Therapeutic Advances in Infectious Disease (Jan 2023)

Monitoring of surface cleaning and disinfection in a Brazilian pediatric unit

  • Lucas de Oliveira Bernardes,
  • Fernando Ribeiro dos Santos,
  • Natália Liberato Norberto Angeloni,
  • Mara Cristina Ribeiro Furlan,
  • Larissa da Silva Barcelos,
  • Adriano Menis Ferreira,
  • Alvaro Francisco Lopes de Sousa,
  • Denise de Andrade,
  • Marília Duarte Valim,
  • Odinea Maria Amorim Batista,
  • Luís Velez Lapão,
  • Aires Garcia dos Santos Junior,
  • Helder de Pádua Lima

DOI
https://doi.org/10.1177/20499361221148007
Journal volume & issue
Vol. 10

Abstract

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Background: Understanding the correlation between the methods of monitoring surface cleaning and disinfection (SCD) is fundamental for better infection control. Purpose: This study aims to correlate the SCD monitoring methods in a Brazilian pediatric unit. This is an exploratory, longitudinal, and correlational study. Methods: The study was conducted in a pediatric hospitalization unit of a medium-sized hospital from December 2020 to March 2021. Four high-contact surfaces were analyzed before and after the cleaning and disinfection process by means of visual inspection, quantification of adenosine triphosphate (ATP), and colony-forming unit (CFU) count. The study consisted of three stages: stage I involving situational diagnosis of the SCD process; stage II referring to the implementation of the Surface Cleaning and Disinfection Standardization Program (SCDSP); and stage III involving long-term assessment after implementing the program. A total of 192 assessments were performed in each stage, totaling 576 in the three study stages. Conclusions: A significant correlation was found between the ATP quantification methods and microbial count in the bed railing ( p = 0.009) and companion’s armchair ( p = 0.018) surfaces. In both cases, Spearman’s correlation coefficients were positive, indicating a positive correlation between ATP and microbial count scores, that is, the higher the ATP values (in RLUs), the greater the microbial counts (in CFUs/cm 2 ). The analysis of the ROC curves suggests that the surfaces presenting ATP below 108 RLUs can be considered approved. The ATP method yielded 78.6% sensitivity; in turn, microbial count presented a sensitivity of 85.7%. It is important to use different methods to monitor the cleaning and disinfection of surfaces, as each one has different sensitivity and specificity.