---
title: ATP – a microbiologist’s square peg
description: ATP – a microbiologist’s square peg
---

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## ATP – a microbiologist’s square peg

<http://static1.squarespace.com/static/595689fc9de4bbc892200518/t/59568acf5fd63b5f292879e2/1498845561883//img.png.com/static/595689fc9de4bbc892200518/t/59568acf5fd63b5f292879e3/1498843855139/1000w/>

I admit it that there are times I can come across as  
 being too zealous, but when I truly believe an injustice is occurring, then I  
 need to do everything in my powers to ensure the issue is addressed.  The widespread misuse of [ATP](http://en.wikipedia.org/wiki/Adenosine_triphosphate)   
(Adenosine Triphosphate) as a means for  
 comparing the effectiveness of different disinfectants is something that I  
 cannot leave unaddressed.  To me it’s the  
 equivalent of trying to force a square peg into a round hole or for that matter  
 trying to use margarine to make [shortbread](http://southernfood.about.com/od/buttercookies/r/bl40318i.htm)....when butter is the only way to  
 go!

Don’t get me wrong, safe and effective disinfection of  
 high-touch environmental surfaces is an important tool in reducing the spread  
 of HAIs and the need for rapid and reliable means of monitoring the  
 effectiveness of such practices are also crucial for training and quality  
 control.  I do agree that ATP has its  
 use; however, there are several limitations to the use of ATP within healthcare  
 facilities.  First, the absence of  
 standardization of the ATP technology from various manufacturers and RLU  
 readings for use within healthcare makes cross-comparisons of readings and  
 benchmarking problematic.  Second, the  
 lack of documented correlation between ATP readings and levels of microbial  
 contamination on environmental surfaces makes meaningful interpretation of the  
 data difficult and distinction between pathogenic and non-pathogenic microbes  
 on the sampled surface virtually impossible. Also, ATP kits cannot detect or  
 measure viral contamination because viruses possess no ATP.  Third, and quite importantly, certain common  
 surface disinfectant chemistries and cleaning tools may interfere to varying  
 degrees with ATP measurements.    
Therefore, the use of ATP as a tool to determine the effectiveness of  
 different cleaning practices or to compare the effectiveness of different  
 cleaning and disinfectant chemistries remains a challenge. 

While we have written a [Technical Bulletin](http://infectionpreventionresource.com/files/PTS%20Technical%20Bulletin%20-%20Use%20of%20ATP%20for%20Evaluating%20Cleaning%20%20Disinfection%20Effectiveness%20Oct%202012%20_2_.pdf) addressing  
 each of the limitations, it’s the limitation in the use of ATP as a comparator  
 tool that catches in my “caw” so to speak.     
From an infection control perspective, we want to ensure that we choose  
 the best disinfectant for our programs so the ability to create numbers to  
 compare different disinfectants is of great interest.  Unfortunately, in our attempts to generate  
 numbers, we have overlooked the limitations of the ATP test itself. 

The issue of different cleaning chemistries and their  
 potential to enhance or quench ATP bioluminescence is especially  
 significant.  Quats and anionic  
 surfactants, for example, may give false positive results by enhancing RLU  
 readings by as much as 10%.  One study  
 with Hydrogen Peroxide showed that concentrations of 0.1% did not have any  
 enhancing or quenching effects on the RLU levels; at 0.5%, quenching effects of  
 3 - 5% were observed. On the other hand, chlorine has been shown to have both  
 enhancing and quenching effects.  At  
 concentrations of 100 ppm chlorine has been shown to significantly enhanced RLU  
 readings.    As concentrations increased  
 to 500 ppm neither quenching or enhancing effects were observed, but as levels  
 of chlorine increase to those (e.g., 1,000-5,000 ppm),  routinely used for environmental surface  
 disinfection in healthcare facilities there may be as much as a 40% deviation  
 in quenching, thereby potentially giving false negatives!  Consequently, [Boyce et al](http://www.ncbi.nlm.nih.gov/pubmed/19489715) in their study on  
 the use of ATP for monitoring the effectiveness of hospital cleaning excluded  
 all those rooms which were disinfected with a 5,000 ppm bleach solution.

I’m not saying it’s wrong to use or that we should not  
 use ATP measurement kits to assess the degree of cleanliness of cleaned and disinfected  
 surfaces in healthcare settings.  I am  
 simply asking that caution is used in the interpretation of the results because  
 several published studies have now documented the potential of cleaning tools  
 and disinfectant chemistries to either enhance or suppress the levels of RLU  
 and may in fact lead to either an over-estimation or an under-estimation of the  
 surface decontamination procedures in place.

Just as making a good shortbread requires butter, if you  
 want to really know how well a disinfectant is working (e.g. killing the bugs)  
 you need to conduct microbiological testing. 

 

Bugging Off!

Nicole

 

 

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