Effectiveness of ATP bioluminescence to assess hospital cleaning: a review

Introduction: Contamination of hospital surfaces plays an important role in the transmission of several healthcare-associated microorganisms, so methods for evaluating hospital surfaces’ cleaning gain importance. Among these there are visual inspection, quantitative microbiology, fluorescent markers and ATP bioluminescence. The latter seems to provide interesting perspectives, detecting the presence of ATP on surface (as Relative Light Units, RLU), a proxy of organic matter and microbial contamination. Several studies have investigated the effectiveness of this technology; with this research we aim to summarize the most significant results. Methods: A literature review was conducted. The keywords: “ATP”, “Bioluminescence”, “Hospital” and “Surfaces” were searched in Pubmed and Scopus databases to find relevant data from 2000 to October 2014. After the selection, we globally considered 27 articles. Results: Most of the studies were conducted in United Kingdom and in USA. Different threshold RLU benchmark values were identified by analyzed studies. Fourteen of these researches compared the ATP bioluminescence with microbiological methods, 11 identified a significant correlation between the two methods, although poor or not complete for 5. Discussion: ATP bioluminescence is not a standardized methodology: each tool has different benchmark values, not always defined. At the moment we can say that the technique could be used to assess, in real time, hospital surfaces where cleanliness is required, but not sterility.
Journal of Preventive Medicine and Hygiene, Vol 58, No 2 (2017): 2017582