Bernardes Lucas de Oliveira, Dos Santos Fernando Ribeiro, Angeloni Natália Liberato Norberto, Ribeiro Furlan Mara Cristina, Barcelos Larissa da Silva, Ferreira Adriano Menis, Lopes de Sousa Alvaro Francisco, de Andrade Denise, Valim Marília Duarte, Batista Odinea Maria Amorim, Lapão Luís Velez, Dos Santos Junior Aires Garcia, Lima Helder de Pádua
Federal University of Mato Grosso do Sul, Três Lagoas Campus, Três Lagoas, Brazil.
Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, Brazil.
Ther Adv Infect Dis. 2023 Jan 10;10:20499361221148007. doi: 10.1177/20499361221148007. eCollection 2023 Jan-Dec.
Understanding the correlation between the methods of monitoring surface cleaning and disinfection (SCD) is fundamental for better infection control.
This study aims to correlate the SCD monitoring methods in a Brazilian pediatric unit. This is an exploratory, longitudinal, and correlational study.
The study was conducted in a pediatric hospitalization unit of a medium-sized hospital from December 2020 to March 2021. Four high-contact surfaces were analyzed before and after the cleaning and disinfection process by means of visual inspection, quantification of adenosine triphosphate (ATP), and colony-forming unit (CFU) count. The study consisted of three stages: stage I involving situational diagnosis of the SCD process; stage II referring to the implementation of the Surface Cleaning and Disinfection Standardization Program (SCDSP); and stage III involving long-term assessment after implementing the program. A total of 192 assessments were performed in each stage, totaling 576 in the three study stages.
A significant correlation was found between the ATP quantification methods and microbial count in the bed railing ( = 0.009) and companion's armchair ( = 0.018) surfaces. In both cases, Spearman's correlation coefficients were positive, indicating a positive correlation between ATP and microbial count scores, that is, the higher the ATP values (in RLUs), the greater the microbial counts (in CFUs/cm). The analysis of the ROC curves suggests that the surfaces presenting ATP below 108 RLUs can be considered approved. The ATP method yielded 78.6% sensitivity; in turn, microbial count presented a sensitivity of 85.7%. It is important to use different methods to monitor the cleaning and disinfection of surfaces, as each one has different sensitivity and specificity.
了解表面清洁与消毒（SCD）监测方法之间的相关性是加强感染控制的基础。
本研究旨在关联巴西一家儿科病房的SCD监测方法。这是一项探索性、纵向和相关性研究。
该研究于2020年12月至2021年3月在一家中型医院的儿科住院病房进行。通过目视检查、三磷酸腺苷（ATP）定量和菌落形成单位（CFU）计数，对四个高接触表面在清洁和消毒过程前后进行分析。该研究包括三个阶段：第一阶段涉及SCD过程的现状诊断；第二阶段指表面清洁与消毒标准化计划（SCDSP）的实施；第三阶段涉及该计划实施后的长期评估。每个阶段共进行192次评估，三个研究阶段总计576次。
在床栏（ρ = 0.009）和陪护扶手椅（ρ = 0.018）表面，ATP定量方法与微生物计数之间存在显著相关性。在这两种情况下，斯皮尔曼相关系数均为正，表明ATP与微生物计数得分之间呈正相关，即ATP值（以相对光单位计）越高，微生物计数（以CFU/cm计）越大。ROC曲线分析表明，ATP低于108相对光单位的表面可视为合格。ATP方法的灵敏度为78.6%；而微生物计数的灵敏度为85.7%。使用不同方法监测表面的清洁和消毒很重要，因为每种方法都有不同的灵敏度和特异性。
