Jahanzeb

Classic and alternative disinfection practices for preventing of hospital-acquired infections: a systemic review

• Authors Details :  
• J. Sheikh

Journal title : International Journal of Environmental Science and Technology

Publisher : Springer Science and Business Media LLC

Online ISSN : 1735-2630

432 Views Reviews Article

Ultraviolet (UV) disinfection technologies are well-known tools for microbial prevention in indoor public places which are frequently employed for disinfecting air, surfaces, and water. Such technologies have drawn a great deal of interest due to its potential application, especially in the domain of healthcare. This article discusses the shortcomings of chemical disinfectants and analyzes the current research standing on the development of various types of UV disinfection technologies for their prospective usage in the healthcare industry. Furthermore, the article provides a thorough analysis and in-depth evaluation of the current antibacterial studies using UV lamps and light-emitting diodes (LEDs) for the treatment of frequently encountered pathogens associated with healthcare. According to the systematic review, UV-LEDs have shown to be a potential source for delivering disinfection which is equally efficient or more effective than traditionally used UV lamps. The findings also provide valuable considerations for potentially substituting conventional lamps with LEDs that would be less expensive, more efficient, more robust, non-fragile and safer. With greater effectiveness and advantages, UV-LEDs have shown to be the potential UV source that could fundamentally be able to transform the disinfection industry. Therefore, the study supports the employment of UV-LED technology as a better and workable approach for effective disinfection applications. The study also offers insightful information that will help to direct future studies in the domain of hygienic practices used in healthcare facilities.

Article DOI & Crossmark Data

DOI : https://doi.org/10.1007/s13762-024-05635-3

Article Subject Details

• Biomedical Engineering
• Environmental microbiology
• Microbial applications
• Microbiology
• Pathogenesis

Article Keywords Details

• Disinfection
• Environment
• Germicidal
• Pathogens
• Ultraviolet-c

Article File

Full Text PDF

Article References

• (1). Abdallah M et al (2015) Impact of growth temperature and surface type on the resistance of Pseudomonas aeruginosa and Staphylococcus aureus biofilms to disinfectants. Int J Food Microbiol 214:38–47
• (2). Adams CE et al (2017) Examining the association between surface bioburden and frequently touched sites in intensive care. J Hosp Infect 95(1):76–80
• (3). Alhmidi H et al (2018) Evaluation of an automated ultraviolet-C light disinfection device and patient hand hygiene for reduction of pathogen transfer from interactive touchscreen computer kiosks. Am J Infect Control 46(4):464–467
• (4). Allegranzi B (2011) Report on the burden of endemic health care-associated infection worldwide. World Health Organization (WHO), Geneva
• (5). Allegranzi B, Pittet D (2009) Role of hand hygiene in healthcare-associated infection prevention. J Hosp Infect 73(4):305–315
• (6). Allegranzi B et al (2007) The first global patient safety challenge “clean care is safer care”: from launch to current progress and achievements. J Hosp Infect 65(Suppl 2):115–123
• (7). Allegranzi B et al (2011) Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet 377(9761):228–241
• (8). Amini Tapouk F et al (2020) Comparative efficacy of hospital disinfectants against nosocomial infection pathogens. Antimicrob Resist Infect Control 9:115
• (9). Ananda T et al (2022) Nosocomial infections and role of nanotechnology. Bioengineering (basel) 9(2):51
• (10). Andersen BM et al (2006) Decontamination of rooms, medical equipment and ambulances using an aerosol of hydrogen peroxide disinfectant. J Hosp Infect 62(2):149–155
• (11). Anderson DJ (2011) Surgical site infections. Infect Dis Clin North Am 25(1):135–153
• (12). Anderson DJ et al (2013) Decontamination of targeted pathogens from patient rooms using an automated ultraviolet-C-emitting device. Infect Control Hosp Epidemiol 34(5):466–471
• (13). Apisarnthanarak A et al (2003) Ventilator-associated pneumonia in extremely preterm neonates in a neonatal intensive care unit: characteristics, risk factors, and outcomes. Pediatrics 112:1283–1289
• (14). Arques-Orobon FJ, Vazquez M, Nuñez N (2020) Lifetime analysis of commercial 3 W UV-A LED. Crystals 10(12):1083
• (15). Bal AM et al (2016) Genomic insights into the emergence and spread of international clones of healthcare-, community- and livestock-associated meticillin-resistant Staphylococcus aureus: blurring of the traditional definitions. J Glob Antimicrob Resist 6:95–101
• (16). Bardi T et al (2021) Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome. Eur J Clin Microbiol Infect Dis 40(3):495–502
• (17). Barnes M et al (2019) Antimicrobial polymer modifications to reduce microbial bioburden on endotracheal tubes and ventilator associated pneumonia. Acta Biomater 91:220–234
• (18). Beggs C et al (2015) Environmental contamination and hospital-acquired infection: factors that are easily overlooked. Indoor Air 25(5):462–474
• (19). Bernard L, Kereveur A, Durand D et al (1999) Bacterial contamination of hospital stethoscope. Infect Control Hosp Epidemiol 20:274–276
• (20). Best EL et al (2010) The potential for airborne dispersal of Clostridium difficile from symptomatic patients. Clin Infect Dis 50(11):1450–1457
• (21). Best E et al (2018) Environmental contamination by bacteria in hospital washrooms according to hand-drying method: a multi-centre study. J Hosp Infect 100(4):469–475
• (22). Bhalla A et al (2004) Acquisition of nosocomial pathogens on hands after contact with environmental surfaces near hospitalized patients. Infect Control Hosp Epidemiol 25:164–167
• (23). Bhatta DR et al (2018) Bacterial contamination of frequently touched objects in a tertiary care hospital of Pokhara, Nepal: how safe are our hands? Antimicrob Resist Infect Control 7:97
• (24). Blanco-Cabra N et al (2019) Novel oleanolic and maslinic acid derivatives as a promising treatment against bacterial biofilm in nosocomial infections: an in vitro and in vivo study. ACS Infect Dis 5(9):1581–1589
• (25). Bolon MK et al (2016) Hand hygiene: an update. Infect Dis Clin N Am 310:591–607
• (26). Bolton JR, Cotton CA (2008) The ultraviolet disinfection handbook, 1st edn. American Water Works Association
• (27). Bonten MJ et al (1996) Epidemiology of colonisation of patients and environment with vancomycin-resistant enterococci. Lancet 348(9042):1615–1619
• (28). Borrusso PA, Quinlan JJ (2017) Prevalence of pathogens and indicator organisms in home kitchens and correlation with unsafe food handling practices and conditions. J Food Prot 80(4):590–597
• (29). Bouchra O et al (2019) Environmental surfaces in healthcare setting: a great potential risk of pathogens transmission. J Adv Microbiol 28:2398–2401
• (30). Boyce JM (2007) Environmental contamination makes an important contribution to hospital infection. J Hosp Infect 65(Suppl 2):50–54
• (31). Boyce JM et al (1997) Environmental contamination due to meticillin-resistant Staphylococcus aureus: possible infection control implications. Infect Control Hosp Epidemiol 18(8):622–627
• (32). Boyce JM et al (2016a) Modern technologies for improving cleaning and disinfection of environmental surfaces in hospitals. Antimicrob Resist Infect Control 5:10
• (33). Boyce JM et al (2016b) Impact of room location on UV-C irradiance and UV-C dosage and antimicrobial effect delivered by a mobile UV-C light device. Infect Control Hosp Epidemiol 37(6):667–672
• (34). Brêda M et al (2021) Potential application of novel technology developed for instant decontamination of personal protective equipment before the doffing step. PLoS ONE 16:e0250854
• (35). Canada H (1998) Infection control guidelines: hand washing, cleaning, disinfection, and sterilization in health care. In Canadian Communicable Disease Report. pp 1–55
• (36). Caselli E et al (2018) Reducing healthcare-associated infections incidence by a probiotic-based sanitation system: a multicentre, prospective, intervention study. PLoS ONE 13(7):e0199616
• (37). Chemaly RF et al (2014) The role of the healthcare environment in the spread of multidrug-resistant organisms: update on current best practices for containment. Ther Adv Infect Dis 2(3–4):79–90
• (38). Chen KH, Chen LR, Wang YK (2014) Contamination of medical charts: an important source of potential infection in hospitals. PLoS ONE 9(2):e78512
• (39). Chen LF et al (2019) A prospective study of transmission of multidrug-resistant organisms (MDROs) between environmental sites and hospitalized patients-the TransFER study. Infect Control Hosp Epidemiol 40(1):47–52
• (40). Chen LH et al (2020) Evaluation of a pulsed xenon ultraviolet light device for reduction of pathogens with biofilm-forming ability and impact on environmental bioburden in clinical laboratories. Photodiagnosis Photodyn Ther 29:101544
• (41). Chen YC et al (2021) Comparing visual inspection and performance observation for evaluation of hospital cleanliness. Am J Infect Control 48:1511–1514
• (42). Cheng Y et al (2020) Inactivation of Listeria and E. coli by Deep-UV LED: effect of substrate conditions on inactivation kinetics. Sci Rep 10(1):3411
• (43). Chou DT et al (2012) The world health organization ‘5 moments of hand hygiene’: the scientific foundation. J Bone Jt Surg Br 94:441–445
• (44). Chowdhury D et al (2018) Transfer of dry surface biofilm in the healthcare environment: the role of healthcare workers’ hands as vehicles. J Hosp Infect 100(3):e85–e90
• (45). Christiansen B, Dettenkofer M, Becker E (2004) Anforderungen an die Hygiene bei der Reinigung und Desinfektion von Flächen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 47:51–61
• (46). Claus H (2021) Ozone generation by ultraviolet lamps(dagger). Photochem Photobiol 97(3):471–476
• (47). CMS. Centers for Medicare and Medicaid Services. Hospital Inpatient Quality Reporting Program (2023) https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/hospitalqualityinits/hospitalrhqdapu.html
• (48). Comar M et al (2019) Introduction of NGS in environmental surveillance for healthcare-associated infection control. Microorganisms 7(12):708
• (49). Conner-Kerr TA, Sullivan P, Gaillard J, Franklin ME, Jones RM (1998) The effects of ultraviolet radiation on antibiotic-resistant bacteria in vitro. Ostomy Wound Manag 44:50–56
• (50). Correa TQ et al (2017) Manual operated ultraviolet surface decontamination for healthcare environments. Photomed Laser Surg 35(12):666–671
• (51). Crawford MH et al (2005) Final LDRD report: ultraviolet water purification systems for rural environments and mobile applications. Sandia Rep 1:37
• (52). Cremers-Pijpers S et al (2021) Disinfecting handheld electronic devices with UV-C in a healthcare setting. Infect Prev Pract 3(2):100133
• (53). Danasekaran R, Mani G, Annadurai K (2014) Prevention of healthcare-associated infections: protecting patients, saving lives. Int J Community Med Public Health 1(1):67
• (54). Dancer SJ (2014) Controlling hospital-acquired infection: focus on the role of the environment and new technologies for decontamination. Clin Microbiol Rev 27(4):665–690
• (55). Dancer SJ et al (2009) Measuring the effect of enhanced cleaning in a UK hospital: a prospective cross-over study. BMC Med 7:28
• (56). Dancer SJ et al (2019) Tracking Staphylococcus aureus in the intensive care unit using whole-genome sequencing. J Hosp Infect 103(1):13–20
• (57). Dantes R et al (2013) National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, 2011. JAMA Intern Med 173(21):1970–1978
• (58). Darge A et al (2019) Bacterial contamination and antimicrobial susceptibility patterns of intensive care units medical equipment and inanimate surfaces at Ayder comprehensive specialized hospital, Mekelle, Northern Ethiopia. BMC Res Notes 12(1):621
• (59). Darvishi M, Forootan M, Nazer MR et al (2020) Nosocomial infections, challenges and threats: a review article. J Med Microbiol 14:162–181
• (60). Datta R et al (2011) Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants. Arch Intern Med 171:491–494
• (61). de Boer HEL, van Elzelingen-Dekker CM (2006) Use of gaseous ozone for eradication of methicillin-resistant Staphylococcus aureus from the home environment of a colonized hospital employee. Infect Control Hosp Epidemiol 27(10):1120–1122
• (62). de Souza RV et al (2020) A comparative study on the inactivation of Penicillium expansum spores on apple using light emitting diodes at 277 nm and a low-pressure mercury lamp at 253.7 nm. Food Control 110:107039
• (63). Deshpande A et al (2017) Are hospital floors an underappreciated reservoir for transmission of health care-associated pathogens? Am J Infect Control 45(3):336–338
• (64). Desrousseaux C et al (2013) Modification of the surfaces of medical devices to prevent microbial adhesion and biofilm formation. J Hosp Infect 85(2):87–93
• (65). Ding X et al (2019) Causative agents and outcome of spontaneous bacterial peritonitis in cirrhotic patients: community-acquired versus nosocomial infections. BMC Infect Dis 19(1):463
• (66). Diseases and Organisms in Healthcare Settings, CDC (2016) Healthcare-associated Infections (HAIs). https://www.cdc.gov/hai/organisms/organisms.html#print
• (67). Dizaj SM et al (2014) Antimicrobial activity of the metals and metal oxide nanoparticles. Mater Sci Eng C 44:278–284
• (68). Donskey CJ (2013) Does improving surface cleaning and disinfection reduce health care-associated infections? Am J Infect Control 41(5 Suppl):S12–S19
• (69). Donskey CJ (2019) Decontamination devices in health care facilities: practical issues and emerging applications. Am J Infect Control 47S:A23–A28
• (70). Drees M et al (2008) Prior environmental contamination increases the risk of acquisition of vancomycin-resistant enterococci. Clin Infect Dis 46(5):678–685
• (71). Du Q, Zhang D, Hu W et al (2021) Nosocomial infection of COVID-19: a new challenge for healthcare professionals (Review). Int J Mol Med 47:31
• (72). Duering H et al (2023) Short-wave ultraviolet-light-based disinfection of surface environment using light-emitting diodes: a new approach to prevent health-care-associated infections. Microorganisms 11(2):386
• (73). Dumford DM 3rd et al (2009) What is on that keyboard? Detecting hidden environmental reservoirs of Clostridium difficile during an outbreak associated with North American pulsed-field gel electrophoresis type 1 strains. Am J Infect Control 37(1):15–19
• (74). El Haddad L et al (2017) Evaluation of a pulsed xenon ultraviolet disinfection system to decrease bacterial contamination in operating rooms. BMC Infect Dis 17(1):672
• (75). Elbehiry A et al (2022) The development of technology to prevent, diagnose, and manage antimicrobial resistance in healthcare-associated infections. Vaccines 10:2100
• (76). Engur D et al (2014) A milk pump as a source for spreading Acinetobacter baumannii in a neonatal intensive care unit. Breastfeed Med 9(10):551–554
• (77). Esteves DC et al (2016) Influence of biological fluids in bacterial viability on different hospital surfaces and fomites. Am J Infect Control 44(3):311–314
• (78). Falk PS et al (2000) Outbreak of vancomycin-resistant enterococci in a burn unit. Infect Control Hosp Epidemiol 21(9):575–582
• (79). Friedman MM et al (1996) Designing an infection control to meet JCAHO standards. Caring 15:18–25
• (80). Gamage SD et al (2016) Water safety and legionella in health care: priorities, policy, and practice. Infect Dis Clin North Am 30(3):689–712
• (81). Gardner A et al (2021) Virucidal efficacy of blue LED and far-UVC light disinfection against feline infectious peritonitis virus as a model for SARS-CoV-2. Viruses 13(8):1436
• (82). Gaston KJ et al (2012) Reducing the ecological consequences of night-time light pollution: options and developments. J Appl Ecol 49(6):1256–1266
• (83). Geadas Farias P et al (2017) Hospital microbial surface colonization revealed during monitoring of Klebsiella spp., Pseudomonas aeruginosa, and non-tuberculous mycobacteria. Antonie Van Leeuwenhoek 110(7):863–876
• (84). Gestrich SA et al (2018) A multicenter investigation to characterize the risk for pathogen transmission from healthcare facility sinks. Infect Control Hosp Epidemiol 39:1467–1469
• (85). Glowicz JB et al (2023) SHEA/IDSA/APIC practice recommendation: strategies to prevent healthcare-associated infections through hand hygiene: 2022 update. Infect Control Hosp Epidemiol 44:355–376
• (86). Gora SL et al (2019) Inactivation of biofilm-bound Pseudomonas aeruginosa bacteria using UVC light emitting diodes (UVC LEDs). Water Res 151:193–202
• (87). Gostine A et al (2016) Evaluating the effectiveness of ultraviolet-C lamps for reducing keyboard contamination in the intensive care unit: a longitudinal analysis. Am J Infect Control 44(10):1089–1094
• (88). Green J, Wright PA, Gallimore CI et al (1998) The role of environmental contamination with small round structured viruses in a hospital outbreak investigated by reverse-transcriptase polymerase chain reaction assay. J Hosp Infect 39:39–45
• (89). Green C et al (2017) Pulsed-xenon ultraviolet light disinfection in a burn unit: Impact on environmental bioburden, multidrug-resistant organism acquisition and healthcare associated infections. Burns 43(2):388–396
• (90). Grist SM et al (2021) Current understanding of ultraviolet-C decontamination of N95 filtering facepiece respirators. Appl Biosaf 26(2):90–102
• (91). Guerrero DM et al (2012) Acquisition of spores on gloved hands after contact with the skin of patients with Clostridium difficile infection and with environmental surfaces in their rooms. Am J Infect Control 40(6):556–558
• (92). Guerrero-Beltr·n JA, Barbosa-C·novas GV (2016) Advantages and limitations on processing foods by UV light. Food Sci Technol Int 10(3):137–147
• (93). Guerrero-Beltrán JA et al (2004) Review: advantages and limitations on processing foods by UV light. Int J Food Sci Technol 10:137–147
• (94). Guettari M, Gharbi I, Hamza S (2021) UVC disinfection robot. Environ Sci Pollut Res Int 28(30):40394–40399
• (95). Guinea J (2014) Global trends in the distribution of Candida species causing candidemia. Clin Microbiol Infect 20(Suppl 6):5–10
• (96). Gusev I et al (2022) Electrochemically deposited zinc (tetraamino)phthalocyanine as a light-activated antimicrobial coating effective against S. Aureas. Materials 15:975
• (97). Hall L et al (2020) Effectiveness of a structured, framework-based approach to implementation: the researching effective approaches to cleaning in hospitals (REACH) trial. Antimicrob Resist Infect Control 9(1):35
• (98). Han J et al (1998) AlGaN/GaN quantum well ultraviolet light emitting diodes. Appl Phys Lett 73(12):1688–1690
• (99). Han JH et al (2015) Cleaning hospital room surfaces to prevent health care-associated infections: a technical brief. Ann Intern Med 163(8):598–607
• (100). Hanczvikkel A, Víg A, Tóth Á (2018) Survival capability of healthcare-associated, multidrug-resistant bacteria on untreated and on antimicrobial textiles. J Ind Text 48(7):1113–1135
• (101). Haque M et al (2018) Health care-associated infections - an overview. Infect Drug Resist 11:2321–2333
• (102). Hardy KJ et al (2007) Rapid recontamination with MRSA of the environment of an intensive care unit after decontamination with hydrogen peroxide vapour. J Hosp Infect 66(4):360–368
• (103). Hassan K, ElBagoury M (2018) The domestic kitchen – the ‘front line in the battle against foodborne disease.’ J Pure Appl Microbiol 12(1):181–187
• (104). Hayden MK et al (2008) Risk of hand or glove contamination after contact with patients colonized with vancomycin-resistant enterococcus or the colonized patients’ environment. Infect Control Hosp Epidemiol 29(2):149–154
• (105). Hessling M, Sicks B, Lau B (2023) Far-UVC radiation for disinfecting hands or gloves? Pathogens 12(2):213
• (106). Hessling M et al. (2021) Review of microbial touchscreen contamination for the determination of reasonable ultraviolet disinfection doses. GMS Hygiene and Infection Control, 16
• (107). Hollosy F et al (2002) Effects of ultraviolet radiation on plant cells. Micron 33:179–197
• (108). Huslage K, Rutala WA (2010) A quantitative approach to defining “high-touch” surfaces in hospitals. Infect Control Hospital Epidemiol 31(8):850–853
• (109). Jamal M, Ahmad W, Andleeb S et al (2017) Bacterial biofilms and associated infections. J Chin Med Assoc 81:7–11
• (110). Jang SH et al (2010) Fabrication and thermal optimization of LED solar cell simulator. Curr Appl Phys 10:S537–S539
• (111). Jarvis P et al (2019) Application of ultraviolet light-emitting diodes (UV-LED) to full-scale drinking-water disinfection. Water 11(9):1894
• (112). Jinadatha C et al (2014) Evaluation of a pulsed-xenon ultraviolet room disinfection device for impact on contamination levels of methicillin-resistant Staphylococcus aureus. BMC Infect Dis 14:1–7
• (113). Jinadatha C et al (2015) Can pulsed xenon ultraviolet light systems disinfect aerobic bacteria in the absence of manual disinfection? Am J Infect Control 43(4):415–417
• (114). Joshi SG (2013) Acinetobacter baumannii: an emerging pathogenic threat to public health. World J Clinic Infect Dis 3(3):25
• (115). Juan C, Pena C, Oliver A (2017) Host and pathogen biomarkers for severe Pseudomonas aeruginosa infections. J Infect Dis 215(suppl 1):S44–S51
• (116). Jury LA et al (2010) Evaluation of an alcohol-based power sanitizing system for decontamination of hospital rooms of patients with methicillin-resistant Staphylococcus aureus carriage. Am J Infect Control 38(3):234–236
• (117). Kaiki Y et al (2021) Methicillin-resistant Staphylococcus aureus contamination of hospital-use-only mobile phones and efficacy of 222-nm ultraviolet disinfection. Am J Infect Control 49(6):800–803
• (118). Kalil AC et al (2016) Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the infectious diseases society of America and the American thoracic society. Clin Infect Dis 63(5):e61–e111
• (119). Kanamori H et al (2016) Healthcare outbreaks associated with a water reservoir and infection prevention strategies. Clin Infect Dis 62:1423–1435
• (120). Karlowsky JA et al (2017) Antimicrobial susceptibility of Gram-negative ESKAPE pathogens isolated from hospitalized patients with intra-abdominal and urinary tract infections in Asia-Pacific countries: SMART 2013–2015. J Med Microbiol 66(1):61–69
• (121). Katsuse Kanayama A et al (2017) Staphylococcus aureus surface contamination of mobile phones and presence of genetically identical strains on the hands of nursing personnel. Am J Infect Control 45(8):929–931
• (122). Kelly S et al (2022) Effectiveness of ultraviolet-C vs aerosolized hydrogen peroxide in ICU terminal disinfection. Hosp Infect 121:114–119
• (123). Kessler R (2013) The minamata convention on mercury: a first step toward protecting future generations. Environ Health Perspect 121(10):A304–A309
• (124). Kh S et al (2017) Bacterial contamination of hospital surfaces according to material make, last time of contact and last time of cleaning/disinfection. J Bacteriol Parasitol 08(03):9597
• (125). Khan MA et al (2005) III–Nitride UV devices. Jpn J Appl Phys 44:10
• (126). Khattak SU et al (2015) Study of the genetic traits associated with antibiotic resistance in Staphylococcus aureus isolated from skin wards of Khyber Pakhtunkhwa, Pakistan. Asian Pac J Trop Dis 5(5):393–398
• (127). Kim S-J et al (2015) Inactivating foodborne pathogens by using UV-C-LEDs at wavelengths from 266 to 279 nm and application to pasteurize sliced cheese. Appl Environ Microbiol 82:11–17
• (128). Kim SJ, Kim DK, Kang DH (2016) Using UVC light-emitting diodes at wavelengths of 266 to 279 nanometers to inactivate foodborne pathogens and pasteurize sliced cheese. Appl Environ Microbiol 82(1):11–17
• (129). Kim DK, Kim SJ, Kang DH (2017) Bactericidal effect of 266 to 279nm wavelength UVC-LEDs for inactivation of gram positive and gram negative foodborne pathogenic bacteria and yeasts. Food Res Int 97:280–287
• (130). Kitagawa H et al (2020) Efficacy of pulsed xenon ultraviolet disinfection of multidrug-resistant bacteria and Clostridioides difficile spores. Infect Dis Health 25(3):181–185
• (131). Klaus P et al (2003) Disinfection of surfaces by photocatalytic oxidation with titanium dioxide and UVA light. Chemosphere 52(1):71–77
• (132). Koganti S et al (2016) Evaluation of hospital floors as a potential source of pathogen dissemination using a nonpathogenic virus as a surrogate marker. Infect Control Hosp Epidemiol 37(11):1374–1377
• (133). Kollef MH et al (2008) Silver-coated endotracheal tubes and incidence of ventilator-associated pneumonia: the NASCENT randomized trial. JAMA Intern Med 300:805–813
• (134). Koscova J, Hurnikova Z, Pistl J (2018) Degree of bacterial contamination of mobile phone and computer keyboard surfaces and efficacy of disinfection with chlorhexidine digluconate and triclosan to its reduction. Int J Environ Res Public Health 15(10):2238
• (135). Koshi E et al (2011) Antimicrobial photodynamic therapy: an overview. J Indian Soc Periodontol 15(4):323
• (136). Koutchma T, Popovi? V, Green A (2019) Overview of ultraviolet (UV) LEDs technology for applications in food production. Ultraviolet LED technology for food applications. Elsevier, pp 1–23
• (137). Kowalski W (2009) UVGI disinfection theory. Ultraviolet germicidal irradiation handbook. Springer, New York, pp 17–50
• (138). Kowalski W et al (2009) Introduction. Ultraviolet germicidal irradiation handbook. Springer, New York
• (139). Kowalski W et al (2009a) UVGI lamps and fixtures. Ultraviolet germicidal irradiation handbook. Springer, New York
• (140). Kowalski W et al (2009b) UVGI guidelines and standards. Ultraviolet germicidal irradiation handbook. Springer, New York
• (141). Kramer A, Schwebke I, Kampf G (2006) How long do nosocomial pathogens persist on inanimate surfaces? a systematic review. BMC Infect Dis 6:130
• (142). Kranz S et al (2019) Bactericidal and biocompatible properties of plasma chemical oxidized titanium (TiOB®) with antimicrobial surface functionalization. Materials 12:866
• (143). Kumar J et al (2019) Environmental contamination with Candida species in multiple hospitals including a tertiary care hospital with a Candida auris outbreak. Pathog Immun 4(2):260–270
• (144). Kumari DN et al (1998) Ventilation grilles as a potential source of meticillin-resistant Staphylococcus aureus causing an outbreak in an orthopaedic ward at a district general hospital. J Hosp Infect 38:213–215
• (145). Kushwaha S (2011) A comprehensive study of various lamps through energy flow diagrams in ETEEE 2011
• (146). Lai ACK, Nunayon SS (2021) A new UVC-LED system for disinfection of pathogens generated by toilet flushing. Indoor Air 31(2):324–334
• (147). Lambert J et al (1998) Organic structural spectroscopy. Prentice Hall Inc., Upper Saddle River
• (148). Lamont Y et al. (2004) Effect of visible light exposure on E. coli treated with Pulsed UV-rich light. In: Conference record of the international power modulator symposium and high voltage workshop
• (149). Larson HJ (2014) The minamata convention on mercury: risk in perspective. Lancet 383(9913):198–199
• (150). Ledwoch K et al (2018) Beware biofilm! dry biofilms containing bacterial pathogens on multiple healthcare surfaces; a multi-centre study. J Hosp Infect 100(3):e47–e56
• (151). Lee K et al (2011) Multidrug-resistant Acinetobacter spp.: increasingly problematic nosocomial pathogens. Yonsei Med J 52(6):879–891
• (152). Levin J et al (2013) The effect of portable pulsed xenon ultraviolet light after terminal cleaning on hospital-associated Clostridium difficile infection in a community hospital. Am J Infect Control 41(8):746–748
• (153). Li Y et al (2017) Impact of nosocomial infections surveillance on nosocomial infection rates: a systematic review. Int J Surg 42:164–169
• (154). Liang JJ et al (2021) The effectiveness of far-ultraviolet (UVC) light prototype devices with different wavelengths on disinfecting SARS-CoV-2. Appl Sci 11(22):10661
• (155). Lim KS et al (2008) Chlorhexidine–pharmacology and clinical applications. Anaesth Intensive Care 36:502–512
• (156). Lin D et al (2017) A meta-analysis of the rates of Staphylococcus aureus and methicillin-resistant S aureus contamination on the surfaces of environmental objects that health care workers frequently touch. Am J Infect Control 45(4):421–429
• (157). Lindsay D et al (2006) Bacterial biofilms within the clinical setting: what healthcare professionals should know. J Hosp Infect 64:313–325
• (158). Liu J-Q et al (2017) Effect of flushing on the detachment of biofilms attached to the walls of metal pipes in water distribution systems. J Zhejiang Univ-SCIENCE A 18(4):313–328
• (159). Liu T et al (2023) Short-term effects of chlorhexidine mouthwash and listerine on oral microbiome in hospitalized patients. Front Cell Infect Microbiol 13:1056534
• (160). Loai S (2016) Development of a method for classification of hospitals based on results of the diagnosis-related groups and the principle of case-mix index. East Mediterr Health J 22(5):327–334
• (161). Magill SS et al (2014a) Multistate point-prevalence survey of health care-associated infections. N Engl J Med 370(13):1198–1208
• (162). Magill SS, Edwards JR, Bamberg W et al (2014b) The emerging infections program healthcare-associated infections and antimicrobial use prevalence survey team. Multistate point-prevalence survey of health care-associated infections. N Engl J Med 370:1198–1208
• (163). Magill SS et al (2018) Changes in prevalence of health care-associated infections in U.S. hospitals. N Engl J Med 379(18):1732–1744
• (164). Mahida N, Vaughan N, Boswell T (2013) First UK evaluation of an automated ultraviolet-C room decontamination device (Tru-D). J Hosp Infect 84(4):332–335
• (165). Maldonado J et al (2020) Label-free detection of nosocomial bacteria using a nanophotonic interferometric biosensor. Analyst 145(2):497–506
• (166). Malik SA et al (2017) Comparison of standard light-emitting diode (LED) and 385 nm ultraviolet A LED (UVA-led) for disinfection of Escherichia coli. Malaysian J Fundam Appl Sci 13:430–437
• (167). Mariita RM, Wilson Miller AC, Randive RV (2022) Evaluation of the virucidal efficacy of Klaran UVC LEDs against surface-dried norovirus. Access Microbiol 4(1):000323
• (168). Maslo C, du Plooy M, Coetzee J (2019) The efficacy of pulsed-xenon ultraviolet light technology on Candida auris. BMC Infect Dis 19(1):540
• (169). Masse J et al (2017) Colonization pressure as a risk factor of ICU-acquired multidrug resistant bacteria: a prospective observational study. Eur J Clin Microbiol Infect Dis 36:797–805
• (170). Matthew Mulle CA, Armstrong I (2018) Best practices for environmental cleaning for prevention and control of infections in all health care settings, P.H. Ontario, Editor. PIDAC
• (171). Miller SL, MacHer JM (2000) Evaluation of a methodology for quantifying the effect of room air ultraviolet germicidal irradiation on airborne bacteria. Aerosol Sci Technol 33(3):274–295
• (172). Miller SL, Linnes J, Luongo J (2013) Ultraviolet germicidal irradiation: future directions for air disinfection and building applications. Photochem Photobiol 89(4):777–781
• (173). Mitchell BG et al (2015) Risk of organism acquisition from prior room occupants: a systematic review and meta-analysis. J Hosp Infect 91(3):211–217
• (174). Mitchell BG et al (2018) Changes in knowledge and attitudes of hospital environmental services staff: the researching effective approaches to cleaning in hospitals (REACH) study. Am J Infect Control 46(9):980–985
• (175). Mitchell BG et al (2019a) An environmental cleaning bundle and health-care-associated infections in hospitals (REACH): a multicentre, randomised trial. Lancet Infect Dis 19(4):410–418
• (176). Mitchell JB et al (2019b) Modelling of ultraviolet light inactivation kinetics of methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, Clostridium difficile spores and murine norovirus on fomite surfaces. J Appl Microbiol 126(1):58–67
• (177). Miyashita T, Ugawa S, Aoki A et al (2001) Photoinduced electron transfer processes in polymer Langmuir-Blodgett films. Stud Surf Sci Catal 132:451–456
• (178). Montero DA et al (2019) Antimicrobial properties of a novel copper-based composite coating with potential for use in healthcare facilities. Antimicrob Resist Infect Control 8:3
• (179). Moore G et al (2012) Use of UV-C radiation to disinfect non-critical patient care items: a laboratory assessment of the Nanoclave cabinet. BMC Infect Dis 12(1):174
• (180). Morgan DJ et al (2012) Transfer of multidrug-resistant bacteria to healthcare workers’ gloves and gowns after patient contact increases with environmental contamination. Crit Care Med 40(4):1045–1051
• (181). Morubagal RR, Shivappa SG et al (2017) Study of bacterial flora associated with mobile phones of healthcare workers and non-healthcare workers’. Iran J Microbiol 9:143–262
• (182). Muzslay M et al (2018) Ultraviolet-C decontamination of hand-held tablet devices in the healthcare environment using the Codonics D6000 disinfection system. J Hosp Infect 100(3):e60–e63
• (183). Nelson MU, Gallagher PG (2012) Methicillin-resistant Staphylococcus aureus in the neonatal intensive care unit. Semin Perinatol 36(6):424–430
• (184). Nicolau T et al (2022) A comprehensive analysis of the UVC LEDs’ applications and decontamination capability. Materials (basel) 15(8):2854
• (185). NLPIP (2010) Availability of LED lighting products for consumers. Lighting Answers, Editor
• (186). Nseir S et al (2011) Risk of acquiring multidrug-resistant Gram-negative bacilli from prior room occupants in the intensive care unit. Clin Microbiol Infect 17(8):1201–1208
• (187). Nunayon SS, Zhang H, Lai ACK (2020) Comparison of disinfection performance of UVC-LED and conventional upper-room UVGI systems. Indoor Air 30(1):180–191
• (188). Nunayon SS et al (2022) Evaluating the efficacy of a rotating upper-room UVC-LED irradiation device in inactivating aerosolized Escherichia coli under different disinfection ranges, air mixing, and irradiation conditions. J Hazard Mater 440:129791
• (189). Nyangaresi PO, Rathnayake T, Beck SE (2023) Evaluation of disinfection efficacy of single UV-C, and UV-A followed by UV-C LED irradiation on Escherichia coli, B. spizizenii and MS2 bacteriophage, in water. Sci Total Environ 859(Pt 1):160256
• (190). Nyhan L et al (2021) Investigating the use of ultraviolet light emitting diodes (UV-LEDs) for the inactivation of bacteria in powdered food ingredients. Foods 10(4):797
• (191). Olsen M et al (2020) Mobile phones represent a pathway for microbial transmission: a scoping review. Travel Med Infect Dis 35:101704
• (192). Omidbakhsh N, Ahmadpour F, Kenny N (2014) How reliable are ATP bioluminescence meters in assessing decontamination of environmental surfaces in healthcare settings? PLoS ONE 9(6):e99951
• (193). Van Osdell D et al. (2002) Defining the effectiveness of UV lamps installed in circulating air ductwork. In: Final Report, Air-Conditioning and Refrigeration Technology, Institute, Arlington, Virginia, p 22203
• (194). Otter JA, Yezli S, French GL (2011) The role played by contaminated surfaces in the transmission of nosocomial pathogens. Infect Control Hosp Epidemiol 32(7):687–699
• (195). Otter JA et al (2014) A guide to no-touch automated room disinfection (NTD) systems. Decontamination in hospitals and healthcare. Elsevier, pp 413–460
• (196). Pal S et al (2019) Staphylococcus aureus: a predominant cause of surgical site infections in a rural healthcare setup of Uttarakhand. J Family Med Prim Care 8(11):3600–3606
• (197). Palma F et al (2022) Use of eco-friendly UV-C LEDs for indoor environment sanitization: a narrative review. Atmosphere 13(9):1411
• (198). Pankove J et al (1873) Luminescence of insulating Be-doped and Li-doped GaN. J Lumin 8:89–93
• (199). Parker CM et al (2008) Ventilator-associated pneumonia caused by multidrug-resistant organisms or Pseudomonas aeruginosa: prevalence, incidence, risk factors, and outcomes. J Crit Care 23(1):18–26
• (200). Percival S, Cutting K (2010) Microbiology of wounds, 1st edn. CRC Press
• (201). Peters A et al (2018) Keeping hospitals clean and safe without breaking the bank; summary of the healthcare cleaning forum 2018. Antimicrob Resist Infect Control 7(1):3
• (202). Peters A et al (2022) Impact of environmental hygiene interventions on healthcare-associated infections and patient colonization: a systematic review. Antimicrob Resist Infect Control 11:38
• (203). Petti S (2016) Nano-TiO2-based photocatalytic disinfection of environmental surfaces contaminated by meticillin-resistant Staphylococcus aureus. J Hosp Infect 93(1):78–82
• (204). Polívková M et al (2017) Antimicrobial treatment of polymeric medical devices by silver nanomaterials and related technology. Int J Mol Sci 18:419
• (205). Raeiszadeh M, Adeli B (2020) A critical review on ultraviolet disinfection systems against COVID-19 outbreak: applicability, validation, and safety considerations. ACS Photon 7(11):2941–2951
• (206). Rajkhowa S (2020) Heat, solar pasteurization, and ultraviolet radiation treatment for removal of waterborne pathogens. Waterborne pathogens. Elsevier, pp 169–187
• (207). Ramasethu J (2017) Prevention and treatment of neonatal nosocomial infections. Matern Health Neonatol Perinatol 3:5
• (208). Rice LB (2008) Federal funding for the study of antimicrobial resistance in nosocomial pathogens: no ESKAPE. J Infect Dis 197(8):1079–1081
• (209). Rohr U et al (2009) Colonization of patients and contamination of the patients’ environment by MRSA under conditions of single-room isolation. Int J Hyg Environ Health 212(2):209–215
• (210). Rosenthal VD et al (2016) International nosocomial infection control consortium report, data summary of 50 countries for 2010–2015: device-associated module. Am J Infect Control 44(12):1495–1504
• (211). Rutala WA, Weber DJ (2013) Disinfectants used for environmental disinfection and new room decontamination technology. Am J Infect Control 41(5 Suppl):S36-41
• (212). Rutala WA, Weber DJ (2016a) Monitoring and improving the effectiveness of surface cleaning and disinfection. Am J Infect Control 44(5 Suppl):69–76
• (213). Rutala WA, Weber DJ (2016b) Disinfection and sterilization in health care facilities: an overview and current issues. Infect Dis Clin North Am 30(3):609–637
• (214). Rutala WA, Weber DJ (2019) Best practices for disinfection of noncritical environmental surfaces and equipment in health care facilities: a bundle approach. Am J Infect Control 47S:A96–A105
• (215). Rutala WA, Gergen MF, Weber DJ (2010) Room decontamination with UV radiation. Infect Control Hosp Epidemiol 31(10):1025–1029
• (216). Rutala WA et al (2018) Enhanced disinfection leads to reduction of microbial contamination and a decrease in patient colonization and infection. Infect Control Hosp Epidemiol 39(9):1118–1121
• (217). Rutala WA et al (2019) Antimicrobial activity of a continuously active disinfectant against healthcare pathogens. Infect Control Hosp Epidemiol 40(11):1284–1286
• (218). Rutala WA et al. (2008) Guideline for disinfection and sterilization in healthcare facilities. In Centers for Disease Control and Prevention. HICPAC
• (219). Rutala WA et al. (2008) Introduction, methods, definition of terms guideline for disinfection and sterilization in healthcare facilities, C.f.D.C.a. Prevention, Editor, CDC, Atlanta, GA
• (220). Ryan K et al (2010) Inactivation of airborne microorganisms using novel ultraviolet radiation sources in reflective flow-through control devices. Aerosol Sci Technol 44:541–550
• (221). Sarwar S et al (2023) Identifying and elucidating the resistance of Staphylococcus aureus isolated from hospital environment to conventional disinfectants. Am J Infect Control 51(2):178–183
• (222). Schalk S et al (2005) UV-lamps for disinfection and advanced oxidation - lamp types. IVA News 8:32–37
• (223). Schechner V et al (2011) Pseudomonas aeruginosa bacteremia upon hospital admission: risk factors for mortality and influence of inadequate empirical antimicrobial therapy. Diagn Microbiol Infect Dis 71(1):38–45
• (224). Schinas G, Polyzou E, Spernovasilis N et al (2023) Preventing multidrug-resistant bacterial transmission in the intensive care unit with a comprehensive approach: a policymaking manual. Antibiotics 12(8):1255
• (225). Sehulster L (2003) Guidelines for environmental infection control in health-care facilities: recommendations of the CDC and the healthcare infection control practices advisory committee (HICPAC), in recommendations and reports: morbidity and mortality weekly report. pp 1–42
• (226). Sexton JD et al (2011) Reduction in the microbial load on high-touch surfaces in hospital rooms by treatment with a portable saturated steam vapor disinfection system. Am J Infect Control 39(8):655–662
• (227). Shams AM et al (2016) Assessment of the overall and multidrug-resistant organism bioburden on environmental surfaces in healthcare facilities. Infect Control Hosp Epidemiol 37(12):1426–1432
• (228). Sharma VK, Demir HV (2022) Bright future of deep-ultraviolet photonics: emerging UVC chip-scale light-source technology platforms, benchmarking, challenges, and outlook for UV disinfection. ACS Photon 9(5):1513–1521
• (229). Shaughnessy MK et al (2011) Evaluation of hospital room assignment and acquisition of Clostridium difficile infection. Infect Control Hosp Epidemiol 32(3):201–206
• (230). SHCHEER (2017) Scientific Committee on Health, E.a.E.R., Opinion on biological effects of UV-C radiation relevant to health with particular reference to UV-C lamps
• (231). Sheikh J et al (2021) Bacterial disinfection and cell assessment post ultraviolet-C LED exposure for wound treatment. Med Biol Eng Comput 59(5):1055–1063
• (232). Sheikh J et al (2023) Surface bacterium disinfection using everlight 6565 UV-C SMD. HumEnTec 2:11–17
• (233). Sholtes KA et al (2016) Comparison of ultraviolet light-emitting diodes and low-pressure mercury-arc lamps for disinfection of water. Environ Technol 37(17):2183–2188
• (234). Sifuentes LY et al (2013) Microbial contamination of hospital reusable cleaning towels. Am J Infect Control 41(10):912–915
• (235). Simmons S et al (2013) Impact of a multi-hospital intervention utilising screening, hand hygiene education and pulsed xenon ultraviolet (PX-UV) on the rate of hospital associated meticillin resistant Staphylococcus aureus infection. J Infect Prev 14(5):172–174
• (236). Simmons S et al (2018) Environmental effectiveness of pulsed-xenon light in the operating room. Am J Infect Control 46(9):1003–1008
• (237). Simmons SE et al (2021) Deactivation of SARS-CoV-2 with pulsed-xenon ultraviolet light: implications for environmental COVID-19 control. Infect Control Hosp Epidemiol 42(2):127–130
• (238). Sitzlar B et al (2013) An environmental disinfection odyssey: evaluation of sequential interventions to improve disinfection of Clostridium difficile isolation rooms. Infect Control Hosp Epidemiol 34(5):459–465
• (239). Smith K, Hunter IS (2008) Efficacy of common hospital biocides with biofilms of multi-drug resistant clinical isolates. J Med Microbiol 57(Pt 8):966–973
• (240). Smith MA, Mathewson JJ, Ulert IA et al (1996) Contaminated stethoscopes revisited. Arch Intern Med 156:82–84
• (241). Sommers CH, Sites JE, Musgrove M (2010) Ultraviolet light (254 Nm) inactivation of pathogens on foods and stainless steel surfaces. J Food Saf 30(2):470–479
• (242). Sood G, Perl TM (2016) Outbreaks in health care settings. Infect Dis Clin North Am 30(3):661–687
• (243). Sooklal S, Khan A, Kannangara S (2014) Hospital Clostridium difficile outbreak linked to laundry machine malfunction. Am J Infect Control 42(6):674–675
• (244). Spataro G et al (2019) UV-C emergency kit in hostile conditions. Am J Infect Control 47(6):19
• (245). Squeri R et al (2016) “Clean care is safer care”: correct handwashing in the prevention of healthcare associated infections. Ann Ig 28(6):409–415
• (246). Sserwadda I et al (2018) Microbial contaminants isolated from items and work surfaces in the post- operative ward at Kawolo general hospital, Uganda. BMC Infect Dis 18(1):68
• (247). Staskel DM, Briley ME, Field LH et al (2007) Microbial evaluation of foodservice surfaces in Texas child-care centers. J Am Diet Assoc 107:854–859
• (248). Suetens C et al (2018) Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. Euro Surveill 23(46):1800516
• (249). Suleyman G, Alangaden G, Bardossy AC (2018) The Role of environmental contamination in the transmission of nosocomial pathogens and healthcare-associated infections. Curr Infect Dis Rep 20(6):12
• (250). Sunkesula VCK et al (2017) A randomized trial to determine the impact of an educational patient hand-hygiene intervention on contamination of hospitalized patient’s hands with healthcare-associated pathogens. Infect Control Hosp Epidemiol 38(5):595–597
• (251). Szeto W et al (2020) The efficacy of vacuum-ultraviolet light disinfection of some common environmental pathogens. BMC Infect Dis 20(1):127
• (252). Tahir S et al (2019) Transmission of Staphylococcus aureus from dry surface biofilm (DSB) via different types of gloves. Infect Control Hosp Epidemiol 40:60–64
• (253). Tanner WD et al (2021) Environmental contamination of contact precaution and non-contact precaution patient rooms in six acute care facilities. Clin Infect Dis 72(Suppl 1):S8–S16
• (254). Tolera M et al (2018) Bacterial nosocomial infections and antimicrobial susceptibility pattern among patients admitted at Hiwot Fana specialized university hospital. Eastern Ethiopia Adv Med 2018:2127814
• (255). Toplitsch D et al (2021) Antimicrobial activity of a novel Cu(NO3)2-containing sol-gel surface under different testing conditions. Materials 14:6488
• (256). Torok ME, Moran E, Cooke F (2016) Oxford handbook of infectious diseases and microbiology. Oxford University Press, Oxford
• (257). Trofa D, Gacser A, Nosanchuk JD (2008) Candida parapsilosis, an emerging fungal pathogen. Clin Microbiol Rev 21(4):606–625
• (258). Uneputty A et al (2022) Strategies applied to modify structured and smooth surfaces: a step closer to reduce bacterial adhesion and biofilm formation. Colloid Interface Sci Commun 46:100560
• (259). Vernez D et al (2020) Reusability of filtering facepiece respirators after decontamination through drying and germicidal UV irradiation. BMJ Glob Health 5(10):003110
• (260). Viana Rel H, dos Santos SG, Oliveira AC (2016) Recovery of resistant bacteria from mattresses of patients under contact precautions. Am J Infect Control 44(4):465–469
• (261). Vincent JL, Marshall J, Silva E et al (2009) International study of the prevalence and outcomes of infection in intensive care units. JAMA Intern Med 302:2323–2329
• (262). Wagenvoort JH, Sluijsmans W, Penders RJ et al (2000) Better environmental survival of outbreak vs. sporadic MRSA isolates. J Hosp Infect 45(3):231–234
• (263). Wallace RL, Ouellette M, Jean J (2019) Effect of UV-C light or hydrogen peroxide wipes on the inactivation of methicillin-resistant Staphylococcus aureus, Clostridium difficile spores and norovirus surrogate. J Appl Microbiol 127(2):586–597
• (264). Wang HP et al (2017) Antimicrobial resistance of 3 types of gram-negative bacteria isolated from hospital surfaces and the hands of health care workers. Am J Infect Control 45(11):e143–e147
• (265). Weber DJ et al (2010) Role of hospital surfaces in the transmission of emerging health care-associated pathogens: norovirus, Clostridium difficile, and Acinetobacter species. Am J Infect Control 38(5 Suppl 1):S25-33
• (266). Weiner LM et al (2016) Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the national healthcare safety network at the centers for disease control and prevention, 2011–2014. Infect Control Hosp Epidemiol 37(11):1288–1301
• (267). WHO (2019) Implementation manual to prevent and control the spread of carbapenem-resistant organisms at the national and health care facility level: interim practical manual supporting implementation of the guidelines for the prevention and control of carbapenem-resistant organisms, WHO, Geneva
• (268). Williams BJ, Dehnbostel J, Blackwell TS (2010) Pseudomonas aeruginosa: host defense in lung diseases. Respirology 15:1037–1056
• (269). Yang JH et al (2019) Effectiveness of an ultraviolet-C disinfection system for reduction of healthcare-associated pathogens. J Microbiol Immunol Infect 52(3):487–493
• (270). Yaun BR et al (2004) Inhibition of pathogens on fresh produce by ultraviolet energy. Int J Food Microbiol 90(1):1–8
• (271). Yue D et al (2017) Hospital-wide comparison of health care-associated infection among 8 intensive care units: a retrospective analysis for 2010–2015. Am J Infect Control 45(1):e7–e13
• (272). Zeber JE et al (2018) Effect of pulsed xenon ultraviolet room disinfection devices on microbial counts for methicillin-resistant Staphylococcus aureus and aerobic bacterial colonies. Am J Infect Control 46(6):668–673