ATP生物冷光反應法和傳統微生物採檢法在醫院環境清潔確效之比較

Comparison of Usefulness between Adenosine Triphosphate Bioluminescence and Aerobic Bacterial Count for the Evaluation of Hospital Cleanliness

為比較ATP生物冷光反應法和傳統微生物採檢法使用於研究醫院的差異性及相關性，從2014年6月至10月期間，於中部某醫學中心呼吸加護病房針對常被接觸的環境物品，包括鍵盤、滑鼠、電話、床欄、呼吸器面板、心電圖監視器、床旁桌及抽痰器，選定採檢部位及面積，將採檢面積分為左右二側，再以隨機方式，決定一側以ATP生物冷光反應法取樣，另一側以傳統微生物採檢法取樣。共收集242套檢體，ATP生物冷光反應檢驗結果有140套為清潔（57.9%），微生物檢驗結果有38套為清潔（15.7%），兩種檢驗方式之清潔率有顯著差異（p＜0.001），ATP值與菌落數則僅呈現低度相關（r=0.167, p＜0.01）。由於很多因素會影響ATP生物冷光反應檢驗的判讀結果，包括菌種、菌落數、細菌生長期、消毒劑和環境表面材質，因此建議應搭配不同的方法確認環境的清潔度。

To compare the usefulness of adenosine triphosphate (ATP) bioluminescence with that of aerobic bacterial count for assessment of environment cleanliness in a medical center, samples were obtained from June to October 2014 from surfaces in nursing stations and patient surroundings in a respiratory intensive care unit that were frequently touched, including computer keyboards and mice, telephone, bedrails, control panels of feeding pumps, and electrocardiography monitors, bedside tables, and suction machines. Each sampling area was divided into two sides equally, and the side to be assessed by using either ATP bioluminescence or aerobic bacterial count was decided. Among 242 samples, the passing rates were 57.9% and 15.7% with ATP bioluminescence and microbiological sampling, respectively (p < 0.001). The correlation coefficient between ATP bioluminescence and aerobic bacterial count was 0.167 (p < 0.01). Many factors influenced the ATP bioluminescence readings, including bacterial species, colony counts, bacterial growth phases, disinfectants, and material surface properties. Therefore, we suggest evaluating hospital cleanliness by using different parameters at the same time, such as visual assessment and ATP bioluminescence or microbiological sampling.