Sarah Fieldhouse, Benhur Bakhtiari Bastaki, Andrea Ledgerton, Paul Clarke, Trystan Lewis
{"title":"利用荧光评估医院清洁效果:概念验证研究和ATP测试的比较。","authors":"Sarah Fieldhouse, Benhur Bakhtiari Bastaki, Andrea Ledgerton, Paul Clarke, Trystan Lewis","doi":"10.1016/j.jhin.2025.08.008","DOIUrl":null,"url":null,"abstract":"<p><p>Visual inspections are used to assess hospital cleanliness as visible contamination may present health risks and influence perceptions of care quality. Problematically, many contaminants are invisible to the naked eye, limiting the reliability of visual checks. Many invisible substances, however, fluoresce - emit visible light after absorbing electromagnetic radiation. Portable torches can detect fluorescent substances 'in situ', offering a potential method to enhance cleaning practices. This study has evaluated fluorescence as a tool for identifying general invisible contamination after hospital cleaning. Visibly clean surfaces in seven single-occupancy patient rooms and two six-bed wards across two NHS hospitals were examined using a portable high-intensity blue and UV light torch. Adenosine triphosphate levels in fluorescent and non-fluorescent areas were taken as a recognised cleaning monitoring tool and statistically analysed using Wilcoxon Signed-Rank tests. Fluorescent contamination that was invisible to the naked eye was found on every surface. ATP Relative Light Unit (RLU) levels were statistically different (higher) in fluorescent substances compared to non-fluorescent (p ≤ 0.05) with large effect sizes on patient chairs, bed frames, overbed tables, bedside units, and pillows, but not toilets, sinks, or commodes. The mean RLU measurement was 161 in fluorescent areas compared to 33 RLU in the control areas. Fluorescence detected alternative contamination which could present toxic risk to humans, possibly cleaning fluid and/or drug contaminated residue, which frequently contain fluorescent constituents. This was an important finding since relying solely on ATP detection may overlook significant contamination risks. Further work to evaluate the method as a cleaning aid is encouraged.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessing Hospital Cleaning Effectiveness Using Fluorescence: A Proof-of-Concept Study and Comparison to ATP Testing.\",\"authors\":\"Sarah Fieldhouse, Benhur Bakhtiari Bastaki, Andrea Ledgerton, Paul Clarke, Trystan Lewis\",\"doi\":\"10.1016/j.jhin.2025.08.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Visual inspections are used to assess hospital cleanliness as visible contamination may present health risks and influence perceptions of care quality. Problematically, many contaminants are invisible to the naked eye, limiting the reliability of visual checks. Many invisible substances, however, fluoresce - emit visible light after absorbing electromagnetic radiation. Portable torches can detect fluorescent substances 'in situ', offering a potential method to enhance cleaning practices. This study has evaluated fluorescence as a tool for identifying general invisible contamination after hospital cleaning. Visibly clean surfaces in seven single-occupancy patient rooms and two six-bed wards across two NHS hospitals were examined using a portable high-intensity blue and UV light torch. Adenosine triphosphate levels in fluorescent and non-fluorescent areas were taken as a recognised cleaning monitoring tool and statistically analysed using Wilcoxon Signed-Rank tests. Fluorescent contamination that was invisible to the naked eye was found on every surface. ATP Relative Light Unit (RLU) levels were statistically different (higher) in fluorescent substances compared to non-fluorescent (p ≤ 0.05) with large effect sizes on patient chairs, bed frames, overbed tables, bedside units, and pillows, but not toilets, sinks, or commodes. The mean RLU measurement was 161 in fluorescent areas compared to 33 RLU in the control areas. Fluorescence detected alternative contamination which could present toxic risk to humans, possibly cleaning fluid and/or drug contaminated residue, which frequently contain fluorescent constituents. This was an important finding since relying solely on ATP detection may overlook significant contamination risks. Further work to evaluate the method as a cleaning aid is encouraged.</p>\",\"PeriodicalId\":54806,\"journal\":{\"name\":\"Journal of Hospital Infection\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-09-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hospital Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jhin.2025.08.008\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hospital Infection","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jhin.2025.08.008","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Assessing Hospital Cleaning Effectiveness Using Fluorescence: A Proof-of-Concept Study and Comparison to ATP Testing.
Visual inspections are used to assess hospital cleanliness as visible contamination may present health risks and influence perceptions of care quality. Problematically, many contaminants are invisible to the naked eye, limiting the reliability of visual checks. Many invisible substances, however, fluoresce - emit visible light after absorbing electromagnetic radiation. Portable torches can detect fluorescent substances 'in situ', offering a potential method to enhance cleaning practices. This study has evaluated fluorescence as a tool for identifying general invisible contamination after hospital cleaning. Visibly clean surfaces in seven single-occupancy patient rooms and two six-bed wards across two NHS hospitals were examined using a portable high-intensity blue and UV light torch. Adenosine triphosphate levels in fluorescent and non-fluorescent areas were taken as a recognised cleaning monitoring tool and statistically analysed using Wilcoxon Signed-Rank tests. Fluorescent contamination that was invisible to the naked eye was found on every surface. ATP Relative Light Unit (RLU) levels were statistically different (higher) in fluorescent substances compared to non-fluorescent (p ≤ 0.05) with large effect sizes on patient chairs, bed frames, overbed tables, bedside units, and pillows, but not toilets, sinks, or commodes. The mean RLU measurement was 161 in fluorescent areas compared to 33 RLU in the control areas. Fluorescence detected alternative contamination which could present toxic risk to humans, possibly cleaning fluid and/or drug contaminated residue, which frequently contain fluorescent constituents. This was an important finding since relying solely on ATP detection may overlook significant contamination risks. Further work to evaluate the method as a cleaning aid is encouraged.
期刊介绍:
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.