Transcript Slide 1

Controlling HAIs
in Healthcare
Settings
INNOVATIVE 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
Reducing Incidence of HAIs
 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.
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
tm
Air Sterilization Unit

Silent

Portable

Powerful

Sustainable
Clinically Proven

MEDIXAIR Clinical Trial
Proof of Performance
Controlling the airborne transmission
of MRSA using UV light
Peder Bo Nielsen
MD MRCPath MSc
DLSHTM DipHIC
Consultant 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
MEDIXAIR Clinical Trial
Proof of Performance
CONTROL ROOM
Light
30%
UV ROOM W/MEDIXAIR
Light
9%
Curtain
22%
Patient
47%
Patient
0%
Bed 61%
Floor 74%
Curtain
9%
Bed 9%
Floor 26%
Swab Test for MRSA: % Positive Results
Nielsen PB. Northwick Park Hospital clinical study. Presented at the
8th
Congress of the International Federation of Infection Control, Oct 2008
MEDIXAIR Clinical Trial
Proof of Performance
CONTROL ROOM
Light
30%
Curtain
22%
Patient
47%
UV ROOM W/MEDIXAIR
Light
9%
Patient
0%
Bed 61%
Floor 74%
Curtain
9%
Bed 9%
Floor 26%
Statistically significant
evidence of environmental
decontamination
MEDIXAIR Clinical Trial
Proof of Performance
Conclusions from the Northwick Park Hospital trial:
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
The principles of the trial also apply for all traditional
respiratory airborne infections: influenza, mumps, measles,
and the common cold
Nielsen PB. Northwick Park Hospital clinical study. Presented at the
8th
Congress of the International Federation of Infection Control, Oct 2008
MEDIXAIR Clinical Trial
Proof of Performance
Clostridium difficile
Aerobiology and nosocomial transmission
• 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
2006
2007
2008
Q1
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
Reduction in all wards 33%
Reduction in acute trauma ward 80%
Nielsen PB. Northwick Park Hospital clinical study. Presented at the
32nd
National Congress of Indian Association of Medical Microbiologist Oct 2008
MEDIXAIR Clinical Trial
Proof of Performance
Clostridium difficile - surveillance data 2006 - 2008
Nielsen PB. Northwick Park Hospital clinical study. Presented at the
32nd
National Congress of Indian Association of Medical Microbiologist Oct 2008
MEDIXAIR In Vitro Testing
UVc Power Level
Proof of Performance
Antimicrobial performance. Data on file, Medixair
MEDIXAIR In Vitro Testing
UVc Power Level
Proof of Performance
Antimicrobial performance. Data on file, Medixair
MEDIXAIR In Vitro Testing
UVc Power Level
Proof of Performance
Antimicrobial performance. Data on file, Medixair
Airborne Infection and HAI
Traditional Definition of Airborne Infection

Airborne infection: contagious and/or respiratory infections transmitted predominantly
by aerosoles from already infected persons
o
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.
Reducing Incidence of HAIs
 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
UVc Light: Key Properties
UV light does not propagate well through the air
Within 5 cm (2 inches) of the source, >70% of the power has dissipated
100%
UVc Power Level
80%
60%
40%
20%
0%
0
1
2
3
4
5
6
Distance from UVc Souce (cm)
7
8
9
10
Data on file, Medixair
UVc Light: Key Properties
Power Dissipation
14,400 mW/cm2
3,750mW/cm2
50 mm /
2 inches
Data on file, Medixair
Patented Technology
Configuration of MEDIXAIR Units
• 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
4 x 3,750mW/cm2 = 15,000mW/cm2
Data on file, Medixair
Configuration of MEDIXAIR Units
Aluminium reflector box increases energy generated
Power
Reflectance
15,000mW cm-2
Minimum Power = 15,000 mW /cm2 + plus reflectance
Data on file, Medixair
Configuration of MEDIXAIR Units
Cross section through the unit
Power distribution in cross section
providing a high level of usable
power
Power Distribution
18000
15000
12000
uWatts/cm2
9000
6000
3000
0
10
15000-18000
12000-15000
9000-12000
 Brandenburg UK Ltd.
0
1
2
8
3
x axis
9
7
4
5
5
6
7
4
8
6
y axis
3
9
10
1
2
0
Data on file, Medixair
2.This does not allow
sufficient exposure
time for the bacteria to
be killed
x
1.Traditionally air is
blown air across the
tubes…..
f
a
n
4.Medixair has
A 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
• airspeed = 0.3m /sec
• L = 450mm
3.In Medixair a fan
draws the air up the
length of the tubes
thus maximizing the
exposure
• t = 1.5seconds
= 15,000mW/cm2
22,500mW/cm2
Data on file
Medixair
FAN
Enclosed
reflective
aluminium
chamber
Slow speed
fan to create
maximum
exposure to
the UV
tm
Design Principles
22,500 µW/cm2
Kills viruses and bacteria
FOUR 254nm UVc
emitters in an array
tm
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
Sustainable Infection Control
Benefits of MEDIXAIR Units
•
•
•
•
•
•
•
•
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
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
M.A.R.S.
INNOVATIVE PRODUCTS
FOR
HEALTHIER LIVING
575 Wentworth Street East, Unit 21
Oshawa, ON
L1H 3V8
1-866-594-3648
[email protected]