAI) 的影响。方法 LAMP 试验在 2 家医院（15 个住院病房）进行，采用整群随机对照、双盲、干预性交叉试验，比较标准终端清洁后进行脉冲氙紫外线 (PX-UV) 消毒（干预组）或假消毒（控制臂）。主要结局是住院第 4 天或之后或出院后 3 天内临床微生物学测试的 eiHAIs 发生率。 EiHAIs 包括耐万古霉素肠球菌 (VRE)、产生广谱 β-内酰胺酶的大肠杆菌或肺炎克雷伯菌、耐甲氧西林金黄色葡萄球菌 (MRSA) 和鲍曼不动杆菌的临床培养物阳性，以及艰难梭菌的粪便 PCR 阳性。结果 2017 年 5 月 18 日至 2020 年 1 月 7 日期间，纳入了 25,732 名患者，其中 eiHAI 发生率为 601 例，患者日数为 180,954 例。干预组和假手术组的 eiHAIs 发生率没有差异（分别为 3.49 例感染/1000 例患者日和 3.17 例感染，RR 1.10 CI（0.94，1.29，p = 0.23））。按 eiHAI 类型、医院和单位类型分层时，研究结果相似。结论 LAMP 研究未能证明在终端清洁后添加紫外线消毒对降低 eiHAI 率有影响。需要针对医院环境表面以及非接触技术在减少医院感染方面的作用进行进一步研究。