Lowering the Acquisition of Multi-drug Resistant Organism (MDROs) with Pulsed-xenon (LAMP) Study: a cluster randomized controlled, double-blinded, interventional crossover trial
Recommended Citation
Dhar S, Jinadatha C, Kilgore PE, Henig O, Divine GW, Todter EN, Coppin JD, Carter MJ, Chopra T, Egbert S, Carling PC, and Kaye KS. Lowering the Acquisition of Multi-drug Resistant Organism (MDROs) with Pulsed-xenon (LAMP) Study: a cluster randomized controlled, double-blinded, interventional crossover trial. Clin Infect Dis 2024.
Document Type
Article
Publication Date
5-14-2024
Publication Title
Clinical infectious diseases
Abstract
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.
Medical Subject Headings
Humans; Cross-Over Studies; Cross Infection/prevention & control; Drug Resistance; Multiple; Bacterial; Female; Male; Disinfection/methods; Double-Blind Method; Middle Aged; Ultraviolet Rays; Aged; Klebsiella pneumoniae/drug effects; Adult; Vancomycin-Resistant Enterococci; Methicillin-Resistant Staphylococcus aureus; Acinetobacter baumannii/drug effects; environmental disinfection; hospital-acquired infection; infection control; multidrug-resistant organisms
PubMed ID
38743564
ePublication
ePub ahead of print
Volume
79
Issue
4
First Page
1024
Last Page
1030
