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Assessing effectiveness of cleaning and disinfection of equipment and environmental surfaces in cystic fibrosis clinics using an ATP assay

Published online by Cambridge University Press:  23 October 2024

Marianne S. Muhlebach Open the ORCID record for Marianne S. Muhlebach [Opens in a new window] ,
Thomas Shields ,
Kushal K. Shah ,
Maria Ansar ,
Isabel Virella-Lowell ,
Juyan J. Zhou ,
John J. LiPuma  and
Lisa Saiman Open the ORCID record for Lisa Saiman [Opens in a new window]
Marianne S. Muhlebach
Affiliation:
Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Thomas Shields
Affiliation:
Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA
Kushal K. Shah
Affiliation:
Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Maria Ansar
Affiliation:
Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA
Isabel Virella-Lowell
Affiliation:
Dept. of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
Juyan J. Zhou
Affiliation:
Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
John J. LiPuma
Affiliation:
Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
Lisa Saiman*
Affiliation:
Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA Department of Infection Prevention & Control, New York-Presbyterian Hospital, New York, NY, USA
*
Corresponding author: Lisa Saiman; Email: [email protected]
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Abstract

Background:

Infection control guidelines for cystic fibrosis (CF) stress cleaning of environmental surfaces and patientcare equipment in CF clinics. This multicenter study measured cleanliness of frequently touched surfaces in CF clinics using an ATP bioluminescence assay to assess the effectiveness of cleaning/disinfection and the impact of feedback.

Methods:

Eight surfaces were tested across 19 clinics (10 pediatric, 9 adult) over 5 rounds of testing. Rounds 1 and 2 served as uncleaned baseline, and Round 3 occurring after routine cleaning. Rounds 4 and 5 were performed after feedback provided to staff and measured after cleaning. Pass rates defined as <250 relative light units were the primary outcome.

Results:

Of the 750 tests performed, 72% of surfaces passed at baseline, and 79%, 83%, and 85% of surfaces passed in Rounds 3, 4, and 5, respectively. The overall pass-rate was significantly higher in adult compared to pediatric clinics (86% vs 71%; P < 0.001). In pediatric clinics, blood pressure equipment and computer keyboards in the pulmonary function lab consistently passed, but the exam room patient/visitor chairs consistently failed in all rounds. In adult clinics blood pressure equipment, keyboards in exam rooms and exam tables passed in all rounds and no surface consistently failed.

Conclusion:

We demonstrate the feasibility of an ATP bioluminescence assay to measure cleanliness of patient care equipment and surfaces in CF clinics. Pass rates improved after cleaning and feedback for certain surfaces. We found that surfaces are more challenging to keep clean in clinics taking care of younger patients.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 45 , Issue 10 , October 2024 , pp. 1213 - 1218
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Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

Preliminary data has been presented at the North American Cystic Fibrosis conference in November 2023 in Phoenix, AZ. USA.

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