ATP Disinfection Can Be Improved for Real-World Application

The way Jason Tetro sees it, one of the many activities going on at the ISSA Show North America 2021, being held this week in Las Vegas, includes an invitation to entrepreneurs and inventors to focus on improving adenosine triphosphate (ATP) bioluminescence. Put simply, ATP is an energy-carrying molecule found in all living things. In the process of infection prevention and control, the levels of ATP on a surface can indicate whether that surface has been properly cleaned of bacterial or fungal contamination. However, tapping into that capability has been a challenge for a number of reasons, says Tetro.

“While ATP may seem like something that is a standard, it really hasn’t proven to be a standard,” says Tetro, who’s the co-author of a study (along with Syed A. Sattar, PhD) on ATP that’s featured at the ISSA conference. He tells Infection Control Today^® that “the reason I say that is because that’s what makes a [conference] like ISSA so important. It gives you an opportunity to see what is out there when it does come down to decision making time for those procurement officers.”

The technology will have to be improved before it can function in a busy health care setting, says Tetro, who is the author of the books The Germ Code and The Germ Files. ATP works fine in controlled laboratory circumstances.

“But that’s for one surface under one controlled environment,” says Tetro. “When you go into the field, you have an infinite number of environments. As a result of that, you can never have a perfect titration curve. And as a result, as we found, you can never actually do quantification of microbes using the ATP test.”

In addition, says Tetro, health care environments contain a number of interfering molecules that can not only hamper the luminescence, but also enhance or augment it. Also, there’s the problem of sampling error.

“Anybody who’s an infection preventionist, who has ever done an audit of infection prevention and control knows that sampling error is a huge issue,” says Tetro. “Because at the end of the day, when we’re swabbing, it doesn’t matter what we’re swabbing, if you don’t have an absolute standard operating procedure, with the exact same type of swab, you’re never going to get repeatable results.”

In other words, infection preventionists and environmental services teams are working with estimates. That’s OK if they’re working in a clean room that has no microbes, or in an industry like food processing. “But when you’re talking about a health care facility where the presence of microbes could literally mean a life-or-death situation for someone, you want to have something that’s far more accurate in terms of the quantification without any chance for sampling error, or interference with the luminescence.”

The point Tetro wants to stress, though, is that ATP’s potential is real. “I think what we’re starting to see now is the ability to improve upon these particular issues by focusing on individual pieces, such as interference, or such as signal loss, or signal degradation, or even just simply sampling error,” says Tetro. “I mean we’ve gotten to a point where we can have better swabs. I think in that sense, especially for people who are attending conferences, such as ISSA, which is incredibly valuable—I’ve been there myself, it’s wonderful—you want to be able to have the ability to tell somebody who’s going to be doing that test: ‘You don’t need to worry about these other things.’”