February 01, 2013      

Scary fact: ?About 1 of every 20 patients gets an infection while hospitalized,? says Dr. Glenn Braunstein, chairman of the Department of Medicine, Cedars-Sinai Hospital, ?and up to 98,000 Americans die from these each year. That makes infections the most common complication in hospital care and one of the nation’s top 10 causes of death.?

CNNMoney & Forbes: According to the American Hospital Association there are approximately 5,815 registered hospitals in the US. and all of them harbor dangerous microorganisms. Hospitals are supposed to be the place where the sick get well. They can also be where the sick get sicker, thanks to the virulent bacteria and viruses that live there.

Xenon bug killer

Enter Xenex, maker of a mobile, robotic device that combats germs with blasts of pulsed xenon UV light. It?s a killing machine for microorganisms.

Set it loose in a hospital room and it will chirp and click its way through a cleaning routine of strobe-like pulses. Those flashes are what’s called “pulsed xenon UV,” a type of ultraviolet light that disinfects and kills microbiological contaminants.

Epidemiologists Julie Stachowiak and Mark Stibich developed the technology that powers the Xenex device at the Houston Technology Center. To commercialize the system, they needed to build a business. That’s where Brian Cruver, a former Enron trader, came in. After starting his career at the company that became infamous for its corruption?a story Cruver told in the book Anatomy of Greed? shifted his career toward entrepreneurship.

“I wanted to get involved with ventures that did some good,” he says.

Cruver joined Xenex in 2009 as the company’s CEO. Cruver brought the idea to Morris Miller, founder of Rackspace Hosting, a large data-storage company, whom he had met doing a talk show for his Enron book tour.

Miller, the son of a physician, and other investors agreed to pitch in $5 million?enough to order some devices and to set up a 5,000-square-foot warehouse in Austin. Miller became CEO of Xenex in January of 2012 and the company relocated to San Antonio, Texas that May.

Because the Xenex device isn?t used on patients, it didn?t require FDA approval. The first units rolled out in mid-2010.


Xerex now has 50 employees, has sold or leased machines to nearly one hundred hospitals at roughly $80,000 a pop, including unlimited replacement bulbs.

A big win: Sodexo, the facilities-management giant, headquartered in Paris, recommends and utilizes the Xenex device as part of its standard hospital-cleaning service.

Infection prevention

The Xenex device disinfects a hospital room in about five to ten minutes, focusing on high-touch surfaces like tray tables, telephones, and bed rails.

After housekeepers finish cleaning a room, they wheel the machine in and hit go.

At Cooley Dickinson Hospital in Northampton, MA, 1 in 129 patients came down with a hospital-acquired infection in 2010. Last January, Cooley began using the Xenex device. It subsequently saw a 67 percent drop in infections from C. diff, a toxic superbug that can cause diarrhea, sepsis and death.

“We think we might have saved five lives and prevented two colostomies,” says Dr. Joanne Levin, medical director of Cooley’s infection prevention program. Dickinson now has two Xenex machines and is getting a third this year, with the goal of using it in every room.

An average-sized hospital, with about 120 beds, would need two Xenex devices to clean all its rooms. Each one costs about $80,000, and can be bought or leased.

That’s not cheap — but infections aren’t either. It costs U.S. hospitals about $35 billion a year to treat hospital-acquired illnesses. The price tag for treating one case of a common bug, MRSA (methicillin-resistant Staphylococcus aureus), is about $28,000, according to Dr. Mary Jo Cagle, the chief quality officer of Cone Health, a five-hospital healthcare system in North Carolina.

Since four of Cone’s hospitals began using the Xenex last January, the chain has reduced its incidence of MRSA infections by 35% hospital-wide, and lowered it to zero in the intensive care units.

A game-changer for hospital-acquired illnesses

Xenex’s market is potentially huge. In the U.S. alone there are about 5,800 hospitals. Xenex’s technology is currently in approximately one hundred hospitals, and the company hopes to double that number in 2013. It’s also moving into Europe and Asia.

Ramanan Laxminarayan, director of the Center for Disease Dynamics, Economics & Policy in Washington D.C., says that as long as Xenex’s technology is cost effective for hospitals, he sees little downside. “It already has an advantage in the marketplace because it doesn’t require doctors or nurses to change their behavior or do more,” he says.

Cone Health estimates that the Xenex device saved it nearly $3 million in just the first six months of operation.

“Rooms are cleaned faster and are safer now,” Cagle says. “When you’re talking about critically ill patients, just getting them into a room 15 minutes faster can mean the difference between life and death.”

In America?s hospitals, approximately 1 in 20 patients will contract a healthcare-associated infection (HAI). For 2010, Cooley Dickinson Hospital reported that 1 in 129 patients got an HAI. Now, those better odds of avoiding an infection at Cooley Dickinson have improved even further, as the hospital has documented a groundbreaking 67% drop in one type of infection, Clostridium difficile (C. diff).

The remarkable drop in the incidence of C. diff occurred following adoption in January of room cleaning with portable UV light, an added step among many CDH already takes to eliminate infections, reports Levin. Cooley Dickinson Hospital was the first hospital in the Northeast to use the Xenex PX-UV Disinfection System.

Cooley Dickinson had a strong infection prevention program in place before adding the UV disinfection, and the program ? which includes best-practice room cleaning and proper hand hygiene ? was already lowering infection rates, Levin says. But a bug like C. diff requires a stronger weapon than the tools they had in place.

Specific rates of C. diff infections are not available, but the Centers for Disease Control and Prevention (CDC) tracked a nearly twofold increase in C. diff infections from 1996 to 2003. Two statewide studies in Oregon and Massachusetts found C. diff infections increasing at an even faster pace. The C. diff. pathogen can be found in the community and can be transmitted when a patient is in any care facility, including a hospital or a nursing home.

What makes C. diff especially virulent is that the organism can make spores, which are like seeds with a hard shell. Even strong hospital cleaning products can?t penetrate the shell, Levin said.

Subsequently, C. diff can live in an environment for months. In one study, C. diff disease was found on 49% of surfaces in hospital rooms housing a patient with the infection and on 29% of surfaces in rooms with a patient who carries the germ but has no symptoms, according to a March 2011 report in Infection Control and Hospital Epidemiology.

C. diff is a bacterium that causes inflammation of the colon. According to the CDC, the elderly and people who have other illnesses or conditions requiring prolonged use of antibiotics are at greater risk of acquiring this disease.