Advertisement

Assessment of a novel antimicrobial surface disinfectant on inert surfaces in the intensive care unit environment using ATP-bioluminesence assay

Published:October 09, 2019DOI:https://doi.org/10.1016/j.ajic.2019.08.026

      Highlights

      • Contamination of inanimate surfaces in the ICU can be a source of HAI-associated pathogens.
      • Selective isopropyl alcohol/organofunctional saline (ISO) solutions have been documented to reduce microbial contamination on inert high-touch inanimate surfaces.
      • A single application of a novel IOS resulted in persistent antimicrobial activity on inanimate ICU surfaces over a six-week study period.

      Background

      Cross-contamination from inanimate surfaces can play a significant role in intensive care unit (ICU)-acquired colonization and infection. This study assessed an innovative isopropyl alcohol/organofunctional silane solution (IOS) to reduce microbial contamination on inert surfaces in a medical ICU.

      Methods

      Baseline adenosine triphosphate bioluminescence testing (ABT)-measurements (N = 200) were obtained on designated inert ICU surfaces followed by IOS treatment. At 1 and 6 weeks, selective surfaces were randomized to either IOS-treated or nontreated controls for comparison using ABT (N = 400) and RODAC colony counts (N = 400). An ABT value of ≤45 relative light units (RLU) was designated as “clean,” whereas >45 was assessed as “dirty.”

      Results

      Mean RLU baseline values ranged from 870.3 (computer keyboard) to 201.6 (bed table), and 97.5% of surfaces were assessed as “dirty.” At 6 weeks, the mean RLU of surfaces treated with IOS ranged from 31.7 (physician workstation) to 51.5 (telephone handpiece), whereas values on comparative control surfaces were 717.3 and 643.7, respectively (P < .001). Some 95.5% of RODAC cultures from IOS-treated sites at 6 weeks were negative, whereas 90.5% of nontreated sites were culture-positive, yielding multiple isolates including multidrug-resistant gram-positive and gram-negative bacteria.

      Conclusions

      IOS-treated surfaces recorded significantly lower RLU and RODAC colony counts compared with controls (P < .001). A single application of IOS resulted in a persistent antimicrobial activity on inert ICU surfaces over the 6-week study interval.

      Key Words

      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Vincent JL
        • Rello J
        • Marshall J
        • Silva E
        • Anzueto A
        • Martin CD
        • et al.
        International study of the prevalence and outcome of infection in intensive care units.
        JAMA. 2009; 302: 2323-2329
        • Russotto V
        • Cortegiani A
        • Maurizio S
        • Giarratano A
        Bacterial contamination of inanimate surfaces and equipment in the intensive care unit.
        J Intensive Care. 2015; 3: 54
        • Costa DM
        • Johani K
        • Melo DS
        • Lopes LKO
        • Lopes Lima LKO
        • Tipple AFV
        • et al.
        Biofilm contamination of high-touched surfaces in intensive care units: epidemiology and potential impacts.
        Lett Appl Microbiol. 2019; 68: 269-276
        • Wille I
        • Mayr A
        • Kreidl P
        • Brühwasser C
        • Hinterberger G
        • Fritz A,
        • et al.
        Cross-sectional point prevalence survey to study the environmental contamination of nosocomial pathogens in intensive care units under real-life conditions.
        J of Hosp Infect. 2018; 98: 90-95
      1. Manual of clinical microbiology.
        in: Jorgensen JH Pfaller MA Carroll KC Manual of clinical microbiology. 11th ed. ASM Press, Washington (DC)2015
      2. Rutala WA, Weber DJ; Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for disinfection and sterilization in healthcare facilities, 2008. Available from: https://www.cdc.gov/infectioncontrol/guidelines/Disinfection/index.html. Accessed August 15, 2019.

        • Asri LATW
        • Crismaru M
        • Roest S
        • Chen Y
        • Ivashenko O
        • Rudolf P
        • et al.
        A shape adaptive, antibacterial-coating of immobilized quaternary-ammonium compounds tethered on hyperbranched polyurea and its mechanism of action.
        Adv Funct Mater. 2014; 24: 346-355
        • Oosterhof JJ
        • Buijssen KJ
        • Busscher HJ
        • van der Laan BF
        • van der Mei HC
        Effects of quaternary ammonium silane coatings on mixed fungal and bacterial biofilms on tracheoesophageal shunt prostheses.
        Appl Environ Microbiol. 2006; 72: 3673-3677
        • Boyce JM
        • Havill HL
        • Guerica KW
        • Schweon SDJ
        • Moore BA
        Evaluation of two organosilane products for sustained antimicrobial activity on high touch surfaces in patient rooms.
        Am J Infection Control. 2014; 42: 326-328
        • Lewis BD
        • Spencer M
        • Rossi PJ
        • Lee CJ
        • Brown KR
        • Malinowski M
        • et al.
        Assessment of an innovative antimicrobial surface disinfectant in the operating room environment using adenosine triphosphate bioluminescence assay.
        Am J Infection Control. 2015; 43: 283-285
        • Hopman J
        • Donskey CJ
        • Boszczowski I
        • Alfa MJ
        Multisite evaluation of environmental cleanliness of high-touch surfaces in intensive care unit patient rooms.
        Am J Infect Control. 2018; 46: 1198-1200
        • Richard RD
        • Bowen TR
        What orthopaedic operating room surfaces are contaminated with bioburden? A study using the ATP bioluminescence assay.
        Clin Orthop Relat Res. 2017; 475: 1819-1824
        • Tamimi AH
        • Carlino S
        • Gerba CP
        Long-term efficacy of a self-disinfecting coating in an intensive care unit.
        Am J Infect Control. 2014; 42: 1178-1181