Use of a Sampling Area-Adjusted Adenosine Triphosphate Bioluminescence Assay Based on Digital Image Quantification to Assess the Cleanliness of Hospital Surfaces

Yu-Huai Ho, Lih-Shinn Wang, Hui-Li Jiang, Chih-Hui Chang, Chia-Jung Hsieh, Dan-Chi Chang, Hsin-Yu Tu, Tan-Yun Chiu, Huei-Jen Chao and Chun-Chieh Tseng
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Yu-Huai Ho: Division of Infection Diseases, Department of Internal Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University; Hualien 97004, Taiwan
Lih-Shinn Wang: Division of Infection Diseases, Department of Internal Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University; Hualien 97004, Taiwan
Hui-Li Jiang: Unit of Infection Control and Management, Buddhist Tzu Chi General Hospital, Hualien 97004, Taiwan
Chih-Hui Chang: Department and Graduate Institute of Public Health, Tzu Chi University, Hualien 97004, Taiwan
Chia-Jung Hsieh: Department and Graduate Institute of Public Health, Tzu Chi University, Hualien 97004, Taiwan
Dan-Chi Chang: Department and Graduate Institute of Public Health, Tzu Chi University, Hualien 97004, Taiwan
Hsin-Yu Tu: Department and Graduate Institute of Public Health, Tzu Chi University, Hualien 97004, Taiwan
Tan-Yun Chiu: Department and Graduate Institute of Public Health, Tzu Chi University, Hualien 97004, Taiwan
Huei-Jen Chao: Department of Laboratory Medicine, Buddhist Tzu Chi General Hospital, Hualien 97004, Taiwan
Chun-Chieh Tseng: Department and Graduate Institute of Public Health, Tzu Chi University, Hualien 97004, Taiwan

IJERPH, 2016, vol. 13, issue 6, 1-12

Abstract: Contaminated surfaces play an important role in the transmission of pathogens. We sought to establish a criterion that could indicate “cleanliness” using a sampling area–adjusted adenosine triphosphate (ATP) assay. In the first phase of the study, target surfaces were selected for swab sampling before and after daily cleaning; then, an aerobic colony count (ACC) plate assay of bacteria and antibiotic-resistant bacteria was conducted. ATP swabs were also tested, and the ATP readings were reported as relative light units (RLUs). The results of the ACC and ATP assays were adjusted according to the sampling area. During the second phase of the study, a new cleaning process employing sodium dichloroisocyanurate (NaDCC) was implemented for comparison. Using the criterion of 2.5 colony-forming units (CFU)/cm 2 , 45% of the sampled sites were successfully cleaned during phase one of the study. During phase two, the pass rates of the surface samples (64%) were significantly improved, except under stringent (5 RLU/cm 2 ) and lax (500 RLU) ATP criteria. Using receiver-operating characteristic curve analysis, the best cut-off point for an area-adjusted ATP level was 7.34 RLU/cm 2 , which corresponded to culture-assay levels of <2.5 CFU/cm 2 . An area adjustment of the ATP assay improved the degree of correlation with the ACC-assay results from weak to moderate.

Keywords: adenosine triphosphate; relative light units; infection control; cleanliness (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2016
References: View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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