Abstract
BackgroundHospital cleanliness in hospitals with a tendency toward long-term care in Japan remains unevaluated. We therefore visualized hospital cleanliness in Japan over a 2-month period by two distinct popular methods: ATP bioluminescence (ATP method) and the standard stamp agar method (stamp method).MethodsThe surfaces of 752 sites within nurse and patient areas in three hospitals located in a central area of Sapporo, Japan were evaluated by the ATP and stamp methods, and each surface was sampled 8 times in 2 months. These areas were located in different ward units (Internal Medicine, Surgery, and Obstetrics and Gynecology). Detection limits for the ATP and stamp methods were determined by spike experiments with a diluted bacterial solution and a wipe test on student tables not in use during winter vacation, respectively. Values were expressed as the fold change over the detection limit, and a sample with a value higher than the detection limit by either method was defined as positive.ResultsThe detection limits were determined to be 127 relative light units (RLU) per 100 cm2 for the ATP method and 5.3 colony-forming units (CFU) per 10 cm2 for the stamp method. The positive frequency of the ATP and stamp methods was 59.8% (450/752) and 47.7% (359/752), respectively, although no significant difference in the positive frequency among the hospitals was seen. Both methods revealed the presence of a wide range of organic contamination spread via hand touching, including microbial contamination, with a preponderance on the entrance floor and in patient rooms. Interestingly, the data of both methods indicated considerable variability regardless of daily visual assessment with usual wiping, and positive surfaces were irregularly seen. Nurse areas were relatively cleaner than patient areas. Finally, there was no significant correlation between the number of patients or medical personnel in the hospital and organic or microbiological contamination.ConclusionsOngoing daily hospital cleanliness is not sufficient in Japanese hospitals with a tendency toward long-term care.
Highlights
Hospital cleanliness in hospitals with a tendency toward long-term care in Japan remains unevaluated
These guidelines recommended cleaning and disinfection of surfaces in close proximity to the patient and those that are likely to be touched by the patient and medical staff members or housekeepers, visual assessment of hospital cleanliness is still popular and has been believed to be linked with reduction of infection. Both adenosine triphosphate (ATP) bioluminescence (ATP method) as indicators of general organic contamination [11,12,13,14,15] and the standard stamp agar method for monitoring microbiological contamination [16,17,18] have been available for monitoring hospital cleanliness
The averaged data obtained as bioluminescence relative light units (RLU) were expressed as the fold change over the detection limit value estimated as follows
Summary
Experimental design This study was conducted at three hospitals of different sizes [“A” hospital (>500 beds), “B” hospital (100–500 beds), and “C” hospital (
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