ABSTRACT
Objective To evaluate the efficacy of adenosine triphosphate ( ATP ) bioluminescence test on quality monitoring of flexible endoscope reprocessing. Methods The patient-used gastroscopes were randomly assigned to two groups after standard reprocessing by one nurse. The group A were assessed by ATP test followed by microbiological surveillance test after cleaning and disinfection; and the gastroscopes in group B were tested in a reverse order. The biological load after endoscopic cleaning and disinfection were compared between ATP test and microbiological surveillance, and the correlation of the two tests on quality assessing of endoscopic cleanliness and disinfection were analyzed. Results A total of 51 samples were valid. The qualified rate of cleaning was 45. 1％ ( 23/51) detected by ATP test, and the qualified rate of disinfection was 92. 2％ ( 47/51) detected by microbiological surveillance. There was no statistical difference in cleaning qualification rate ( 50. 0％ VS 40. 0％,χ2=0. 515, P=0. 473) and disinfection qualification rate ( 96. 2％ VS 88. 0％,χ2=0. 316, P=0. 574) between the two groups. The logarithmic value of relative light unit ( RLU) of ATP test after cleaning was higher than the value after disinfection ( 1. 68 ± 0. 50 VS 0. 88 ±0. 49, t=2. 335,P=0. 024) . For gastroscopes disinfected appropriately, the RLU logarithmic value of ATP test after cleaning ( t=2. 505, P=0. 016) and disinfection ( t=2. 485, P=0. 016) were lower than that of disqualification. The correlation between the value of ATP test and the colony forming units of microbiological surveillance after cleaning was not statistically significant ( r=0. 199, P=0. 171 ) , but there was a low correlation between the two monitoring results after disinfection (r=0. 391, P=0. 005). There was a low correlation between the value of ATP test after cleaning and the colony forming units of microbiological surveillance after disinfection ( r=0. 301, P=0. 032) . Conclusion ATP bioluminescence test can be used to evaluate the trend of endoscopic biological load change and the quality of flexible endoscope reprocessing.