title: A pilot study into locating the bad bugs in a busy intensive care unit.
abstract: BACKGROUND
  The persistence of multidrug-resistant organisms (MDROs) within an intensive care unit (ICU) possibly contained within dry surface biofilms, remains a perplexing confounder and is a threat to patient safety. Identification of residential locations of MDRO within the ICU is an intervention for which new scientific approaches may assist in finding potential MDRO reservoirs.
  
  
  METHODS
  This study investigated a new approach to sampling using a more aggressive environmental swabbing technique of high-touch objects (HTOs) and surfaces, aided by 2 commercially available adenosine triphosphate (ATP) bioluminometers.
  
  
  RESULTS
  A total of 13 individual MDRO locations identified in this pilot study. The use of ATP bioluminometers was significantly associated with the identification of 12 of the 13 individual MDRO locations. The MDRO recovery and readings from the 2 ATP bioluminometers were not significantly correlated with distinct cutoffs for each ATP device, and there was no correlation between the 2 ATP devices.
  
  
  CONCLUSIONS
  The specific MDRO locations were not limited to the immediate patient surroundings or to any specific HTO or type of surface. The use of ATP testing helped rapidly identify the soiled locations for MDRO sampling. The greatest density of positive MDRO locations was around and within the clinical staff work station.
authors.affiliation: School of Science and Health, University of Western Sydney, Richmond, NSW Australia; Whiteley Corporation Pty Ltd, North Sydney, NSW Australia. Electronic address: gsw@whiteley.com.au.
authors.forename: Greg S
authors.initials: GS
authors.lastname: Whiteley
authors.affiliation: School of Medicine, University of Western Sydney, Campbelltown, NSW Australia; Ingham Institute for Applied Medical Research, Antibiotic Resistance and Mobile Elements Group, Campbelltown, NSW Australia; Molecular Medicine Research Group, Liverpool, NSW Australia.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Knight
authors.affiliation: School of Science and Health, University of Western Sydney, Richmond, NSW Australia.
authors.forename: Chris W
authors.initials: CW
authors.lastname: Derry
authors.affiliation: School of Medicine, University of Western Sydney, Campbelltown, NSW Australia; Ingham Institute for Applied Medical Research, Antibiotic Resistance and Mobile Elements Group, Campbelltown, NSW Australia; Molecular Medicine Research Group, Liverpool, NSW Australia.
authors.forename: Slade O
authors.initials: SO
authors.lastname: Jensen
authors.affiliation: Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, North Ryde, NSW Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Vickery
authors.affiliation: School of Medicine, University of Western Sydney, Campbelltown, NSW Australia; Ingham Institute for Applied Medical Research, Antibiotic Resistance and Mobile Elements Group, Campbelltown, NSW Australia; Molecular Medicine Research Group, Liverpool, NSW Australia; Department of Microbiology and Infectious Diseases, Sydney South West Pathology Service, Liverpool, NSW Australia.
authors.forename: Iain B
authors.initials: IB
authors.lastname: Gosbell
mesh_terms: D000255:Adenosine Triphosphate / Q000032:analysis; D001419:Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D024901:Drug Resistance, Multiple, Bacterial; D004783:Environmental Microbiology; D006801:Humans; D007362:Intensive Care Units; D008163:Luminescent Measurements; D010865:Pilot Projects
chemical_list: D000255:Adenosine Triphosphate
keywords: ATP correlation; Dry surface biofilm; High-touch objects; Intensive care unit; MDRO locations; Staff work area