PDF(Pubmed)
Abstract：
OBJECTIVE: During the COVID-19 pandemic the search for complementary methods to enhance manual disinfection in dental and medical practices raised relevance. We sought evidence for the addition of ultraviolet-C (UV-C) disinfection to manual cleaning protocols -and whether it improves the logarithmic (log) reduction of surface pathogen colonies.
METHODS: This review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD420200193961. Six electronic sources were consulted looking for clinical trials performed in healthcare environments in which pathogens were quantified by colony-forming unit (CFU)-enumeration before and after interventions, all databases were last consulted on May 2021. We assessed the risk of bias using an adapted Revised Cochrane Risk of Bias Tool (RoB 2). The certainty of the evidence was qualified according to the Classification of Recommendations, Evaluation, Development, and Evaluation (GRADE) approach.
RESULTS: We identified 1012 records and 12 studies fulfilled the inclusion criteria. All included studies reported enhanced disinfection in the UV-C arm; most of them reported 1-log to 2-log reduction in approximately 10 to 25 min. Only three studies reached a 5-log and 6-log reduction. When manual cleaning was performed alone, only two studies reported a 1-log reduction using a chlorine-based disinfectant. We detected a high risk of bias in 1 study. Certainty of evidence was classified as moderate and low.
CONCLUSIONS: The evidence points out the effectiveness of UV-C technology in reducing manual cleaning failures, enhancing the logarithmic reduction of surface pathogen colonies. However, the safety and success of these devices will depend on several physical and biological factors. A judicious project must precede their use in clinical and medical offices under the supervision of a physicist or other trained professional.
METHODS: This review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD420200193961. Six electronic sources were consulted looking for clinical trials performed in healthcare environments in which pathogens were quantified by colony-forming unit (CFU)-enumeration before and after interventions, all databases were last consulted on May 2021. We assessed the risk of bias using an adapted Revised Cochrane Risk of Bias Tool (RoB 2). The certainty of the evidence was qualified according to the Classification of Recommendations, Evaluation, Development, and Evaluation (GRADE) approach.
RESULTS: We identified 1012 records and 12 studies fulfilled the inclusion criteria. All included studies reported enhanced disinfection in the UV-C arm; most of them reported 1-log to 2-log reduction in approximately 10 to 25 min. Only three studies reached a 5-log and 6-log reduction. When manual cleaning was performed alone, only two studies reported a 1-log reduction using a chlorine-based disinfectant. We detected a high risk of bias in 1 study. Certainty of evidence was classified as moderate and low.
CONCLUSIONS: The evidence points out the effectiveness of UV-C technology in reducing manual cleaning failures, enhancing the logarithmic reduction of surface pathogen colonies. However, the safety and success of these devices will depend on several physical and biological factors. A judicious project must precede their use in clinical and medical offices under the supervision of a physicist or other trained professional.
摘要：
目的：在COVID-19大流行期间，寻找补充方法来加强牙科和医疗实践中的手动消毒提高了相关性。我们寻求在手动清洁方案中添加紫外线C（UV-C）消毒的证据，以及是否可以改善表面病原体菌落的对数（log）减少。
方法：本综述在国际前瞻性系统评价注册中心（PROSPERO）注册，编号为CRD420200193961。咨询了六个电子来源，以寻找在医疗环境中进行的临床试验，其中在干预前后通过菌落形成单位（CFU）计数对病原体进行定量。所有数据库的最后一次咨询是在2021年5月。我们使用修订的Cochrane偏差风险工具（RoB2）评估偏差风险。根据建议分类，证据的确定性是合格的，评价,发展,和评估(等级)方法。
结果：我们确定了1012条记录，12项研究符合纳入标准。所有包括的研究都报告了UV-C臂的消毒增强；其中大多数报告了大约10到25分钟内1-log到2-log的减少。只有三项研究达到了5-log和6-log的减少。当单独进行手动清洁时，只有两项研究报告使用氯基消毒剂减少了1-log.我们在1项研究中发现了高偏倚风险。证据的确定性分为中等和低。
结论：证据指出了UV-C技术在减少手动清洁失败方面的有效性，增强表面病原体菌落的对数减少。然而,这些设备的安全性和成功将取决于几个物理和生物因素。明智的项目必须在物理学家或其他受过培训的专业人员的监督下在临床和医疗办公室使用它们之前。
方法：本综述在国际前瞻性系统评价注册中心（PROSPERO）注册，编号为CRD420200193961。咨询了六个电子来源，以寻找在医疗环境中进行的临床试验，其中在干预前后通过菌落形成单位（CFU）计数对病原体进行定量。所有数据库的最后一次咨询是在2021年5月。我们使用修订的Cochrane偏差风险工具（RoB2）评估偏差风险。根据建议分类，证据的确定性是合格的，评价,发展,和评估(等级)方法。
结果：我们确定了1012条记录，12项研究符合纳入标准。所有包括的研究都报告了UV-C臂的消毒增强；其中大多数报告了大约10到25分钟内1-log到2-log的减少。只有三项研究达到了5-log和6-log的减少。当单独进行手动清洁时，只有两项研究报告使用氯基消毒剂减少了1-log.我们在1项研究中发现了高偏倚风险。证据的确定性分为中等和低。
结论：证据指出了UV-C技术在减少手动清洁失败方面的有效性，增强表面病原体菌落的对数减少。然而,这些设备的安全性和成功将取决于几个物理和生物因素。明智的项目必须在物理学家或其他受过培训的专业人员的监督下在临床和医疗办公室使用它们之前。
