Subject(s)
Anti-Bacterial Agents/pharmacology , Carrier State/microbiology , Methicillin-Resistant Staphylococcus aureus/drug effects , Mupirocin/pharmacology , Staphylococcal Infections/microbiology , Surgical Wound Infection/microbiology , Adult , Aged , Aged, 80 and over , Drug Resistance, Multiple, Bacterial , Hospitals, Veterans , Humans , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Microbial Sensitivity Tests , Middle Aged , Nose/microbiology , Population SurveillanceABSTRACT
BACKGROUND: The application of adenosine triphosphate (ATP) luminometry for monitoring sanitized hospital surfaces is an evolving infection control practice. The goal of this study is to validate and compare 3 commercially available ATP luminometry, swab, rapid-test systems for use in hospital surface sanitization testing. Regulatory agencies may consider this a point-of-care laboratory test; it is therefore imperative that validation criteria are established. METHODS: The ability of instruments to measure long-term stability of ATP dried on surfaces was determined. Dilutions of 3 species of microorganisms and a blood sample were dried onto a surface and tested. The performance characteristics of instruments were compared side-by-side for their ability to recover microorganism-derived ATP from surfaces. RESULTS: Timed studies showed that surface biologic-ATP remained detectable for 10 days. Instrument clinical sensitivity, precision, detection range, limit of detection, and linearity were determined. Swab recovery of microorganisms from surfaces varied by instrument and organism. All 3 systems detected microorganisms in the presence of disinfectants. CONCLUSION: All instruments were validated, but only 1 was verified, because of variations in performance for each system. These studies indicate that careful consideration of the technologic application and instrument performance are important criteria for the selection of an ATP monitoring system.
Subject(s)
Acinetobacter baumannii/isolation & purification , Adenosine Triphosphate/analysis , Candida albicans/isolation & purification , Infection Control/methods , Luminescent Measurements/instrumentation , Staphylococcus aureus/isolation & purification , Acinetobacter baumannii/metabolism , Adenosine Triphosphate/metabolism , Candida albicans/metabolism , Environmental Monitoring/methods , Housekeeping, Hospital/standards , Humans , Infection Control/standards , Luminescent Measurements/methods , Luminescent Measurements/standards , Reproducibility of Results , Sanitation/standards , Sensitivity and Specificity , Stainless Steel , Staphylococcus aureus/metabolism , Time FactorsABSTRACT
Antimicrobials have been used in excess for decades. As a result, antimicrobial resistance and cost have increased. In response to this growing national problem, hospital antimicrobial teams were recom-mended in 1988, but few institutions have invested in comprehensive, interdisciplinary programs. The division of infectious diseases at the University of Louisville School of Medicine was a leader in 1990 by establishing an antimicrobial team at the University of Louisville Hospital and Veterans Affairs Hospital. This manuscript reviews the activities of the antimicrobial teams to create antimicrobial guidelines, evaluate antimicrobial use, and provide feedback to physicians. It also summarizes the successful impact the teams have had on optimizing antimicrobial use in the hospital by improving compliance with the guidelines, controlling resistant organisms, and preventing escalation of antimicrobial cost over the years.
