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Evaluation of the total adenylate (ATP + ADP + AMP) test for cleaning verification in healthcare settings.

ABSTRACT: Introduction:Evaluation of cleaning methods is the first step in the prevention of healthcare-associated infections. ATP hygiene monitoring tests are widely used for assessing the effectiveness of cleaning procedures. The test is easy to use and gives immediate results, however, ATP can be metabolized and degraded to ADP and AMP. Recently, a total adenylate [ATP + ADP + AMP(A3)] monitoring test has been developed. Our objective was to evaluate the usefulness of the A3 test for cleaning verification in healthcare settings. Methods:The detection sensitivities of the ATP and the A3 tests were compared using blood, and debris derived from gloved-hand method and endoscopes immediately after endoscopic examination. The performance of the A3 test in monitoring cleanliness of high touch surfaces in the hospital and endoscopes at each cleaning step was also evaluated. Results:For the hemolysate, the measurement values of the A3 test were stable, although ATP was promptly degraded. In debris from hands, the amount of A3 was 20 times higher than that of ATP. The detection sensitivities of the A3 test on residues derived from gastroscopes and colonoscopes were 3 and 8 times higher, respectively, than those from the ATP test. A field study indicated that a large number of microorganisms tend to show high A3 values on high touch surfaces in the hospital and on endoscopes. Conclusions:The A3 test showed higher detection sensitivities than the conventional ATP test for organic debris associated with healthcare settings.

SUBMITTER: Bakke M

PROVIDER: S-EPMC6614569 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Evaluation of the total adenylate (ATP + ADP + AMP) test for cleaning verification in healthcare settings.

Bakke M M Suzuki S S Kirihara E E Mikami S S

Journal of preventive medicine and hygiene 20190628 2

<h4>Introduction</h4>Evaluation of cleaning methods is the first step in the prevention of healthcare-associated infections. ATP hygiene monitoring tests are widely used for assessing the effectiveness of cleaning procedures. The test is easy to use and gives immediate results, however, ATP can be metabolized and degraded to ADP and AMP. Recently, a total adenylate [ATP + ADP + AMP(A3)] monitoring test has been developed. Our objective was to evaluate the usefulness of the A3 test for cleaning v ...[more]

PMID: 31312743

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Project description:Prostate cancer is among the major malignancies that affect men around the world. Adenine nucleotides are important signaling molecules that mediate innumerous biological functions in pathophysiological conditions, including cancer. These molecules are degraded by several ectoenzymes named ectonucleotidases that produce adenosine in the extracellular medium. Some of these ecto-enzymes can be found in soluble in the blood stream. Thus, the present study aimed to evaluate the hydrolysis of adenine nucleotides (ATP, ADP, and AMP) in the plasma blood of patients with prostate cancer. Peripheral blood samples were collected, and questionnaires were filled based on the clinical data of the medical records. The nucleotide hydrolysis was performed by Malachite Green method using ATP, ADP, and AMP as substrates. Plasma from prostate cancer patients presented an elevated hydrolysis of all nucleotides evaluated when compared to healthy individuals. NTPDase inhibitor (ARL67156) and the alkaline phosphatase inhibitor (levamisole) did not alter ATP hydrolysis. However, AMP hydrolysis was reduced by the CD73 inhibitor, APCP, and by levamisole, suggesting the action of a soluble form of CD73 and alkaline phosphatase. On microvesicles, it was observed that there was a low expression and activity of CD39 and almost absent of CD73. The correlation of ATP, ADP, and AMP hydrolysis with clinic pathological data demonstrated that patients who received radiotherapy showed a higher AMP hydrolysis than those who did not, and patients with lower clinical stage (CS-IIA) presented an elevated ATP hydrolysis when compared to those with more advanced clinical stages (CS-IIB and CS-III). Patients of all clinical stages presented an elevated AMPase activity. Therefore, we can suggest that the nucleotide hydrolysis might be attributed to soluble ecto-enzymes present in the plasma, which, in a coordinate manner, produce adenosine in the blood stream, favoring prostate cancer progression.

Project description:Cleaning and disinfecting tasks and product use are associated with elevated prevalence of asthma and respiratory symptoms among healthcare workers; however, the levels of exposure that pose a health risk remain unclear. The objective of this study was to estimate the peak, average, and determinants of real-time total volatile organic compound (TVOC) exposure associated with cleaning tasks and product-use. TVOC exposures were measured using monitors equipped with a photoionization detector (PID). A simple correction factor was applied to the real-time measurements, calculated as a ratio of the full-shift average TVOC concentrations from a time-integrated canister and the PID sample, for each sample pair. During sampling, auxiliary information, e.g. tasks, products used, engineering controls, was recorded on standardized data collection forms at 5-min intervals. Five-minute averaged air measurements (n = 10 276) from 129 time-series comprising 92 workers and four hospitals were used to model the determinants of exposures. The statistical model simultaneously accounted for censored data and non-stationary autocorrelation and was fit using Markov-Chain Monte Carlo within a Bayesian context. Log-transformed corrected concentrations (cTVOC) were modeled, with the fixed-effects of tasks and covariates, that were systematically gathered during sampling, and random effect of person-day. The model-predicted geometric mean (GM) cTVOC concentrations ranged from 387 parts per billion (ppb) for the task of using a product containing formaldehyde in laboratories to 2091 ppb for the task of using skin wipes containing quaternary ammonium compounds, with a GM of 925 ppb when no products were used. Peak exposures quantified as the 95th percentile of 15-min averages for these tasks ranged from 3172 to 17 360 ppb. Peak and GM task exposures varied by occupation and hospital unit. In the multiple regression model, use of sprays was associated with increasing exposures, while presence of local exhaust ventilation, large room volume, and automatic sterilizer use were associated with decreasing exposures. A detailed understanding of factors affecting TVOC exposure can inform targeted interventions to reduce exposures and can be used in epidemiologic studies as metrics of short-duration peak exposures.

Dataset Information

Evaluation of the total adenylate (ATP + ADP + AMP) test for cleaning verification in healthcare settings.

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Evaluation of the total adenylate (ATP + ADP + AMP) test for cleaning verification in healthcare settings.

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