269. Comparing adenosine triphosphate (ATP) luminescence technology to contact plate-based microbiologic sampling for the assessment of cleanliness of the patient care environment
Session: Poster Abstract Session: HAI: Environment and Device Cleaning
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • 269_IDWPOSTER.pdf (473.8 kB)
  • Background: Adenosine triphosphate (ATP) luminescence technology is increasingly used in hospitals to monitor the cleanliness of the patient care environment; however, microbiological data to support the cut-off values used to determine if a surface “passes” or “fails” a cleanliness test are limited. We examined the relationship between ATP concentration and bacterial burden on environmental surfaces in the hospital.

    Methods: Adjacent surfaces in occupied patient rooms and other patient care areas within an acute care hospital were sampled using two techniques: ATP burden in luminescence relative light units (RLU) using the 3M CleanTrace Hygiene Management System and bacterial burden in colony forming units (CFU) per cm2 using BD BBL™ Rodac contact plates. Plates with >200 CFU were considered too numerous to count and recorded as 200 CFU for analysis. To assess the relationship between RLU and CFU, Spearman and Pearson correlations were calculated and a negative binomial model was selected. To determine an appropriate RLU cut-off value, logistic regression and an ROC curve were completed.

    Results: 98 surfaces were sampled. The median RLU value was 372 (13-139,021) and median CFU count was 0.7 colonies per cm2 (0-7.8). The Pearson and Spearman correlations between CFU and log-transformed RLU were 0.23 and 0.30, respectively. Under the negative binomial model, RLU was a statistically significant predictor for CFU (p=0.0080). In this model, if the RLU value increased 100%, the mean CFU count increased 15.7%. The ROC curve determined that the best cut-off value for RLU is 384 (between 379 and 394); however, the area under the curve was 0.63.

    Conclusion: While ATP luminescence technology monitoring is not equivalent to microbiologic testing of environmental surfaces, these findings suggest that a correlation exists between RLU and CFU and that surfaces for which sampling yields an RLU value of at least 384 RLU are more likely to have a positive bacterial culture (≥1 CFU/cm2).Thus, given its ease and rapid turnaround time, ATP luminescence technology may serve as a useful marker of cleanliness that can provide real time data to allow immediate feedback to persons responsible for cleaning the hospital environment.

    Elizabeth Salsgiver, MPH1, Daniel Bernstein, BA1, Matthew S. Simon, MD, MS1,2, William Greendyke, MD3, Haomiao Jia, PhD3, Amy Robertson, BS1,2, Selma Salter, BS1,2, Audrey Schuetz, MD2,4,5, Lisa Saiman, MD, MPH, FSHEA2,6, E. Yoko Furuya, MD, MS2,7 and David P. Calfee, MD, MS, FIDSA, FSHEA1,2, (1)Weill Cornell Medicine, New York, NY, (2)NewYork-Presbyterian Hospital, New York, NY, (3)Columbia University Medical Center, New York, NY, (4)Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, (5)Mayo Clinic, Rochester, MN, (6)Pediatrics, Columbia University Medical Center, New York, NY, (7)Medicine, Columbia University Medical Center, New York, NY

    Disclosures:

    E. Salsgiver, None

    D. Bernstein, None

    M. S. Simon, None

    W. Greendyke, None

    H. Jia, None

    A. Robertson, None

    S. Salter, None

    A. Schuetz, None

    L. Saiman, None

    E. Y. Furuya, None

    D. P. Calfee, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.