Abstract
BackgroundOur previous study into assessing hospital cleanliness in Japan by two common methods, ATP bioluminescence and the stamp agar method, revealed considerable variability in the data of both methods (BMC Research Notes, 7: 121, 2014). To investigate the reason(s) for the variability, we reanalyzed the data (n = 752) from the point of view of the material surface properties of sampling sites.MethodsData obtained from surfaces with unknown properties and different purposes such as floor were omitted, and the remaining data (n = 488) were used for this study. The material surface properties on sampling sites were divided into six categories: melamine coated (n = 216), vinyl chloride (n = 16), stainless steel (n = 144), wood (n = 63), and acrylonitrile-butadiene styrene resin coated (n = 48). The data between individual material properties were compared.ResultsThe ATP values of high-touch places were significantly different depending on the type of surface, but no significant difference in stamp values between material properties was seen, indicating that in contrast to stamp values, ATP-accumulation more depends on the physical properties of the material surface such as electronic charges or roughness. To confirm this, we assessed a degree of roughness on vinyl chloride material surface (disutilized floor samples actually used for each of the hospitals) by observation with scanning electron microscope (SEM). As a result, SEM observation similarly revealed considerable roughness on the materials, which may allow microbes to contaminate the materials without noticing it.ConclusionMaterial properties must be considered when evaluating hospital cleanliness with ATP values, and provide a strong warning into evaluating hospital cleanliness.
Highlights
Our previous study into assessing hospital cleanliness in Japan by two common methods, adenosine triphosphate (ATP) bioluminescence and the stamp agar method, revealed considerable variability in the data of both methods (BMC Research Notes, 7: 121, 2014)
Control and Prevention, include appropriate monitoring of hospital environments with a warning that visual assessment of hospital cleanliness is not enough to control hospital-acquired infections [8,9,10]. Both the adenosine triphosphate (ATP) bioluminescence (ATP method), which is an indicator of general organic contamination [11,12,13,14,15], and the standard stamp agar method, which is an indicator of microbiological contamination [16,17,18], has been used worldwide
The commercial stamp agar assay was based on soybean casein digest (10 cm2 surface area; Nissui Pharmaceutical Co., Ltd., Tokyo, Japan) for monitoring environments for microorganism contamination; the agar plate was cultured for 5–7 days under aerobic conditions at 30 °C, colonies were counted and these data were estimated as colony-forming unit (CFU) per 10 cm2 [19]
Summary
Our previous study into assessing hospital cleanliness in Japan by two common methods, ATP bioluminescence and the stamp agar method, revealed considerable variability in the data of both methods (BMC Research Notes, 7: 121, 2014). The results revealed the presence of a wide range of organic contamination spread via hand touching, including microbial contamination [19]. Both methods indicated considerable variability regardless of daily visual assessment and wiping, and positive surfaces were irregularly seen, suggesting that ongoing daily hospital cleanliness is insufficient, the exact reason for the variability remains unclear [19]
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