J Korean Biol Nurs Sci.  2021 Nov;23(4):339-346. 10.7586/jkbns.2021.23.4.339.

Evaluation of Environmental Contamination and Disinfection Effects in Patient Rooms with Carbapenem-Resistant Enterobacteriaceae Using ATP Measurements and Microbial Cultures

  • 1Department of Clinical Nursing, Graduate School of Industry, University of Ulsan, Seoul, Korea
  • 2Department of Nursing, Asan Medical Center, Seoul, Korea
  • 3Department of Diagnostic Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
  • 4Department of Infection Control, Severance Hospital Yonsei University College of Medicine, Seoul, Korea


To determine the extent of environmental contamination and the effect of disinfection around patients with carbapenemresistant Enterobacteriaceae (CRE) using adenosine triphosphate (ATP) measurements and microbial culture tests. Methods: The subjects of this study were 10 patients hospitalized in a single room due to CRE from April 13 to 21, 2021. One hundred and sixty samples were collected using cotton swabs from the patients’ environment including the surface and drain of sinks and toilet seats before and after disinfection of the room after discharge. Twenty-one samples were collected from the nurses’ personal digital assistants (PDAs), keyboards, and computer mice before disinfection. The relative light units (RLUs) and CRE colony-forming units (CFU) of 181 samples were measured using ATP test equipment and chrome agar plates, respectively. Results: The highest RLUs were measured at the sink drains before and after disinfection. Four CRE samples from the sink drains (2), sink surface (1), and toilet bowl (1) before disinfection were cultured. Based on the failure criteria ( ≥ 250 RLU/cm2 and ≥ 1 CFU/100 cm2 ), 90 % and 50 % of the samples from the drain exceeded the failure criteria before and after disinfection, respectively. In the culture tests, CRE was not detected after disinfection. Conclusion: According to the RLU and CFU measurements of drain samples, disinfection was not effective. Thus, improvements in the disinfection methods of drains, as well as more efficient and systematic environmental decontamination and disinfection evaluation tools, are needed to accurately evaluate the effectiveness of disinfection in various places.


Carbapenem-resistant Enterobacteriaceae; Disinfection; Adenosine Triphosphate
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