理性看待ATP检测技术在医疗机构的使用，想给大家泼点冷水。ATP 检测技术在食品和公共卫生领域有广泛的使用经验。其对光滑表面和液体样本具有一定的可靠性。它在公共环境的清洁效果检验上有一定优势。目前，被医院引入，尝试进行清洗和清洁效果的检测，以提升感染防控水平。做为一种新的方法手段，尝试性探索其作用值得提倡。院感需要新方法，新思路。需要有人做探索性工作研究或者开发。但做为常规和成熟的方法使用于感染防控，要理性思考和慎重对待。
美国APIC 2012年8月15日发布了一个立场文件，虽然其是针对多孔材料和纺织物而言，但其循证证据，可以适用于感染防控关心的相关物品。由于该方法的非特异性、局限性、结果不定性，各厂产品不统一性，方法学不可靠性等原因，APIC建议目前推广使用还是不可取的。
相信在不久的将来，通过专家的研究努力，开发的产品具有基于标准化试验方法建立起统一的行业标准，能够只针对细菌等关键标的物响应，推广使用将水到渠成。ATP检测技术产品才能做为一种有效工具，真正发挥其感染防控的作用。现传相关文献的节选一篇，供参考。
APIC Practice Guidelines Committee (PGC) Position Statement on Adenosine Triphosphate (ATP) Testing
In years past, microbiological sampling of the healthcare environment traditionally involved collection of samples from environmental surfaces, air, soils, or water and assaying contamination present therein via environmental microbiological cultures. More recently, however, an advanced technology that measures the presence of adenosine triphosphate (ATP) in organic matter from a range of sources that includes living microbes, soil bioburden, and natural materials is used increasingly to detect residual contamination on hard, non-porous surfaces in the indoor environment.
ATP testing has been used extensively in the food industry as part of a broad system to ensure food safety. Despite this experience, there remains potential for misinterpretation of test readings. Recently, however, there has been some interest in extending use of the ATP-detection technology .There is currently no evidence to support its use in this service arena.
This type of application is an inappropriate use of the technology for several reasons.
1. This sampling technology is not currently designated for use on porous surfaces; manufacturers have designated that its use be limited to non-porous surface sampling or use in fluids.
2. There is concern that false elevated RLU values when sampling natural fibers will confound accurate interpretation of the results.
3. To date there have been no efforts on the part of the various manufacturers to achieve standardization of the ATP technology and its RLU readings for use within healthcare, thereby making cross-comparisons of RLU readings and benchmark values problematic.
4. Fourth, and most importantly, there have been no laboratory-based or in-use studies to define the use of such technology for end product testing of the laundering process for reusable textiles.
APIC believes the use of ATP detection technology for determining the cleanliness of hygienically clean is inappropriate and unwarranted . |
发表于 2013-4-27 11:54
发表于 2013-4-27 13:07
