三磷酸腺苷生物荧光检测法在ICU清洁质量管理中的应用价值

摘要

Objective To explore the application value of adenosine triphosphate ( ATP) bioluminescence assay in the monitoring of cleaning quality in ICU .Methods A total of 101 specimens from the object surfaces with high contact frequency by medical staffs in ICU were collected .Sampling and measurement were performed using both ATP bioluminescence assay and smear -culture method with cotton swab,and the pass rate of cleaning quality and the positive rate of object surface pollution detected were compared between these two approaches .With smear-culture method with cotton swab as a golden standard ,monitoring efficacy of ATP bioluminescence assay for object surface pollution was evaluated .Results The pass rate of cleaning quality of object surface detected by ATP bioluminescence assay was 66.3%,slightly lower compared to that by smear-culture method with cotton swab(71.3%),and the positive rate of object surface pollution detected was 33.7%,slightly higher compared to that by smear-culture method with cotton swab(33.7%),but neither with statistical significance (P>0.05).Positive correlation was found in the monitoring result of object surface pollution between two approaches(P<0.05).The sensitivity, specificity and accuracy of ATP bioluminescence assay for monitoring object surface pollution were 100%,93.06%,and 95.05%,respectively. Conclusion As an approach for monitoring the cleaning quality of ICU environment with good sensitivity ,specificity,and accuracy,ATP bioluminescence assay can quickly and directly reflex the cleaning degree of object surface in ICU ,indicating its application in the management of cleaning quality in ICU.%目的：探讨三磷酸腺苷（ATP）生物荧光检测法在监测ICU清洁质量中的应用价值。方法采集ICU医务人员接触频次较高的物体表面，共101份标本。同时采用ATP生物荧光检测法、棉拭子涂抹培养法进行采样检测，计算两种方法清洁质量的监测合格率及对物体表面污染情况检测的阳性率；以棉拭子涂抹培养法为金标准，评价ATP生物荧光检测法对物体表面污染情况的监测效能。结果 ATP荧光检测法对物体表面清洁质量的检测合格率为66．3％，稍低于棉拭子涂抹培养法的71．3％，对物体表面污染情况检测的阳性率为33．7％，稍高于经典棉拭子涂抹培养法的28．7％，但两者比较差异均无统计学意义（P＞0．05）。两种方法对物体表面污染情况的监测结果呈正相关（P＜0．05）。 ATP生物荧光检测法监测物体表面污染情况的灵敏度、特异度、准确性分别达100％、93．06％、95．05％。结论将ATP荧光检测法作为对ICU环境清洁质量监测的方法，具有较好地灵敏度、特异度及准确性，能快速、直接反映ICU 环境物体表面的清洁程度，可应用于ICU清洁质量的管理中。