Ultraviolet-C (UV-C) monitoring made simple: Colorimetric indicators to assess delivery of UV-C light by room decontamination devices

Objective: To evaluate the use of colorimetric indicators for monitoring ultraviolet-C (UV-C) light delivery to sites in patient rooms. Methods: In laboratory testing, we examined the correlation between changes in color of 2 commercial colorimetric indicators and log(10) reductions in methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile spores with exposure to increasing doses of UV-C from a low-pressure mercury room decontamination device. In patient rooms, 1 of the colorimetric indicators was used to assess UV-C dose delivery to 27 sites in the room. Results: In laboratory testing, the manufacturer's reference colors for MRSA and C. difficile reduction corresponded with doses of similar to 10,000 and 46,000 mu J/cm(2); these doses resulted in >3 log(10) reductions in MRSA and C. difficile spores, respectively. In patient rooms, the colorimetric indicators demonstrated suboptimal delivery of UV-C dosing to shadowed areas, which was improved by providing cycles on each side of the patient bed rather than in a single position and altering device placement. Increasing duration of exposure increased the number of sites achieving adequate dosing to kill C. difficile spores. Conclusions: Commercial colorimetric indicators provide rapid and easy-to-interpret information on the UV-C dose delivered to sites in patient rooms. The indicators may be useful for training environmental services personnel and optimizing the effectiveness of UV-C room decontamination devices.