A ‘Star Wars’ like battle against the pathogenic empire

A light saber-wielding robot with a passing resemblance to R2-D2 is fighting deadly pathogens at St. Joseph Medical Center.

It’s not science fiction at the 366-room hospital, but rather plain science.

CHI Franciscan Health, the parent organization of St. Joseph, acquired three robots in February that use ultraviolet light to disinfect patient rooms and medical equipment.

The system, Tru-D SmartUVC, uses the long-known antiseptic properties of ultraviolet light to kill a variety of disease-causing pathogens.

The new system hasn’t shoved aside traditional disinfecting methods. Instead it adds a new dimension of cleaning. The light can penetrate areas that traditional cleaners can’t.

Hospital-acquired infections (HAIs) come in different categories and include potentially fatal Clostridium difficile (C. diff) and Methicillian-resistant Staphylococcus aureus (MRSA). Other HAIs include influenza, norovirus, rhinovirus and common bacteria.

Some HAIs have been on the rise and others have been decreasing. But all of them are major concerns for health care facilities around the world.

“MRSA used to be only a hospital-acquired infection. But now it’s also prevalent in the community,” said Dr. Olympia Tachopoulou, medical director for infection prevention at CHI Franciscan. “Now we have people who come in with MRSA.”

On any given day, about one in 25 hospital patients has at least one HAI according to the Centers for Disease Control and Prevention. A survey reported that in 2011 there were an estimated 722,000 HAIs in U.S. acute care hospitals. About 75,000 patients with HAIs died during their hospitalizations.

“Now we are dealing with more resistant organisms,” Tachopoulou said. “Now we have to be more proactive.”

Unlike with other pathogen-fighting protocols such as antibiotics, pathogens can’t build resistance to UV light. But the organisms themselves are becoming more deadly.

C. diff is particularly worrisome. “Sometime in 2005, 2006 the organism mutated and it acquired a gene that made it produce 20 times the amount of toxin. It became a terror overnight and much more prevalent,” Tachopoulou said.

Tru-D is not a tanning parlor. The light is so strong it can burn skin. So it’s only used in empty rooms. Common window glass filters the potentially harmful rays so technicians can watch through windows.

The UV unit is not used every time a patient is released or otherwise leaves a room. The first priority is for rooms vacated by a patient with a dangerous and or hard-to-kill microorganism.

Tru-D speaks with a male robotic voice (the accompanying iPad controller speaks in a feminine tone) but the unit doesn’t move on its own.

Franciscan has three of the $87,000 units. They are used on average in 1 out of 100 patient rooms on a daily basis.

On Wednesday, environmental services supervisor Nate Waye was pushing the device from room to room at St. Joseph. Entering a post-surgery patient room that smelled strongly of bleach Waye removed protective covers and exposed 28 light tubes configured in a 360 degree pattern.

Waye then opened drawers, raised the bed, opened the bathroom door and basically tried to expose every surface he could.

“It will even get the underside of tables,” said Brad Bailey, environmental services manager.

Drapes had already been removed from the room. Noncleanable items such as boxes of latex gloves were disposed of.

Safely outside the room Waye ran the system through a series of checks before Tru-D’s robotic voice started a countdown from 15.

While it’s irradiating the room, the device measures light reflecting back on itself. It determines how long it needs to run. The typical room takes 35 to 45 minutes of constant light, Waye said.

If a door opens or the systems detects movement it automatically shuts down as a safety precaution.

The UV light destroys the DNA structure of microorganisms, which either kills them or prevents them from reproducing.

The light is so strong that even when it’s reflected off room surfaces it can still kill microorganisms in shadows and hard to access areas. That’s a bonus when it comes to killing C. diff, which spreads by spores.

“Those spores can be present anywhere in the room,” Tachopoulou said. “You can’t just clean certain parts of the room. You have to clean everywhere.”

The units aren’t just being used in rooms but also in intensive care units, the emergency department, surgery rooms, equipment rooms and other places where either patients have been or equipment is kept.

Tru-D systems also are being used at the University of Washington Medical Center, Walter Reed Army Medical Center and the National Institutes of Health.

At Tacoma General and Mary Bridge Children’s Hospitals, UV light sterilization has been in use since 2013.

Parent organization MultiCare Health System has eight UV robots made by Infection Prevention Technologies at its five hospitals, according to Tammy Buyok, vice president, environment of care.

Multicare also uses small box-style UV lights to clean small items such as keyboards, cellphones, stethoscopes and pagers. They’re placed at several nursing stations and operated by nursing staff, Buyok said.

UV light has long been established as a public health tool. It’s used to sterilize drinking water and wastewater.

Seattle Public Utilities uses a UV system to sterilize drinking water at its Cedar Treatment Facility. It’s particularly effective in destroying Cryptosporidium, a water-transmitted parasite that is difficult to treat with chlorine.

Ultraviolet light is only coming into use now in hospitals because of portable units such as Tru-D and studies that have shown its effectiveness.

“We have those studies that report (decreased infection rates) of 20 percent, up to 40 percent depending on the microorganism,” Tachopoulou said.

As scary as HAIs are, Tachopoulou said patients and the public with normal, healthy immune systems shouldn’t worry. Just follow the normal precautions of cleanliness.

“I see patients with C. diff many times a week,” Tachopoulou said. “I’ve never gotten C. diff.”

This story was originally published March 26, 2016 at 5:19 AM with the headline "A ‘Star Wars’ like battle against the pathogenic empire."