Adenosin triiphosphat Bioluminiscence Hospital Cleaning--A Method to Influence Invasive Fungal Infections

Invasive fungal infections are infections determinate by fungal invasion and can be endogenous from patient mycobiome or through horizontal transmission from medical workers’ hands and from patients hospital environment especially candidemia with C. parapsilosis. Candidemia is one of leading bloodstream infections associated with healthcare situated on fourth position and USA with high mortality rates especially for immunosuppressed patients. Demonstrating the level of cleaning using adenosine triphosphate bioluminescence technique we can improve the cleaning and hand hygiene and can influence decreasing of invasive fungal infections transmitted by hands. Material and methods: We have evaluated 200 samples from hands and patient environment on 2 hospitals with pneumology and infectious diseases profile (I and II) using bioluminescence to establish the status of hygiene and to determine measures of cleaning. Results: Regarding hand hygiene the level of relative light units over the values recommended by producer (FAIL) was 66% (6 of 9) in unit I and 75% in unit II (3 from 4). Regarding the level of cleaning in other places in direct contact with patients like toilets, bed bar, commodes the results were FAIL over 60%. Conclusions: In this moment in hospitals the hygiene is evaluated visually and no objective method was implemented beside the sanitation tests in Romania. ATP Bioluminescence evaluates in 15 seconds the level of cleaning in comparison with other methods and generates input in cleaning process, influencing indirectly decreasing hospital acquired infections including invasive fungal infections, together with other measures like education, antibiotic stewardship, increasing patient safety. In hospitals evaluated cleaning of hands and surfaces need improvement and investment in cleaning products and processes monitoring.