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Comparing ATP values with bacterial contamination in a nursing home


Bacterial surface contamination is an important reservoir for micro-organisms and a potential route for transmission. ATP bioluminescence is a relatively new method to assess environmental contamination, and gives direct results.


We compared ATP bioluminescence with aerobic colony count and presence of ESBL-producing Enterobacteriaceae.


The study was performed in a nursing home in the Netherlands during an outbreak of ESBL-producing Enterobacteriaceae, mainly Escherichia coli. During 5 consecutive surveys, ATP measurements (3M, Zoeterwoude, The Netherlands) were performed on several predefined surfaces. ATP measurements were combined with aerobic colony count, using Rodac agar plates in 2 surveys, and selective culture for ESBL-producing Enterobacteriaceae in 3 surveys. ATP bioluminescence was expressed in relative light units (RLU), AAC was expressed in cfu/cm2;for the analysis a Natural Logarithmic transformation was performed to obtain an normal distribution of the values (LnRLU and LnCFU).


In total we performed 483 ATP-measurements, 197 ACC cultures and 285 ESBL-selective cultures. Toilet seats were significantly associated with higher RLU (P<0.001), higher prevalence of more than 40 cfu/cm2on aerobic colony count, but not with difference in prevalence of ESBL-producing Enterobacteriaceae (P=0.31), compared to water taps, kitchen- and living room areas.

The ATP and ACC results of the 98 paired samples showed a good correlation between LnRLU and LnCFU(R2=0.277; P<0.001). Furthermore, LnRLU of the sample sites which yielded an ESBL-producing Enterobacteriaceae was significantly higher than of other the sites (P=0.016).


Our study showed that ATP bioluminescence has a good correlation with bacterial contamination determined of surfaces. Furthermore, we did find a significant correlation between LnRLU and surface contamination with ESBL-producing Enterobacteriaceae. In conclusion, ATP bioluminescence is a valid replacement for measuring the bacterial contamination of surfaces, and can be a useful tool for direct feedback to assess cleaning properties.

Disclosure of interest

I. Overdevest: None declared, I. Willemsen: None declared, Y. Hendriks: None declared, C. Verhulst: None declared, J. Kluytmans Consultant for: Pfizer, biomerieux, 3M.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Overdevest, I., Willemsen, I., Hendriks, Y. et al. Comparing ATP values with bacterial contamination in a nursing home. Antimicrob Resist Infect Control 4 (Suppl 1), P28 (2015).

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