Adenosine Triphosphate Monitoring Research Articles

Can measuring environmental cleanliness using ATP aid in the monitoring of wards with periods of increased incidence of Clostridium difficile?

Management of periods of increased incidence of Clostridium difficile (PIIs) on a ward have become multi-factorial and involve isolation of patients, typing of the isolates, antibiotic audit and a weekly environmental audit completed until three consecutive weekly passes are obtained. The aim of this study was to establish if monitoring the environment using adenosine triphosphate (ATP) could aid in reducing the length of time the wards remained on the weekly environmental audit. Secondly, it was to establish if certain pieces of equipment had continually high ATP scores requiring wider interventions. The study took place across three hospital sites covered by one infection control team over a 22 month period. There were three study periods, with the only difference being that ATP monitoring was conducted during period B. There was a difference in the length of time the wards remained on the audit between the first period and the ATP period; however this decrease was sustained in the third period when ATP monitoring ceased. There was an increase in the percentage of sites achieving a pass with ATP week on week. ATP monitoring provided the staff with non-subjective results and immediate feedback that facilitated discussions about cleaning regimes. ATP monitoring was a useful adjunct to environmental audits.

Improved hand hygiene technique and compliance in healthcare workers using gaming technology

In 2009, the World Health Organization recommended the use of a 'multi-faceted, multi-modal hand hygiene strategy' (Five Moments for Hand Hygiene) to improve hand hygiene compliance among healthcare workers. As part of this initiative, a training programme was implemented using an automated gaming technology training and audit tool to educate staff on hand hygiene technique in an acute healthcare setting. To determine whether using this automated training programme and audit tool as part of a multi-modal strategy would improve hand hygiene compliance and technique in an acute healthcare setting. A time-series quasi-experimental design was chosen to measure compliance with the Five Moments for Hand Hygiene and handwashing technique. The study was performed from November 2009 to April 2012. An adenosine triphosphate monitoring system was used to measure handwashing technique, and SureWash (Glanta Ltd, Dublin, Ireland), an automated auditing and training unit, was used to provide assistance with staff training and education. Hand hygiene technique and compliance improved significantly over the study period (P<0.0001). Incorporation of new automated teaching technology into a hand hygiene programme can encourage staff participation in learning, and ultimately improve hand hygiene compliance and technique in the acute healthcare setting.

Validation and comparison of three adenosine triphosphate luminometers for monitoring hospital surface sanitization: A Rosetta Stone for adenosine triphosphate testing

The application of adenosine triphosphate (ATP) luminometry for monitoring sanitized hospital surfaces is an evolving infection control practice. The goal of this study is to validate and compare 3 commercially available ATP luminometry, swab, rapid-test systems for use in hospital surface sanitization testing. Regulatory agencies may consider this a point-of-care laboratory test; it is therefore imperative that validation criteria are established. The ability of instruments to measure long-term stability of ATP dried on surfaces was determined. Dilutions of 3 species of microorganisms and a blood sample were dried onto a surface and tested. The performance characteristics of instruments were compared side-by-side for their ability to recover microorganism-derived ATP from surfaces. Timed studies showed that surface biologic-ATP remained detectable for 10 days. Instrument clinical sensitivity, precision, detection range, limit of detection, and linearity were determined. Swab recovery of microorganisms from surfaces varied by instrument and organism. All 3 systems detected microorganisms in the presence of disinfectants. All instruments were validated, but only 1 was verified, because of variations in performance for each system. These studies indicate that careful consideration of the technologic application and instrument performance are important criteria for the selection of an ATP monitoring system.

Comparison of results of ATP bioluminescence and traditional hygiene swabbing methods for the determination of surface cleanliness at a hospital kitchen

Adenosine triphosphate (ATP) bioluminescence and traditional microbiological swabbing culture methods were used for detection of surface hygiene on worktops, cutting boards and equipments at a hospital kitchen. A total of 280 surface samples were collected from the kitchen. The agreement between the two methods (coefficient of Kappa) was statistically significant (corrected χ 2 = 30.886 ; κ = 0.249 ; p < 0.001 ). Consequently, the ATP monitoring method provides results rapidly with improved benefits in the control of surface contamination and application of corrective action against poor hygiene. However, it is not a substitute for culturing methods, the combination of both methods was emphasized for surface hygiene monitoring. Besides, the results indicate that, for food safety and public health, the hygienic status of the surfaces in the kitchen should be improved and food handlers should be trained well on hygiene.

Bioluminescence determination of enzyme activity of firefly luciferase in the presence of pesticides

Firefly luciferase (EC 1.13.12.5) (FL) is the key enzyme in the firefly bioluminescence method (FB), which is widely used to determine the viability of living cells. The FB method can also be applied to monitoring the influence of different pollutants, such as pesticides. Firefly luciferase is a hydrophobic enzyme and its activity depends on the type of solvent, pH and substances present in the reaction mixture. The influence of three aromatic pesticides, including fenoxaprop-p-ethyl (I), diclofop-methyl (II) and metsulfuron methyl (III), on the enzyme activity was indirectly evaluated through the measurement of emitted light in the bioluminescence reaction, expressed in relative luminescence units (RLU). The reaction mixture used in the bioluminescence measurements consisted of: Tris buffer (pH 7.75), adenosine triphosphate (ATP) and ATP monitoring reagent, where FL is present. Ethanol-water solutions of each pesticide were then added at concentrations of 2.4 x 10(-4)-2.4 x 10(-8) mol/L. The FL activity inhibition factors (FL In%) were determined. The FL activity was maximally inhibited in the presence of all pesticides under study at a concentration of 2.4 x 10(-4) mol/L and was lowered by about 15-26% for pesticide I at concentrations of 2.4 x 10(-5)-2.4 x 10(-8) mol/L, whereas pesticides II and III, applied in the same concentration range, showed smaller FL inhibition values (5.3-20%). The pesticide degradation products (obtained after a 1 month period), measured in the same experimental conditions, in most cases exhibited a much less inhibitory effect on the enzyme activity than the corresponding initial pesticide.

Bioluminescence ATP monitoring as a surrogate marker for microbial load on hands and surfaces in the home

To evaluate the validity and reliability of adenosine triphosphate (ATP) monitoring as a surrogate marker for cleanliness, the kitchen table surface in 225 inner-city homes was sampled by microbiologic culture and by two types of biomass monitoring systems (HY-LiTE™ 2 ATP System and HY-RiSE Colour Hygiene Test Strip, EM Science, Gibbstown, New Jersey, USA). A randomly selected hand of the homemaker ( n=225) was also cultured and sampled with the ATP monitoring system immediately after handwashing. Log microbial counts on hands ranged from 3.2 to 7.0 and from the table, 1.0 to 5.5. While the traditional ATP readings (HY-LiTE) and the color strips were significantly correlated ( R=0.18, P=0.01), there was no significant correlation between the ATP monitor readings and the colony-forming units counts on either the hands ( R=−0.03, P=0.62) or the table ( R=0.04, P=0.58). Such biomass measurements are not a substitute for quantitation of microbial load.

Reduced human lymphocyte blastogenesis and enhancement of adenosine triphosphate (ATP) by L-carnitine.

Carnitine is associated with lipid synthesis and its deficiency may lead to cardiomegaly with parenchymal lipid in the heart, kidney and liver. In our study we found that pretreatment of peripheral blood mononuclear cells (PBMC) with serial dilutions of L-Carnitine (100 micrograms/ml-1 pg/ml) inhibits, in a dose-dependent manner, lymphocyte DNA synthesis stimulated with PHA (20 micrograms/ml). L-Carnitine did not have any effect on resting PBMC. The maximum inhibition was found at 10 micrograms/ml of L-Carnitine. Moreover, in a time-course study and using an enzymatic analysis (ATP monitoring reagent), L-Carnitine enhanced ATP production on PBMC treated and untreated with PHA, reaching a maximum effect at 30 min incubation. In another set of experiments PBMC were treated with L-Carnitine alone and in combination with PHA, and the percent of receptors CD3, CD4, and CD8 were calculated with flow cytometry. After the cell incubation with L-Carnitine, the percent of all receptors studied did not change compared to L-Carnitine-untreated cells (controls). These data suggest that L-Carnitine inhibits, in a dose-dependent manner, lymphocyte blastogenesis induced by PHA, probably through the enhancement of ATP synthesis, which is considered an inhibitor of phospholipase C activity and a suppressor in lymphocyte cultures.