Clinical Significance of Surgical Hand Washing Evaluation Based on Adenosine Triphosphate Measurement

Abstract

  Standard evaluation for surgical hand washing is based on the glove juice method using bacterial culture. However, this method is complicated and routine implementation is difficult. On the other hand, simple equipment to measure adenosine triphosphate (ATP) is used to evaluate the purity of medical instrumentations. The present study evaluated the use of ATP measurement for evaluation of surgical hand washing. Samples were obtained according to the modified glove juice method before and after surgical hand washing. Colony forming unit (CFU) and ATP of the samples were determined and converted to ATP or bacterial amount (BA) per one hand. There was a significant correlation between log (BA) and log (ATP). There was no correlation between BA reduction rate and ATP reduction rate. Comparing our method with the standard method, measuring time is short, operation is simple, and cost is low. If scientific evidence is established, this method is clinically useful. The BA reduction rate did not correlate with the ATP reduction rate, probably because ATPs exist in bacteria as well as in non-bacterial sweat and skin drop debris and both are measured. On the other hand, the ATP reduction rate was lower than BA reduction rate suggesting that ATP provides a more sensitive indicator. More research is required to improve this method and to consider criteria to apply this method.