Controlling HAIs in Healthcare Settings I NNOVATIVE P RODUCTS FOR H EALTHIER L IVING 575 Wentworth Street East, Unit 21, Oshawa, ON L1H 3V8 Telephone #:

Controlling HAIs in

Healthcare SettingsINNOVATIVE PRODUCTS

FOR HEALTHIER LIVING

575 Wentworth Street East, Unit 21, Oshawa, ON L1H 3V8 Telephone #: 905-723-9600/1-866-594-3648 Fax: 905-723-9610 www.marsbiomed.com

Hand hygiene Respiratory hygiene Personal protective equipment Appropriate use of antibiotics Reprocessing of reusable devices Sterilization of reusable instruments and devices High level disinfection of reusable instruments and devices Environmental cleaning

CDC. HAIs: Infection Prevention Checklist for Outpatient Settings: Minimum Expectations for Safe Care. July 2011. Available at http://www.cdc.gov/HAI/settings/outpatient/checklist/outpatient-care-checklist-observations.html.

Reducing Incidence of HAIs

How Can M.A.R.S. Help?

• Reduce the incidence of HAIs• Improve infection control score• Limit cross-contamination by airborne pathogens• Reduce readmission rates, specifically those related to HAIs• Reduce costs• Reduce treatment time and resources dedicated to HAIs• Reduce hospital staff sick leave• Improve patient perception of TUHS• Improve staff satisfaction with work environment

Air Sterilization Unit Silent Portable Powerful Sustainable Clinically Proven

tm

Controlling the airborne transmission of MRSA using UV light

Peder Bo NielsenMD MRCPath MSc

DLSHTM DipHICConsultant Microbiologist

Northwick Park Hospital

London, UK

MEDIXAIR Clinical Trial Proof of Performance

Goal: “intervene” in the environmental transmission cycle of MRSA

Method• Select 2 identical general medical ward rooms

o Test room

o Control room

• Both wards

o MRSA hot-spots

o Identical cleaning regimes

• At start, patients not colonized or infected with MRSA

• Swabs taken 3 times per week

o From patients: groin, nose, axilla

o In rooms : floor, curtains, bedrails, monitor screens, etc

• Duration: 3 months


Nielsen PB. Northwick Park Hospital clinical study. Presented at the

8th Congress of the International Federation of Infection Control, Oct 2008

Curtain 9%

Bed 9%

Floor 26%

Light 9%

UV ROOM W/MEDIXAIR

Curtain 22%

Bed 61%

Floor 74%

Light 30%

CONTROL ROOM

Patient 47%

Patient 0%

Swab Test for MRSA: % Positive Results




Curtain 22%

Bed 61%

Floor 74%

Light 30%

Curtain 9%

Bed 9%

Floor 26%

Light 9%

UV ROOM W/MEDIXAIR

CONTROL ROOM

Patient 47%

Patient 0%

Statistically significant evidence of

environmental decontamination


1. MRSA and other pathogens are present in the aerobiological environment

2. Pathogens collect in “hot-spots”

3. There is a correlation between these hot-spots of environmental contamination and the colonization of patients

4. For MRSA specifically, there is a correlation between the number of colonized patients and those who develop blood stream infections and ultimate mortality

5. Intervention in this cycle of transmission shows statistically significant and positive results

Conclusions from the Northwick Park Hospital trial:


The principles of the trial also apply for all traditional respiratory airborne infections: influenza, mumps, measles, and the common cold



2006 2007 2008Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3

All Hospital Wards 76 79 84 47 62 93 64 38 44 49 50

Acute Trauma Ward 6 6 4 0 8 12 4 1 1 0 0

• Beginning in July 2007, ten Medixair units were placed in the trauma ward, one in each side room and one in each bay

• During the study period, the hospital had an active protocol against CDI

• The protocol for the trauma ward was not distinct from the rest of the hospital except for the installation of the air sterilization units

Clostridium difficile Aerobiology and nosocomial transmission

Reduction in all wards 33%Reduction in acute trauma ward 80%


32nd National Congress of Indian Association of Medical Microbiologist Oct 2008


Clostridium difficile - surveillance data 2006 - 2008



32nd National Congress of Indian Association of Medical Microbiologist Oct 2008

MEDIXAIR In Vitro Testing Proof of Performance

UV

c P

ow

er

Level

Antimicrobial performance. Data on file, Medixair


UV

c P

ow

er

Level



UV

c P

ow

er

Level


Traditional Definition of Airborne Infection Airborne infection: contagious and/or respiratory infections transmitted predominantly

by aerosoles from already infected personso e.g, chicken pox, mumps, measles, the common cold, and influenza

New Definition Pathogens can remain viable in dry dust

o e.g, staphylococcus aureus, spores of clostridia, bacilli, and viruses

These pathogens can be easily distributed into the air by staff activities (e.g., bed making) and other vectors of air movement (e.g., air conditioning)

Schael KP. J Hosp Infect. 1991;18 Suppl A:451-9.Medical and microbiological problems arising from airborne infection in hospitals.

Airborne Infection and HAI

Hard and soft surface disinfection Hard and soft surface sterilization Disinfection of reusable instruments and devices Sterilization of reusable instruments and devices Air disinfection Air sterilization

Reducing Incidence of HAIs

0%

20%

40%

60%

80%

100%

0 1 2 3 4 5 6 7 8 9 10

UVc Light: Key Properties

UV light does not propagate well through the air

Distance from UVc Souce (cm)

UV

c P

ow

er

Level

Within 5 cm (2 inches) of the source, >70% of the power has dissipated

Data on file, Medixair

50 mm /2 inches

14,400 mW/cm2 3,750mW/cm2

UVc Light: Key Properties

Power Dissipation


Patented Technology

4 x 3,750mW/cm2 = 15,000mW/cm2

• 4 tubes built into an array - each tube reinforces the power from its neighbors

• Result: produce a power distribution of sufficient intensity to provide the basis for UVGI – Ultra Violet Germicidal Irradiation

Overlap UVc Lights

Overlapping Power

Configuration of MEDIXAIR Units


15,000mW cm-2

Minimum Power = 15,000 mW /cm2 + plus reflectance

Aluminium reflector box increases energy generated

Power Reflectance



01

23

45

67

89

1001

23

45

67

89

100

3000

6000

9000

12000

15000

18000

uWatts/cm2

x axisy axis

Power Distribution

15000-18000

12000-15000

9000-12000

Brandenburg UK Ltd.

Power distribution in cross section providing a high level of usable

power

Cross section through the unit



x

• airspeed = 0.3m /sec

fan

1.Traditionally air is blown air across the tubes…..

2.This does not allow sufficient exposure time for the bacteria to be killed

3.In Medixair a fan draws the air up the length of the tubes thus maximizing the exposure

4.Medixair hasA controlled airspeed

5… a fixed tube length

6.Therefore a residence time inside the unit of

7.Thus when combined with the power of

8.Medixair has minimum energy of

• L = 450mm

• t = 1.5seconds

= 15,000mW/cm2

22,500mW/cm2

Data on file Medixair

tmFAN

FOUR 254nm UVc emitters in an array

Slow speed fan to create maximum exposure to the UV

Enclosed reflective aluminium chamber

Design Principles

22,500 µW/cm2

Kills viruses and bacteria

Product Features• Mobile or wall mount

• Ease of use

• Portable – instant isolation wards

• Producing 25m3 of sterile air per hour

• Ease of service – lamp/filter change

• Whisper quiet <33dB

• Safety approved and CE marked

tm

Sustainable Infection Control

• Kills 99.999% of all viruses and bacteria• No ozone generation• No UVC exposure• Safe for use in close proximity to patients and healthcare

workers• Continuous and sustainable infection control• Ease of installation, low maintenance• Quiet (<33 dB)• Highly portable and compact

Benefits of MEDIXAIR Units

How Can M.A.R.S. Help?

• Reduce the incidence of HAIs• Improve infection control score• Limit cross-contamination by airborne pathogens• Reduce readmission rates, specifically those related to HAIs• Reduce costs• Reduce treatment time and resources dedicated to HAIs• Reduce hospital staff sick leave• Improve patient perception of TUHS• Improve staff satisfaction with work environment

575 Wentworth Street East, Unit 21

Oshawa, ON

L1H 3V8

1-866-594-3648

[email protected]

M.A.R.S. INNOVATIVE PRODUCTS

FOR HEALTHIER LIVING

Documents

Controlling HAIs in Healthcare Settings I NNOVATIVE P RODUCTS FOR H EALTHIER L IVING 575 Wentworth Street East, Unit 21, Oshawa, ON L1H 3V8 Telephone #: