"No touch" methods for health care room disinfection: Focus on clinical trials

Background: Hospital patient room surfaces are frequently contaminated with multidrug-resistant organisms. Since studies have demonstrated that inadequate terminal room disinfection commonly occurs, "no touch" methods of terminal room disinfection have been developed such as ultraviolet light (UV) devices and hydrogen peroxide (HP) systems. Methods: This paper reviews published clinical trials of "no touch" methods and "self-disinfecting" surfaces. Results: Multiple papers were identified including clinical trials of UV room disinfection devices (N = 20), HP room disinfection systems (N = 8), handheld UV devices (N = 1), and copper-impregnated or coated surfaces (N = 5). Most but not all clinical trials of UV devices and HP systems for terminal disinfection demonstrated a reduction of colonization/infection in patients subsequently housed in the room. Coppercoated surfaces were the only "self-disinfecting" technology evaluated by clinical trials. Results of these clinical trials were mixed. Discussion: Almost all clinical trials reviewed used a "weak" design (eg, before-after) and failed to assess potential confounders (eg, compliance with hand hygiene and environmental cleaning). Conclusions: The evidence is strong enough to recommend the use of a "no-touch" method as an adjunct for outbreak control, mitigation strategy for high-consequence pathogens (eg, Candida auris or Ebola), or when there are an excessive endemic rates of multidrug-resistant organisms. (c) 2023 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.