title: Time-dependent influence on assessment of contaminated environmental surfaces in operating rooms.
abstract: There is no established method to assess the contamination of environmental surfaces because the results change with time. We evaluated current methods for assessment of contamination of environmental surfaces in the operating room (OR).
  
  
  
  Contamination of environmental surfaces in the OR was assessed using an adenosine triphosphate (ATP) test and bacterial culture. We collected 480 ATP test samples from 17 surfaces in 6 ORs to determine the influence of surface features, including frequency of touching and surface orientation on contamination, after completion of daily scheduled operations. Another 54 pairs of ATP and microbial samples were taken from 3 surfaces in each of the same OR except 1 to determine the time course of the results of ATP and microbial tests when ORs were not used.
  
  
  
  Multivariate analysis demonstrated that the ATP results were strongly influenced by frequency of touching and orientation of environmental surfaces. The microbial counts declined over time, whereas the ATP results remained at a high level.
  
  
  
  The ATP test result could be used as a relatively stable trace of contamination of environmental surfaces; however, it is not a surrogate indicator of the number of viable microbes which declines over time.
authors.affiliation: Surgical Center, University of Tokyo Hospital, Tokyo, Japan. Electronic address: saitoyu-ope@h.u-tokyo.ac.jp.
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Surgical Center, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yasuhara
authors.affiliation: Surgical Center, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Murakoshi
authors.affiliation: Surgical Center, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Takami
authors.initials: T
authors.lastname: Komatsu
authors.affiliation: Surgical Center, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Fukatsu
authors.affiliation: Surgical Center, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Yushi
authors.initials: Y
authors.lastname: Uetera
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D001419:Bacteria / Q000302:isolation & purification*; D003428:Cross Infection / Q000517:prevention & control*; D004787:Environmental Pollution; D004866:Equipment Contamination; D006801:Humans; D016015:Logistic Models; D008163:Luminescent Measurements; D015999:Multivariate Analysis; D009873:Operating Rooms / Q000592:standards*; D013997:Time Factors
chemical_list: D000255:Adenosine Triphosphate
keywords: Assessment method; Environmental contamination; Health care–associated infection; Time course