Infection Control Implications of Protracted Lengths of Stay With Noninfluenza Viral Influenza-Like Illnesses in Hospitalized Adults During the 2015 Influenza A (H₃N₂) Epidemic

Abstract

We agree that the use of rapid ATP testing has a growing body of published support. However, the lack of common acceptance for rapid ATP testing at this point in time is well expressed in the EPIC 3 Guidelines (2014) from an expert committee in the United Kingdom. 2 Unfortunately, Ms Roady somewhat misses the point of our paper. In our study, we did not attempt to equate rapid ATP testing with detection of bacterial contamination. We showed that the variability that occurs when measuring responses to controlled quantitated microbial cultures is the same variability that occurs when controlled concentrations of pure ATP solutions are measured. The issue is therefore not correlation with detection but data variability.This variability is undetectable to ATP device users and applies to all sources of detected ATP. The ATP variability problem (ie, imprecision in results) that we have outlined in our most recent paper is common to each of the ATP device brands we tested. This finding does have implications for sampling methodology and analysis. 3 We set out to validate several branded ATP devices using a standardized approach and focusing on precision and accuracy. 4 The first issue we encountered was uncontrolled variability and the lack of precision at any testing point. The issue of accuracy is problematic because the scale of relative light units (RLU) is neither universally standardized nor standardized among ATP device suppliers.We welcome the engagement with the industry. We would like to see better quality of results for ATP testing devices, including testing for precision and the development of a common measurement scale. There remains a tremendous upside for ATP use once these issues are resolved. acknowledgmentsPotential conflicts of interest. None of the authors has any conflict of interest to declare.

Practical Guidance for Clinical Microbiology Laboratories: Viruses Causing Acute Respiratory Tract Infections

“…Although we can begin to predict patterns of respiratory virus circulation as surveillance and detection capacities improve (9), viruses may be identified outside their normal seasonal infection patterns due to patient activities, such as travel to regions where the virus is currently circulating (10). Knowing the travel history combined with active pathogen surveillance (e.g., identifying a patient who presents during a North American summer with acute respiratory infection after travel to the Southern Hemisphere where FLU or RSV is circulating) can help direct appropriate infection prevention and control measures, as not all respiratory viruses require the same level of patient isolation (11,12).…”

Impact of multiplexed respiratory viral panels on infection control measures and antimicrobial stewardship: a review of the literature

“…Two studies report that the results of MRVP affected infection control management, but also mention that logistical problems can limit their effect [ 35 , 37 ]. Braybrook et al found that infection control measures of hospitalized children were affected by MRVP in one-quarter of cases, but the value of testing was directly related to the number of isolation rooms available.…”