Evaluation of different monitoring methods of surface cleanliness in operating rooms.

Elaine Aparecida Da Silva Nascimento,Vanessa De Brito Poveda,Jussimara Monteiro

doi:10.1590/0034-7167-2020-1263

Abstract

to evaluate different monitoring methods for detecting the presence of organic or biological matter before and after the cleaning and disinfection processes of the operating room. this is a cross-sectional study based on visual inspection, adenosine triphosphate levels and microbiological culture for the assessment of cleaning and disinfection. 93.3% of the surfaces inspected visually for this study purpose were considered clean, even when high levels of adenosine triphosphate and microbiological analysis detected presence of microorganisms relevant to biofilm formation. the cleaning and disinfection processes reduced the microbial load and organic matter of the inspected surfaces, demonstrated by the values obtained by the adenosine triphosphate bioluminescence assay and microbiological analysis, but the visual inspection as a unique tool to assess the surfaces' cleanliness may give a false impression of clean environment.

Highlights

OBJECTIVESThe optimization of processes related to the cleaning and disinfection (CD) of surfaces in healthcare environments is currently under discussion[1]
Note: *SD – Standard Deviation; †Min – minimum; ‡Max – maximum; §Paired Wilcoxon test. These methods that were used in this study evaluate three distinct analytes that contribute to the quality of surface CD, namely a reduction in the amount of organic matter (ATP levels), microbiological pathogens and visual dirt
The Adenosine triphosphate (ATP) bioluminescence assay detected high levels of organic matter, even on surfaces subjected to CD protocols, while the microbiological analysis detected the presence of pathogens relevant to the incidence of healthcare-associated infections (HAIs), statistically significant reduction in these MOs levels was observed after CD

Summary

Introduction

OBJECTIVESThe optimization of processes related to the cleaning and disinfection (CD) of surfaces in healthcare environments is currently under discussion[1]. Contaminated surfaces contribute to the endemic and/ or epidemic transmission of microbial pathogens that cause healthcare-associated infections (HAIs), including Clostridium difficile, vancomycin-resistant enterococci (VRE), methicillinresistant Staphylococcus aureus (MRSA), Acinetobacter baumannii, Pseudomonas aeruginosa and norovirus. These HAI-causing MOs harbor an innate ability of long-term survival even on surfaces that have been subjected to CD processes[3,4]. Contaminated surfaces may act as a reservoir for these pathogens, which would allow their direct or indirect transmission to the patient[5] Measures such as improving environmental CD quality and reducing pathogens spreading on surfaces can help preventing the spread of potentially pathogenic MOs, especially multidrugresistant strains. These measures, beneficial for both patients and healthcare professionals, play a vital role in the control of HAIs[6,7]

Objectives

Results

Discussion

Conclusion