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ATP measurement as method to monitor the quality of reprocessing flexible endoscopes
Dorothea Hansen1, Daniel Benner, Martin Hilgenhöner
1Krankenhaushygiene, Universitätsklinikum Essen, Germany. dorothea.hansen@uni-essen.de
Abstract:
Insufficient performance of cleaning and disinfection of flexible endoscopes can pose an infection risk to patients. Actually quality of reprocessing is checked by performing microbiological cultures. Unfortunately, their results are not available on the same day so that more rapid methods are desirable. We compared the ATP (adenosine triphosphate) bioluminescence for hygiene checking of the reprocessing procedures of 108 flexible endoscopes with routine microbiological culture technics. Sensitivity and specifity of ATP bioluminescence was calculated. 28 endoscopes showed bacterial growth of at least one sample. Depending on the applied threshold of bioluminescence between 67 and 28 endoscopes were positive. Sensitivity varied between 0.46 and 0.75 and specifity between 0.43 and 0.81. ATP bioluminescence does not replace routine microbiologic methods but it can indicate the need of immediate check of reprocessing.
Insights
Adenosine triphosphate (ATP) bioluminescence offers a rapid method for checking flexible endoscope reprocessing hygiene. While not replacing microbiological cultures, it can quickly flag scopes needing immediate inspection to reduce patient infection risk.
Area of Science:
- Microbiology
- Infection Control
- Medical Device Reprocessing
Background:
- Inadequate cleaning of flexible endoscopes poses a significant patient infection risk.
- Current quality control relies on microbiological cultures with delayed results.
- Rapid methods for assessing endoscope reprocessing are needed.
Purpose of the Study:
- To compare the efficacy of adenosine triphosphate (ATP) bioluminescence with routine microbiological cultures for evaluating flexible endoscope reprocessing.
- To determine the sensitivity and specificity of ATP bioluminescence as a hygiene indicator.
Main Methods:
- 108 flexible endoscopes underwent reprocessing and subsequent testing.
- ATP bioluminescence assays were performed for rapid hygiene assessment.
- Results were compared against traditional microbiological culture techniques.
Main Results:
- Bacterial growth was detected in 28 endoscopes via microbiological cultures.
- ATP bioluminescence identified between 28 and 67 endoscopes as positive, depending on the threshold used.
- Sensitivity ranged from 0.46 to 0.75, and specificity from 0.43 to 0.81.
Conclusions:
- ATP bioluminescence is not a substitute for standard microbiological testing.
- ATP bioluminescence can serve as a valuable, rapid tool to indicate the need for immediate reprocessing checks.
- Implementing ATP bioluminescence can potentially enhance patient safety by enabling quicker interventions.
