Correlation Between Surface Cleaning and Disinfection Methods in an Emergency Room

Bruna Andrade dos Santos Oliveira1, Elaine Mazuqui Rigonato1, Alvaro Francisco Lopes de Sousa2, 3, *, Adriano Menis Ferreira1, Larissa da Silva Barcelos1, Mara Cristina Ribeiro Furlan1, Marcelo Alessandro Rigotti1, Guilherme Schneider2, Denise de Andrade2, Luis Velez Lapão3, Aires Garcia dos Santos Junior1
1 Campus Três Lagoas, Federal University of Mato Grosso do Sul, Três Lagoas, Brazil
2 Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil
3 Global Health and Tropical Medicine, Ribeirão Preto, Brazil, Nova University of Lisbon, Lisbon, Portugal

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Creative Commons License
© 2021 dos Santos Oliveira et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the University of São Paulo, Ribeirão Preto College of Nursing, Brazil; E-mail:



To evaluate the correlation between microbiological culture, ATP tests by bioluminescence and visual inspection for monitoring the surface cleaning and disinfection in an emergency room.


This is a prospective, analytical study with a quantitative approach. Data analysis was guided by the following tests: Spearman’s correlation, Fisher ‘s exact test and receiver operating characteristic (ROC) curve.


There was a correlation between ATP quantification methods and microbial count for the women’s bathroom door handle (ρ = 0.526; p= 0.008). In this study, considering the ROC curve, the ATP value below 20 RLU is suggested to classify surfaces as approved in the emergency room.


Using different methods of monitoring the cleaning and disinfection process is essential, considering that each method has a different purpose.

Keywords: Equipment contamination, Hospital Cleaning Service, Disinfection, Clostridium difficile, Staphylococcus aureus, Adenosine Triphosphate (ATP), Colony Count (ACC).