Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
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.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 20 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 29 citations in OpenAlex.
- Characterising the Hospital Microbiota: A Descriptive Study of Environmental Monitoring.Pathogens (Basel, Switzerland) · 2026Article
- Strategies to prevent cross-transmission of multidrug-resistant microorganisms in intensive care units: A narrative review.Journal of intensive medicine · 2026Review
- The role of ATP bioluminescence in monitoring surface hygiene in hospital settings: a comprehensive review.Antimicrobial resistance and infection control · 2026Review
- Risk Factors and Medical Burden of Multidrug-Resistant Organism Infection in Hospitalized Patients with Pneumonia.Infection and drug resistance · 2026Article
- Intravenous medication administration by nursing staff: adherence to aseptic measures and touching environmental surfaces.Revista brasileira de enfermagem · 2026Article
- What are the microbial burden and potential pathogens on hospital surfaces before and after cleaning?Frontiers in microbiology · 2026Article
- Clean to Prevent, Monitor to Protect: A Scoping Review on Strategies for Monitoring Cleaning in Hospitals to Prevent HAIs.Infectious disease reports · 2025Review
- ICU environment as a reservoir of KPC-ST307-Klebsiella pneumoniae high-risk clone resistant to ceftazidime-avibactam.Scientific reports · 2025Article
- Development and validation of a nomogram model for predicting MDRO infections in elderly ICU patients with pulmonary infections.Aging clinical and experimental research · 2025Article
- Elevated antibiotic resistance gene abundance of ICU healthcare workers, a multicentre, cross-sectional study.Critical care (London, England) · 2025Observational
- Cleaning and disinfection in neonatal intensive care units: correlation of evaluation methods.Revista brasileira de enfermagem · 2025Article
- Inactivation of multidrug-resistant bacteria using cold atmospheric-pressure plasma technology.Frontiers in medicine · 2025Article
- Comparison of the efficacy of soaking and drying methods for the disinfection of handwashing sinks in ICU.Frontiers in public health · 2025Article
- Hand and environmental hygiene: respective roles for MRSA, multi-resistant gram negatives, Clostridioides difficile, and Candida spp.Antimicrobial resistance and infection control · 2024Review
- Genomic characterization and outbreak investigations of methicillin-resistantFrontiers in microbiology · 2024Article
- Effectiveness of inspector mechanism for the emergency infection prevention and control in the SARS-CoV-2 epidemic period: a self-control real-word study.BMC infectious diseases · 2023Article
- When fear takes control: the multidrug resistance story during pandemics.Intensive care medicine · 2023Article
- Article
- Bacterial Cross-Transmission between Inanimate Surfaces and Patients in Intensive Care Units under Real-World Conditions: A Repeated Cross-Sectional Study.International journal of environmental research and public health · 2022Article
- Environmental cleaning and disinfection: Sustaining changed practice and improving quality in the community hospital.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
21 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundMultidrug-resistant organisms (MDROs) frequently contaminate hospital environments. We performed a multicenter, cluster-randomized, crossover trial of 2 methods for monitoring of terminal cleaning effectiveness.
methodsSix 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.
resultsThe 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], 0.807-0.951; P = .002). Including the baseline period, the ATP method was associated with reduced infection with MDROs (IRR 0.924; 95% CI, 0.855-0.998; P = .04), and MDR-GNB infection or colonization (IRR 0.856; 95% CI, 0.825-0.887; P < .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.
conclusionsIntensive monitoring of ICU terminal room cleaning with an ATP modality is associated with a reduction of MDRO infection and colonization.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.