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Application of a fluorescent marker with quantitative bioburden methods to assess cleanliness

Published online by Cambridge University Press:  17 September 2018

I-Chen Hung ,
Hao-Yuan Chang ,
Aristine Cheng ,
An-Chi Chen ,
Ling Ting ,
Mei-Wen Chen ,
Yeur-Hur Lai  and
Wang-Huei Sheng
I-Chen Hung
Affiliation:
Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan
Hao-Yuan Chang
Affiliation:
School of Nursing, National Taiwan University, Taipei, Taiwan
Aristine Cheng
Affiliation:
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
An-Chi Chen
Affiliation:
Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan
Ling Ting
Affiliation:
Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan
Mei-Wen Chen
Affiliation:
Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
Yeur-Hur Lai
Affiliation:
School of Nursing, National Taiwan University, Taipei, Taiwan Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
Wang-Huei Sheng*
Affiliation:
Center for Infection Control, National Taiwan University Hospital, Taipei, Taiwan Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
*
Author for correspondence: Wang-Huei Sheng MD, PhD, Center for Infection Control, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei 100, Taiwan. E-mail: whsheng@ntu.edu.tw
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Abstract

Background

Improvement of environmental cleaning in hospitals has been shown to decrease in-hospital cross transmission of pathogens. Several objective methods, including aerobic colony counts (ACCs), the adenosine triphosphate (ATP) bioluminescence assay, and the fluorescent marker method have been developed to assess cleanliness. However, the standard interpretation of cleanliness using the fluorescent marker method remains uncertain.

Objective

To assess the fluorescent marker method as a tool for determining the effectiveness of hospital cleaning.

Design

A prospective survey study.

Setting

An academic medical center.

Methods

The same 10 high-touch surfaces were tested after each terminal cleaning using (1) the fluorescent marker method, (2) the ATP assay, and (3) the ACC method. Using the fluorescent marker method under study, surfaces were classified as totally clean, partially clean, or not clean. The ACC method was used as the standard for comparison.

Results

According to the fluorescent marker method, of the 830 high-touch surfaces, 321 surfaces (38.7%) were totally clean (TC group), 84 surfaces (10.1%) were partially clean (PC group), and 425 surfaces (51.2%) were not clean (NC group). The TC group had significantly lower ATP and ACC values (mean ± SD, 428.7 ± 1,180.0 relative light units [RLU] and 15.6 ± 77.3 colony forming units [CFU]/100 cm2) than the PC group (1,386.8 ± 2,434.0 RLU and 34.9 ± 87.2 CFU/100 cm2) and the NC group (1,132.9 ± 2,976.1 RLU and 46.8 ± 119.2 CFU/100 cm2).

Conclusions

The fluorescent marker method provided a simple, reliable, and real-time assessment of environmental cleaning in hospitals. Our results indicate that only a surface determined to be totally clean using the fluorescent marker method could be considered clean.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 11 , November 2018 , pp. 1296 - 1300
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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