{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:48:58Z","timestamp":1788432538735,"version":"build-2803163510"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T00:00:00Z","timestamp":1643673600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"CDC Epicenters for the Prevention of Healthcare Associated Infections"},{"name":"National Institute for Allergy and Infectious Diseases","award":["K23 AI143925"],"award-info":[{"award-number":["K23 AI143925"]}]},{"name":"National Institute for Allergy and Infectious Diseases","award":["K23 AI121485"],"award-info":[{"award-number":["K23 AI121485"]}]},{"name":"National Institute for Allergy and Infectious Diseases","award":["L30 AI120149"],"award-info":[{"award-number":["L30 AI120149"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIH Roadmap for Medical Research","award":["UL1 TR002345"],"award-info":[{"award-number":["UL1 TR002345"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Multidrug-resistant organisms (MDROs) frequently contaminate hospital environments. We performed a multicenter, cluster-randomized, crossover trial of 2 methods for monitoring of terminal cleaning effectiveness.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Six intensive care units (ICUs) at 3 medical centers received both interventions sequentially, in randomized order. Ten surfaces were surveyed each in 5 rooms weekly, after terminal cleaning, with adenosine triphosphate (ATP) monitoring or an ultraviolet fluorescent marker (UV\/F). Results were delivered to environmental services staff in real time with failing surfaces recleaned. We measured monthly rates of MDRO infection or colonization, including methicillin-resistant Staphylococcus aureus, Clostridioides difficile, vancomycin-resistant Enterococcus, and MDR gram-negative bacilli (MDR-GNB) during a 12-month baseline period and sequential 6-month intervention periods, separated by a 2-month washout. Primary analysis compared only the randomized intervention periods, whereas secondary analysis included the baseline.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The ATP method was associated with a reduction in incidence rate of MDRO infection or colonization compared with the UV\/F period (incidence rate ratio [IRR] 0.876; 95% confidence interval [CI], 0.807\u20130.951; P\u2005=\u2005.002). Including the baseline period, the ATP method was associated with reduced infection with MDROs (IRR 0.924; 95% CI, 0.855\u20130.998; P\u2005=\u2005.04), and MDR-GNB infection or colonization (IRR 0.856; 95% CI, 0.825\u20130.887; P\u2005&amp;lt;\u2005.001). The UV\/F intervention was not associated with a statistically significant impact on these outcomes. Room turnaround time increased by a median of 1 minute with the ATP intervention and 4.5 minutes with UV\/F compared with baseline.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Intensive monitoring of ICU terminal room cleaning with an ATP modality is associated with a reduction of MDRO infection and colonization.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac070","type":"journal-article","created":{"date-parts":[[2022,1,27]],"date-time":"2022-01-27T04:13:18Z","timestamp":1643256798000},"page":"1217-1223","source":"Crossref","is-referenced-by-count":33,"title":["Stopping Hospital Infections With Environmental Services (SHINE): A Cluster-randomized Trial of Intensive Monitoring Methods for Terminal Room Cleaning on Rates of Multidrug-resistant Organisms in the Intensive Care Unit"],"prefix":"10.1093","volume":"75","author":[{"given":"Matthew J","family":"Ziegler","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"},{"name":"Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"},{"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"},{"name":"Department of Healthcare Epidemiology, Infection Prevention and Control, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary H","family":"Babcock","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine , Saint Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon F","family":"Welbel","sequence":"additional","affiliation":[{"name":"Cook County Health , Chicago, Illinois , USA"},{"name":"Rush Medical College , Chicago, Illinois , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K","family":"Warren","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine , Saint Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E","family":"Trick","sequence":"additional","affiliation":[{"name":"Cook County Health , Chicago, Illinois , USA"},{"name":"Rush Medical College , Chicago, Illinois , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pam","family":"Tolomeo","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Omorogbe","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Garcia","sequence":"additional","affiliation":[{"name":"Cook County Health , Chicago, Illinois , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy","family":"Habrock-Bach","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine , Saint Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onofre","family":"Donceras","sequence":"additional","affiliation":[{"name":"Cook County Health , Chicago, Illinois , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Gaynes","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania, University of Pennsylvania Health System , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh","family":"Cressman","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason P","family":"Burnham","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine , Saint Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren","family":"Bilker","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"},{"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujan C","family":"Reddy","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Pegues","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"},{"name":"Department of Healthcare Epidemiology, Infection Prevention and Control, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebbing","family":"Lautenbach","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"},{"name":"Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"},{"name":"Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan J","family":"Kelly","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"},{"name":"Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, 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