222-nm UVC light as a skin-safe solution to antimicrobial resistance in acute hospital settings with a particular focus on methicillin-resistant Staphylococcus aureus and surgical site infections: a review

The increasing burden of antimicrobial resistance necessitates a novel approach to disinfect multidrug resistant pathogens. Conventional 254-nm ultraviolet-C (UVC) light shows high germicidal efficacy against bacteria. However, it induces pyrimidine dimerization in exposed human skin with carcinogenic potential. Recent developments suggest 222-nm UVC light can be used to disinfect bacteria and cause less harm to human DNA. This new technology can be used to disinfect healthcare-associated infections and more specifically surgical site infections (SSIs). This includes but is not limited to methicillin-resistant Staphylococcus aureus (MRSA), P. aeruginosa, C. difficile, E. coli, and other aerobic bacteria. This thorough review of scarce literature assesses the germicidal efficacy and skin safety of 222-nm UVC light with a particular focus on its clinical applications to MRSA and SSIs. The study reviews a variety of experimental models, including in vivo and in vitro cell cultures, live human skin, human skin models, mice skin, and rabbit skin. The potential for long-term eradication of bacteria and efficacy against specific pathogens is appraised. This paper focuses on the methods and models used in past and present research to determine the efficacy and safety of 222-nm UVC in the acute hospital setting with a focus on MRSA and its applicability to SSIs.