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South African Teaching Hospital Achieves CRE Superbug Decrease Following Novel Environmental Hygiene Intervention

Wits University Donald Gordon Medical Centre announced novel study results indicating for the first time that Ultraviolet (UV) room decontamination technology paired with manual cleaning protocols decreased the transmission of Carbapenem-resistant Enterobacterales (CRE) by 23% in a hospital setting. The study results have been published in the March 2022 issue of The Journal of Hospital Infection.

The team of researchers at Wits Donald Gordon Medical Centre (WDGMC), the first private teaching hospital in South Africa, demonstrated the reduction in CRE transmission following a 26-month study and the sustained use of a UV room decontamination device (UVDI-360 Room Sanitizer, provided by US-based manufacturer UVDI and eHealthGroup Infection Control) as an adjunct to standard cleaning, including the use of bleach and quaternary ammonium disinfectants, across the 210-bed hospital. The intervention included broad UV room decontamination across five high-risk patient units (including critical care, oncology, transplant and gastrointestinal surgery rooms) during a 12-month period following a 12-month baseline and two-month, wash-in period.

“Our team’s study indicated that enhanced environmental hygiene utilizing UV room decontamination technology in the hospital can help prevent the transmission of Carbapenem-resistant Enterobacterales , an especially challenging set of multidrug-resistant organisms,” stated lead investigator Dr. Warren Lowman, Clinical Microbiologist & Infection Prevention and Control Specialist, Wits Donald Gordon Medical Centre.

The UV room decontamination device was implemented in three usage scenarios: terminal cleaning following patient discharge, terminal cleaning following patient transfer and, in a novel treatment, occupied rooms where the patient had an existing MDRO infection and was moved during device use. For each scenario, the UV device was operated with five-minute treatment cycles, the number of which varied per room setting and size.

CRE refers to a broader set of microorganisms that demonstrate resistance to at least one of the Carbapenem antibiotics.1 Recent published surveillance studies in South Africa have indicated a CRE infection crude mortality rate of nearly 40%.2

“This research underlines WDGMC’s steadfast commitment to patient and staff safety through the use of novel infection prevention protocols,” said Dr. Sue Tager, Chief Executive Officer, Wits Donald Gordon Medical Centre. “In the ongoing fight to prevent the transmission of superbugs, both in and beyond Africa, these results provide hope and concrete proof that effective solutions exist.”

About Wits Donald Gordon Medical Centre

Wits Donald Gordon Medical Centre (WDGMC) is the first and only private teaching hospital in South Africa. It was established in 2002 when the University of the Witwatersrand (Wits University) bought the Kenridge Hospital with a founding donation from the Donald Gordon Foundation. The institution was then renamed the Wits Donald Gordon Medical Centre. The 210-bed facility’s main specialties are transplant surgery, oncology (paediatric and adult), gastroenterology (medical and surgical), geriatric medicine, interventional radiology ophthalmology, ear-nose and throat, urology, nephrology, cardiology, women’s health and orthopaedics.

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1 https://www.cdc.gov/hai/organisms/cre/technical-info.html
2 Perovic O, Ismail H, Quan V, Bamford C, Nana T, Chibabhai V, Bhola P, Ramjathan P, Swe Swe-Han K, Wadula J, Whitelaw A, Smith M, Mbelle N, Singh-Moodley A; for GERMS-SA. Carbapenem-resistant Enterobacteriaceae in patients with bacteraemia at tertiary hospitals in South Africa, 2015 to 2018. Eur J Clin Microbiol Infect Dis. 2020 Jul;39(7):1287-1294. doi: 10.1007/s10096-020-03845-4. Epub 2020 Mar 2. PMID: 32124106.

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