Meta-analysis of cleaning and disinfection effect of ATP bioluminescence detection method on the surface of environmental objects in ICU (Preprint)
Authors: 王 雪玉 
Published: September 2024

BACKGROUND

Intensive Care Unit (ICU) is the department with the highest incidence of hospital infection, and it is also one of the departments that the hospital infection management department focuses on [1,2]. In recent years, the detection rate of multidrug-resistant bacteria (resistant to ≥3 kinds of antimicrobial agents) has been increasing, and they are increasingly dominating the microbial community in hospital environment. Determining effective infection control measures to prevent cross-transmission of MDRO between patients and the environment can minimize potential infection outbreaks. Zhao Lihua et al [3] found that improving the cleaning and disinfection methods in ICU plays an important role in improving the quality of cleaning and disinfection and reducing the proportion of strains causing hospital infection in MDRO. Cotton swab sampling is the gold standard for testing whether there is pathogenic microorganism pollution on the surface of high-frequency contact [4], and it has always been an important tool to judge the cleanliness of the environment. The guidelines for environmental infection control of the Centers for Disease Control and Prevention in the United States point out that medical institutions do not need routine monitoring of air, water and environmental surfaces, and the cost of routine monitoring is high and the income is insufficient. The correlation between positive results of environmental hygiene monitoring and the incidence of nosocomial infection needs to be studied [3]. In recent years, adenosine triphosphate (ATP) fluorescence monitoring method provides direct and real-time feedback. ATP fluorescence detection method is used to evaluate the cleaning and disinfection effect of environmental objects in ICU, which can provide a favorable reference for the management of environmental cleaning and disinfection in ICU. This study objectively evaluates the effect of ATP fluorescence detection method through a meta-analysis of the cleaning and disinfection effect of environmental objects in ICU, providing a basis for improving the surface cleaning of environmental objects in ICU and reducing the incidence of hospital infection.

OBJECTIVE

Meta-analysis method was used to evaluate the cleaning and disinfection effect of ATP bioluminescence detection on the surface of environmental objects in ICU.

METHODS

Search China Biomedical Literature Database, CNKI China Knowledge Resource Database, Wanfang Medical Academic Journals, VIP Chinese Journals Database, and all related literatures of PubMed, Cochrane, Embase, Web of Science, MEDLINE and CINAHL from the establishment of the database to June 18th, 2024, collect the intervention research on improving the surface cleaning and disinfection effect of environmental objects in ICU by ATP bioluminescence detection, and use RevMan 5.3 and Stata16.0 software for Meta-analysis.

RESULTS

A total of 11 articles were included, including 9 before-and-after controlled studies and 2 prospective studies. The final indicators were the qualified rate of environmental surface cleaning and disinfection. The results of meta-analysis showed that the qualified rate increased by at least 29% and at most 41% after the feedback and supervision of environmental cleaning and disinfection in ICU based on ATP fluorescence detection results, which was statistically significant (Z=11.65, P < 0.05). After the intervention measures such as guidance intervention, education and training, and optimization of environmental disinfection and cleaning process were superimposed, the qualified rate increased by at least 34% and at most 42%, with statistical significance (Z=17.41, P < 0.05). After the implementation of the cluster intervention measures, the qualified rate increased by at least 18% and at most 34%, with statistical significance (Z=4.84, P<0.05).

CONCLUSIONS

The ATP fluorescence detection method is simple to operate, and the data can be directly read on site, so that potential problems can be found in time and corrective measures can be put forward, which can significantly enhance the awareness of medical staff to strengthen cleaning and disinfection and improve the qualified rate of cleaning and disinfection effects on the surface of environmental objects.

CLINICALTRIAL

NA