Assessing environmental contamination in Dutch and Belgian nursing homes: a cross-border ATP-based study

Area of Science:

• Environmental microbiology
• Infection control
• Healthcare facility hygiene

Background:

• Nursing homes present unique infection control challenges due to vulnerable populations.
• Environmental contamination is a significant factor in healthcare-associated infections.
• Objective measurement tools are needed to assess and improve nursing home hygiene.

Purpose of the Study:

• To quantify environmental contamination levels in nursing homes using adenosine triphosphate (ATP) measurements.
• To identify high-risk fomites and areas requiring focused cleaning interventions.
• To compare contamination levels across different nursing homes and geographical regions.

Main Methods:

• Adenosine triphosphate (ATP) measurements were performed on 15 predefined surfaces per ward in 28 nursing homes.
• A 3M Clean Trace NG luminometer was used, with results reported in relative light units (RLU).
• A threshold of >1000 RLU was defined as "not clean"; data were compared between countries and fomite types.

Main Results:

• A total of 1,794 ATP measurements were conducted, with a median RLU of 1,037.
• 51.3% of all measurements exceeded the "not clean" threshold of 1000 RLU.
• Significant variations in contamination levels were observed between nursing homes, countries, and specific fomite groups.

Conclusions:

• ATP measurements provide an objective method for assessing environmental contamination in nursing homes.
• Identified differences in contamination highlight specific nursing homes, countries, and fomite groups as targets for improved cleaning protocols.
• This data supports the development of targeted strategies to enhance overall cleanliness and reduce infection risks in long-term care facilities.