Hostname: page-component-8448b6f56d-c47g7 Total loading time: 0 Render date: 2024-04-23T21:30:44.566Z Has data issue: false hasContentIssue false
  • English
  • Français

Usefulness of Adenosinetriphosphate Bioluminescence Assay (ATPmetry) for Monitoring the Reprocessing of Endoscopes

Published online by Cambridge University Press:  20 October 2015

Pierre Batailler ,
Philippe Saviuc ,
Romain Picot-Gueraud ,
Jean-Luc Bosson  and
Marie-Reine Mallaret
Pierre Batailler*
Affiliation:
Grenoble University Hospital Center, Public Health Center, Hygiene Unit and Hospital Risk Management, Grenoble, France
Philippe Saviuc
Affiliation:
Grenoble University Hospital Center, Public Health Center, Hygiene Unit and Hospital Risk Management, Grenoble, France
Romain Picot-Gueraud
Affiliation:
Grenoble University Hospital Center, Public Health Center, Hygiene Unit and Hospital Risk Management, Grenoble, France
Jean-Luc Bosson
Affiliation:
French Institute of Health and Medical Research CIC, Grenoble, France Univ. Grenoble Alpes, Laboratory for Techniques for Biomedical Engineering and Complexity Management—Informatics, Mathematics, and Applications, Grenoble, France
Marie-Reine Mallaret
Affiliation:
Grenoble University Hospital Center, Public Health Center, Hygiene Unit and Hospital Risk Management, Grenoble, France Univ. Grenoble Alpes, Laboratory for Techniques for Biomedical Engineering and Complexity Management—Informatics, Mathematics, and Applications, Grenoble, France
*
Address correspondence to Pierre Batailler, MD, Unité d’Hygiène Hospitalière, CHU de Grenoble, CS 10217-38043 Grenoble CEDEX 9 (pbatailler@chu-grenoble.fr).
Get access Rights & Permissions [Opens in a new window]

Abstract

OBJECTIVE

To assess the diagnostic value of an adenosinetriphosphate bioluminescence assay (ATPmetry) to monitor the effectiveness of the reprocessing of endoscopes compared with microbiologic sampling.

DESIGN

Diagnostic study.

SETTING

A 2,200-bed teaching hospital performing 5,000 to 6,000 endoscopic procedures annually.

INCLUSION CRITERIA

All samples from bronchial or gastrointestinal endoscopes whatever the context.

METHODS

Samples for microbiologic analysis and ATPmetry measurements were taken when each endoscope was inspected following reprocessing. Sampling was performed by flushing each endoscope with 300 mL Neutralizing Pharmacopeia Diluent thiosulfate rinsing solution divided equally between the endoscope channels. For each endoscope a series of 3 ATPmetry measurements were made on a vial containing the first jet from each channel and a second series on the whole sample.

RESULTS

Of 165 samples from endoscopes, 11 exceeded the acceptability threshold of 25 colony-forming units/endoscope. In the first jet collected, the median (interquartile range) level of ATPmetry was 30.5 (15.3–37.7) relative light units (RLU) for samples with 25 or fewer colony-forming units compared with 37.0 (34.7–39.3) RLU for samples with more than 25 colony-forming units (P=.008). For the whole sample, the median (interquartile range) level of ATPmetry was 24.8 (14.3–36.3) RLU and 36.3 (36.0–38.3) RLU (P=.006), respectively. After adjusting on the batch of cleansing solution used, no difference in ATPmetry values was found between microbiologically acceptable and unacceptable samples.

CONCLUSION

ATPmetry cannot be used as an alternative or complementary approach to microbiologic tests for monitoring the reprocessing of endoscopes in France

Infect. Control Hosp. Epidemiol. 2015;36(12):1437–1443

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 12 , December 2015 , pp. 1437 - 1443
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Eléments d’assurance qualité en hygiène relatifs au contrôle microbiologique des endoscopes et à la traçabilité en endoscopie, Comité techniques des infections nosocomiales et des infections liées aux soins, Conseil supérieur d’hygiène publique en France, Mars 2007. http://nosobase.chu-lyon.fr/recommandations/ctinils/2007_dispositifs_medicaux_CTINILS.pdf. Published 2007. Accessed May 1, 2015.Google Scholar
2. Saviuc, P, Picot-Guéraud, R, Shum, J, et al. Evaluation of the reprocessing quality of gastrointestinal endoscopes. Infect Control Hosp Epidemiol 2015;29:1–7.Google Scholar
3. Rutala, WA, Weber, DJ. Gastrointestinal endoscopes: a need to shift from disinfection to sterilization? JAMA 2014;312:1405–1406.Google Scholar
4. Murphy, SC, Kozlowski, SM, Bandler, DK, Boor, KJ. Evaluation of adenosine triphosphate-bioluminescence hygiene monitoring for trouble-shooting fluid milk shelf-life problems. J Dairy Sci 1998;81:817–820.Google Scholar
5. Worsfold, D, Griffith, CJ. An assessment of cleaning regimes and standards in butchers’ shops. Int J Environ Health Res 2001;11:245–256.Google Scholar
6. Lewis, T, Griffith, C, Gallo, M, Weinbren, M. A modified ATP benchmark for evaluating the cleaning of some hospital environmental surfaces. J Hosp Infect 2008;69:156–163.Google Scholar
7. Boyce, JM, Havill, NL, Dumigan, DG, Golebiewski, M, Balogun, O, Rizvani, R. Monitoring the effectiveness of hospital cleaning practices by use of an adenosine triphosphate bioluminescence assay. Infect Control Hosp Epidemiol 2009;30:678–684.Google Scholar
8. Sherlock, O, O’Connell, N, Creamer, E, Humphreys, H. Is it really clean? An evaluation of the efficacy of four methods for determining hospital cleanliness. J Hosp Infect 2009;72:140–146.Google Scholar
9. Wadhawan, T, McEvoy, J, Prüβ, BM, Khan, E. Assessing tetrazolium and ATP assays for rapid in situ viability quantification of bacterial cells entrapped in hydrogel beads. Enzyme Microb Technol 2010;47:166–173.Google Scholar
10. Turner, DE, Daugherity, EK, Altier, C, Maurer, KJ. Efficacy and limitations of an ATP-based monitoring system. J Am Assoc Lab Anim Sci 2010;49:190–195.Google Scholar
11. Shama, G, Malik, DJ. The uses and abuses of rapid bioluminescence-based ATP assays. Int J Hyg Environ Health 2013;216:115–125.Google Scholar
12. Alfa, MJ, Fatima, I, Olson, N. Validation of adenosine triphosphate to audit manual cleaning of flexible endoscope channels. Am J Infect Control 2013;41:245–248.Google Scholar
13. Alfa, MJ, Fatima, I, Olson, N. The adenosine triphosphate test is a rapid and reliable audit tool to assess manual cleaning adequacy of flexible endoscope channels. Am J Infect Control 2013;41:249–253.Google Scholar
14. Alfa, MJ, Olson, N, Murray, BL. Comparison of clinically relevant benchmarks and channel sampling methods used to assess manual cleaning compliance for flexible gastrointestinal endoscopes. Am J Infect Control 2014;42:e1–e5.Google Scholar
15. Obee, PC, Griffith, CJ, Cooper, RA, Cooke, RP, Bennion, NE, Lewis, M. Real-time monitoring in managing the decontamination of flexible gastrointestinal endoscopes. Am J Infect Control 2005;33:202–206.Google Scholar
16. Visrodia, KH, Ofstead, CL, Yellin, HL, Wetzler, HP, Tosh, PK, Baron, TH. The use of rapid indicators for the detection of organic residues on clinically used gastrointestinal endoscopes with and without visually apparent debris. Infect Control Hosp Epidemiol 2014;35:987–994.Google Scholar
17. Fernando, G, Collignon, P, Beckingham, W. ATP bioluminescence to validate the decontamination process of gastrointestinal endoscopes. Healthcare Infection 2014;19:59–64.Google Scholar
18. Fushimi, R, Takashina, M, Yoshikawa, H, et al. Comparison of adenosine triphosphate, microbiologic load, and residual protein as indicators for assessing the cleanliness of flexible gastrointestinal endoscopes. Am J Infect Control 2013;41:161–164.Google Scholar