N O V E M B E R 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 6 7
microbiologically clean (Griffith et al., 2000). Common organisms
found on theses surfaces include methicillin-resistant Staphylococcus
aureus (MRSA), vancomycin-resistant enterococci (VRE),
Acinetobacter baumannii and Clostridium difficile, to name just a
few.
Cleaning verification
More bad news: Current measuring tools for verifying cleaning may
be coming up short. One of the most commonly used tools to measure
and monitor contamination removal in the healthcare setting is adeno-
sine triphosphate (ATP) testing. ATP is the universal unit of energy in
all living cells. But many in the industry are questioning the usefulness
of ATP residual testing in overcoming the actual challenges of surface
cleaning and disinfection.
"ATP does not measure chemical efficacy," says Maurits Hughes,
director of logistics and support services at the University of Michigan
Health System. "It measures cleaning efficacy. This means if organic
material is measured by ATP, it cannot distinguish whether it is alive
or dead."
ATP's inability to distinguish between organic materials could under-
mine the overall success of your infection prevention program.
"ATP bioluminescence detection works by capitalizing on the ability to
measure light — in relative light units or RLUs — as a result of a chemi-
cal reaction between ATP and luciferin," says Dr. Green. "Since ATP is
found in all biological cells — such as skin, food, microbes and other
debris — the RLUs resulting from a normal ATP test in a perioperative
setting are non-specific and reflect the ATP from all sources."
Ironically, even residues from some cleaning products can react
with the ATP test, resulting in inflated or under-inflated results.
"Bottom line: You should not rely on this test as an indicator of proper
