title: Validation and comparison of three adenosine triphosphate luminometers for monitoring hospital surface sanitization: a Rosetta Stone for adenosine triphosphate testing.
abstract: BACKGROUND
  The application of adenosine triphosphate (ATP) luminometry for monitoring sanitized hospital surfaces is an evolving infection control practice. The goal of this study is to validate and compare 3 commercially available ATP luminometry, swab, rapid-test systems for use in hospital surface sanitization testing. Regulatory agencies may consider this a point-of-care laboratory test; it is therefore imperative that validation criteria are established.
  
  
  METHODS
  The ability of instruments to measure long-term stability of ATP dried on surfaces was determined. Dilutions of 3 species of microorganisms and a blood sample were dried onto a surface and tested. The performance characteristics of instruments were compared side-by-side for their ability to recover microorganism-derived ATP from surfaces.
  
  
  RESULTS
  Timed studies showed that surface biologic-ATP remained detectable for 10 days. Instrument clinical sensitivity, precision, detection range, limit of detection, and linearity were determined. Swab recovery of microorganisms from surfaces varied by instrument and organism. All 3 systems detected microorganisms in the presence of disinfectants.
  
  
  CONCLUSIONS
  All instruments were validated, but only 1 was verified, because of variations in performance for each system. These studies indicate that careful consideration of the technologic application and instrument performance are important criteria for the selection of an ATP monitoring system.
authors.affiliation: Robley Rex Veterans Affairs Medical Center, Pathology and Laboratory Medicine Service, Louisville, KY 40206, USA. Carmen.Sciortino@va.gov
authors.forename: Carmen V
authors.initials: CV
authors.lastname: Sciortino
authors.forename: R Allen
authors.initials: RA
authors.lastname: Giles
mesh_terms: D040981:Acinetobacter baumannii / Q000302:isolation & purification* / Q000378:metabolism; D000255:Adenosine Triphosphate / Q000032:analysis* / Q000378:metabolism; D002176:Candida albicans / Q000302:isolation & purification* / Q000378:metabolism; D004784:Environmental Monitoring / Q000379:methods; D006797:Housekeeping, Hospital / Q000592:standards; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000592:standards; D008163:Luminescent Measurements / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D015203:Reproducibility of Results; D012499:Sanitation / Q000592:standards; D012680:Sensitivity and Specificity; D013193:Stainless Steel; D013211:Staphylococcus aureus / Q000302:isolation & purification* / Q000378:metabolism; D013997:Time Factors
chemical_list: D013193:Stainless Steel; D000255:Adenosine Triphosphate