The adenosine triphosphate test is a rapid and reliable audit tool to assess manual cleaning adequacy of flexible endoscope channels.

The study objective was to verify that the adenosine triphosphate (ATP) benchmark of <200 relative light units (RLUs) was achievable in a busy endoscopy clinic that followed the manufacturer's manual cleaning instructions. All channels from patient-used colonoscopes (20) and duodenoscopes (20) in a tertiary care hospital endoscopy clinic were sampled after manual cleaning and tested for residual ATP. The ATP test benchmark for adequate manual cleaning was set at <200 RLUs. The benchmark for protein was <6.4 μg/cm(2), and, for bioburden, it was <4-log10 colony-forming units/cm(2). Our data demonstrated that 96% (115/120) of channels from 20 colonoscopes and 20 duodenoscopes evaluated met the ATP benchmark of <200 RLUs. The 5 channels that exceeded 200 RLUs were all elevator guide-wire channels. All 120 of the manually cleaned endoscopes tested had protein and bioburden levels that were compliant with accepted benchmarks for manual cleaning for suction-biopsy, air-water, and auxiliary water channels. Our data confirmed that, by following the endoscope manufacturer's manual cleaning recommendations, 96% of channels in gastrointestinal endoscopes would have <200 RLUs for the ATP test kit evaluated and would meet the accepted clean benchmarks for protein and bioburden. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Citation

Michelle J Alfa, Iram Fatima, Nancy Olson. The adenosine triphosphate test is a rapid and reliable audit tool to assess manual cleaning adequacy of flexible endoscope channels. American journal of infection control. 2013 Mar;41(3):249-53

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PMID: 22975364

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