Abhishek Deshpande1, Aaron N Dunn2, Jacqueline Fox3, Jennifer L Cadnum4, Thriveen S C Mana4, Annette Jencson5, Thomas G Fraser6, Curtis J Donskey7, Steven M Gordon6. 1. Department of Infectious Disease, Respiratory Institute, Cleveland Clinic, Cleveland, OH; Center for Value-Based Care Research, Medicine Institute, Cleveland Clinic, Cleveland, OH; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH. Electronic address: abhishekdp@gmail.com. 2. Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH. 3. Center for Value-Based Care Research, Medicine Institute, Cleveland Clinic, Cleveland, OH. 4. Department of Medicine, Division of Infectious Diseases, Case Western Reserve University, Cleveland, OH. 5. Geriatric Research Education and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH. 6. Department of Infectious Disease, Respiratory Institute, Cleveland Clinic, Cleveland, OH. 7. Department of Medicine, Division of Infectious Diseases, Case Western Reserve University, Cleveland, OH; Geriatric Research Education and Clinical Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH.
Abstract
BACKGROUND: The degree to which daily intensive care unit (ICU) cleaning practices impacts bacterial burden is controversial. The study aimed to assess the utility of using adenosine triphosphate (ATP) bioluminescence assays for monitoring effectiveness of daily cleaning in ICU environments. METHODS: We sampled 364 total samples from 57 patient rooms and 18 common areas in 3 medical ICUs over 12 weeks, before and after routine daily cleaning. Endpoints were ATP levels (relative light units, RLU) and bacterial bioburden (colony forming units, CFU). RESULTS: High-touch surfaces in ICU patient rooms and common areas were contaminated before and after cleaning. Routine cleaning significantly reduced bacterial burden in patient rooms (0.14 log10 CFU reduction, P = .008; 0.21 log10 RLU reduction, P < .001) and in ICU common areas (1.18 log10 CFU reduction, P < .001; 0.72 log10 RLU reduction, P < .001). Among sites with colony counts >20 CFUs, the proportion of sites with ATP readings >250 RLU was significantly higher than those with ATP readings ≤250 RLU (90.0% vs 10.0%, P < .05). CONCLUSION: Routine cleaning significantly reduced bacterial burden on ICU environment surfaces. Although not an alternative to culture methods, ATP assays may be a useful technique to provide rapid feedback on surface cleanliness in ICU settings.
BACKGROUND: The degree to which daily intensive care unit (ICU) cleaning practices impacts bacterial burden is controversial. The study aimed to assess the utility of using adenosine triphosphate (ATP) bioluminescence assays for monitoring effectiveness of daily cleaning in ICU environments. METHODS: We sampled 364 total samples from 57 patient rooms and 18 common areas in 3 medical ICUs over 12 weeks, before and after routine daily cleaning. Endpoints were ATP levels (relative light units, RLU) and bacterial bioburden (colony forming units, CFU). RESULTS: High-touch surfaces in ICU patient rooms and common areas were contaminated before and after cleaning. Routine cleaning significantly reduced bacterial burden in patient rooms (0.14 log10 CFU reduction, P = .008; 0.21 log10 RLU reduction, P < .001) and in ICU common areas (1.18 log10 CFU reduction, P < .001; 0.72 log10 RLU reduction, P < .001). Among sites with colony counts >20 CFUs, the proportion of sites with ATP readings >250 RLU was significantly higher than those with ATP readings ≤250 RLU (90.0% vs 10.0%, P < .05). CONCLUSION: Routine cleaning significantly reduced bacterial burden on ICU environment surfaces. Although not an alternative to culture methods, ATP assays may be a useful technique to provide rapid feedback on surface cleanliness in ICU settings.
Authors: Guangjian Yang; Chengming Liu; Jiaqi Hu; Yang Sun; Peizeng Hu; Liu Liu; Haiyan Xu; Dazhou Li; Weihua Li; Yaning Yang; Nan Sun; Jie He; Yan Wang Journal: Front Oncol Date: 2022-02-11 Impact factor: 6.244