Adenosine Triphosphate Bioluminescence Testing Research Articles

Outbreak investigation of Serratia marcescens bloodstream infection in an obstetric ward for high-risk pregnant women

BackgroundSerratia marcescens is a gram-negative bacterium that is widespread in the environment. S. marcescens bacteremia can be fatal during pregnancy and cause persistent chorioamnionitis. This study reports an outbreak of Serratia marcescens bloodstream infection (BSI) among high-risk pregnant women in an obstetric ward. The purpose of this study is to report our experience with the usefulness of the ATP test in hospital environmental management and to confirm that bloodstream infections of patients with the same strain were correlated by WGS testing.MethodsThis retrospective study collected the data of inpatients with S. marcescens bacteremia in obstetric ward for high-risk pregnant women from August 22, 2021, to October 14, 2021. We performed: an adenosine triphosphate (ATP) bioluminescence test in the environment with a high-contact area; environmental culture; on-site monitoring and staff education; and whole-genome sequencing (WGS) to evaluate genetic relationships among S. marcescens isolates.ResultsS. marcescens BSI occurred in four consecutive patients. None of the patients had central venous catheters. An ATP bioluminescence test revealed that high-contact areas and areas for injection preparation were not clean (≥ 1000 relative light units). However, S. marcescens was not identified in the environmental cultures, likely due to intensive environmental cleaning and discarding of potentially contaminated specimens before the culture test. On-site monitoring and education were conducted for 1 month. There were no further reports of BSI until 6 months after the last patient was discharged. WGS performed on three isolates from three patients indicated that the isolated S. marcescens was likely from the same strain.ConclusionsWe controlled an S. marcescens outbreak by improving environmental cleaning as well as education of and behavior changes in healthcare workers. Using the ATP bioluminescence test can provide feedback on environmental cleaning and education. WGS played a role in determining the spread of BSI caused by the same strain.

Assessment of Soiling on Highly Touched Clinical Surfaces in Intensive Care Units.

The aim of this study is to evaluate highly touched clinical surfaces using visual inspection methods and adenosine triphosphate by bioluminescence to identify soiling in intensive care units. Descriptive, cross-sectional study carried out in three intensive care units located in Belo Horizonte, MG, Brazil. Data collection included 142 assessments of environmental surfaces. For data analysis, the Pareto diagram and descriptive statistics were used through measures of central tendency. The visual inspection identified dirtiness in the infusion pump, alcohol dispenser, and telephone. The surface that showed a high level of contamination by organic matter identified by the adenosine triphosphate bioluminescence test was the telephone, with a median of 1012 RLU/cm2 (±348.8). The surface evaluation methods used in the intensive care units made it possible to identify dirt on surfaces highly touched by hands, reinforcing the need for investments in training and audits in the process of cleaning and disinfecting surfaces.

Assessment of a novel antimicrobial surface disinfectant on inert surfaces in the intensive care unit environment using ATP-bioluminesence assay

Cross-contamination from inanimate surfaces can play a significant role in intensive care unit (ICU)-acquired colonization and infection. This study assessed an innovative isopropyl alcohol/organofunctional silane solution (IOS) to reduce microbial contamination on inert surfaces in a medical ICU. Baseline adenosine triphosphate bioluminescence testing (ABT)-measurements (N = 200) were obtained on designated inert ICU surfaces followed by IOS treatment. At 1 and 6 weeks, selective surfaces were randomized to either IOS-treated or nontreated controls for comparison using ABT (N = 400) and RODAC colony counts (N = 400). An ABT value of ≤45 relative light units (RLU) was designated as "clean," whereas >45 was assessed as "dirty." Mean RLU baseline values ranged from 870.3 (computer keyboard) to 201.6 (bed table), and 97.5% of surfaces were assessed as "dirty." At 6 weeks, the mean RLU of surfaces treated with IOS ranged from 31.7 (physician workstation) to 51.5 (telephone handpiece), whereas values on comparative control surfaces were 717.3 and 643.7, respectively (P < .001). Some 95.5% of RODAC cultures from IOS-treated sites at 6 weeks were negative, whereas 90.5% of nontreated sites were culture-positive, yielding multiple isolates including multidrug-resistant gram-positive and gram-negative bacteria. IOS-treated surfaces recorded significantly lower RLU and RODAC colony counts compared with controls (P < .001). A single application of IOS resulted in a persistent antimicrobial activity on inert ICU surfaces over the 6-week study interval.

Adenosine Triphosphate Bioluminescence Test of the Nasal Spray Nozzles Attached to an Ear-nose-throat Treatment Unit

Adenosine Triphosphate Bioluminescence Test of the Nasal Spray Nozzles Attached to an Ear-nose-throat Treatment Unit

Effect evaluation of adenosine triphosphate bioluminescence test on quality monitoring of flexible endoscope reprocessing

Objective To evaluate the efficacy of adenosine triphosphate (ATP) bioluminescence test on quality monitoring of flexible endoscope reprocessing. Methods The patient-used gastroscopes were randomly assigned to two groups after standard reprocessing by one nurse. The group A were assessed by ATP test followed by microbiological surveillance test after cleaning and disinfection; and the gastroscopes in group B were tested in a reverse order. The biological load after endoscopic cleaning and disinfection were compared between ATP test and microbiological surveillance, and the correlation of the two tests on quality assessing of endoscopic cleanliness and disinfection were analyzed. Results A total of 51 samples were valid. The qualified rate of cleaning was 45.1% (23/51) detected by ATP test, and the qualified rate of disinfection was 92.2% (47/51) detected by microbiological surveillance. There was no statistical difference in cleaning qualification rate (50.0% VS 40.0%, χ2=0.515, P=0.473) and disinfection qualification rate (96.2% VS 88.0%, χ2=0.316, P=0.574) between the two groups. The logarithmic value of relative light unit (RLU) of ATP test after cleaning was higher than the value after disinfection (1.68±0.50 VS 0.88±0.49, t=2.335, P=0.024). For gastroscopes disinfected appropriately, the RLU logarithmic value of ATP test after cleaning (t=2.505, P=0.016) and disinfection (t=2.485, P=0.016) were lower than that of disqualification. The correlation between the value of ATP test and the colony forming units of microbiological surveillance after cleaning was not statistically significant (r=0.199, P=0.171), but there was a low correlation between the two monitoring results after disinfection (r=0.391, P=0.005). There was a low correlation between the value of ATP test after cleaning and the colony forming units of microbiological surveillance after disinfection (r=0.301, P=0.032). Conclusion ATP bioluminescence test can be used to evaluate the trend of endoscopic biological load change and the quality of flexible endoscope reprocessing. Key words: Endoscopes, gastrointestinal; Quality control; Disinfection; Fluorometry

Characterization of microbial community composition, antimicrobial resistance and biofilm on intensive care surfaces.

Organisms causing healthcare associated infections can be sourced from the inanimate environment around patients. Residing in a biofilm increases the chances of these organisms persisting in the environment. We aimed to characterise bacterial environmental contamination, genetically and physiologically, and relate this to general intensive care unit (ICU) cleanliness. Cleanliness was determined by adenosine triphosphate (ATP) measurements of 95 high-touch objects. Bacteriological samples were obtained from the same sites (n=95) and from aseptically removed sections (destructive samples, n=20). Bacterial enrichment culture was conducted using tryptone soya broth prior to plating on horse blood agar, MacConkey agar, and screening chromogenic agar for identification of multidrug resistance organism (MDRO). Bacterial load and microbial diversity were determined using quantitative PCR (qPCR) and next generation DNA sequencing respectively. Confocal laser scanning microscopy and scanning electron microscopy were used to visually confirm the biofilm presence. Many intensive care surfaces (61%) were highly contaminated by biological soil as determined by ATP bioluminescence testing. The degree of biological soiling was not associated with bacterial contamination as detected by qPCR. Bacterial load ranged from 78.21 to 3.71×108 (median=900) bacteria/100cm2. Surface swabs from 71/95 sites (75%) were culture-positive; of these 16 (22.5%) contained MDRO. The most abundant genera were Staphylococcus, Propionibacterium, Pseudomonas, Bacillus, Enterococcus, Streptococcus and Acinetobacter. Biofilm was visually confirmed by microscopy on 70% (14/20) of items. Bacterial biofilms and MDROs were found on ICU surfaces despite regular cleaning in Saudi Arabia, suggesting that biofilm development is not controlled by current cleaning practices.

Fine-Tuning the Surface of Forward Osmosis Membranes via Grafting Graphene Oxide: Performance Patterns and Biofouling Propensity.

Graphene oxide (GO) nanosheets were attached to the polyamide selective layer of thin film composite (TFC) forward osmosis (FO) membranes through a poly L-Lysine (PLL) intermediary using either layer-by-layer or hybrid (H) grafting strategies. Fourier transform infrared spectroscopy, zeta potential, and thermogravimetric analysis confirmed the successful attachment of GO/PLL, the surface modification enhancing both the hydrophilicity and smoothness of the membrane's surface demonstrated by water contact angle, atomic force microscopy, and transmission electron microscopy. The biofouling resistance of the FO membranes determined using an adenosine triphosphate bioluminescence test showed a 99% reduction in surviving bacteria for GO/PLL-H modified membranes compared to pristine membrane. This antibiofouling property of the GO/PLL-H modified membrane was reflected in reduced flux decline compared to all other samples when filtering brackish water under biofouling conditions. Further, the high density and tightly bound GO nanosheets using the hybrid modification reduced the reverse solute flux compared to the pristine, which reflects improved membrane selectivity. These results illustrate that the GO/PLL-H modification is a valuable addition to improve the performance of FO TFC membranes.

Who is really caring for your environment of care? Developing standardized cleaning procedures and effective monitoring techniques

Health care facilities have procedures for cleaning patient care environments, but there is often confusion about the division of labor when it comes to cleaning responsibilities. In addition, systems to monitor cleaning effectiveness are frequently suboptimal. In 2007, a multidisciplinary task force revised policies outlining staff responsibilities for cleaning in-patient nursing care units and chose a monitoring system using a specialized adenosine triphosphate bioluminescence test.

EVALUATION OF ADENOSINE TRIPHOSPHATE (ATP) BIOLUMINESCENCE FOR ESTIMATING BACTERIA ON SURFACES OF BEEF CARCASSES

A rapid (&lt;15 min), inexpensive and simple method has been developed to estimate the concentration of bacteria on surfaces of beef carcasses using adenosine triphosphate (ATP) bioluminescence. Surfaces (5x5 cm2) of beef carcasses (n= 159) were collected by excision. An ATP assay and aerobic plate count were performed on each sample. A significant (p &lt; 0.001) positive linear relationship (r = 0.83) between plate count and ATP assay was obtained for 159 beef carcass samples. When thresholds levels were set at 1 × 104, 1 × 105 and 1 × 106 CFU/cm2, there was moderate to good agreement between the ATP bioluminescence assay and the aerobic plate count as determined by the k‐statistic. The application of this ATP bioluminescence test to HACCP systems for beef slaughter processes is discussed.

Rapid Assessment of the Microbiological Quality of Poultry Carcasses Using ATP Bioluminescence

The meat industry is in need of faster and more reliable methods to determine microbial loads in food products. A rapid method (<15 min) has been developed to assess the microbiological quality of chicken carcasses using the adenosine triphosphate (ATP) bioluminescence assay. The results indicate that, following modifications, the ATP bioluminescence test produced an acceptable correlation with plate counts (r = 0.85, p < 0.001) and demonstrated good repeatability between replicates. It is envisaged that the modified ATP bioluminescence assay would best be used as a platform rejection test. Using threshold levels determined from the regression equation, the ATP bioluminescence assays gave about 90% agreement with plate counts for carcass rinses with counts above 5 × 104 CFU/ml. These findings suggest that the modified ATP bioluminescence assay could be used for monitoring critical control points (CCPs) in programs based on hazard analysis of critical control points (HACCP).