北京市西城区某医院胃镜清洗消毒效果分析
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摘要
目的了解医院胃镜清洗过程中不同节点的清洗消毒效果,验证生物膜清洗液的更换频率对清洗消毒效果的影响。方法 2017年,北京市某三甲医院胃镜室操作所用胃镜,分别于清洗过程中、消毒前、后对每条胃镜的活检、送气送水和负压吸引孔道进行采样,并且对胃镜清洗过程中使用的生物膜清洗剂进行采样,4 h内送实验室进行菌落总数计数和细菌种类分型鉴定。结果共采集胃镜56条,168份样本,胃镜清洗总无菌率为7.14%,其中活检、送气送水和负压吸引孔道无菌率分别为28.6%,35.7%和57.1%;胃镜消毒总合格率为96.4%。结论胃镜消毒后基本能达到标准要求,生物膜清洗液重复利用后微生物污染严重。
Objective To understand the disinfection effect of gastroscope in each procedure in a hospital, and to verify the disinfection effect of the replacement frequency of biofilm rinse fluid. Methods The gastroscopes of a tertiary grade A hospital in Beijing during 2017 were collected and tested. During the procedures of rinsing, before and after the disinfection, the biopsy duct, air duct, and negative pressure suction duct were sampled. And the rinse fluid of the biofilm was collected. All samples were sent to the laboratory within 4 hours to test the total number of colonies and to identify the bacterial species. Results In this study, 56 gastroscopes were included and 168 samples were obtained. Before disinfection, the total qualification rates of gastroscopy, biopsy duct, air duct, and negative pressure suction duct were 7.14%, 28.6%, 35.7% and 57.1%. The overall qualification rate of was 96.4%. Conclusion The disinfection of gastroscopes in the hospital can substantially meet the qualification. The disinfection qualification of the reutilized biofilm rinse fluid is low.
Objective To understand the disinfection effect of gastroscope in each procedure in a hospital, and to verify the disinfection effect of the replacement frequency of biofilm rinse fluid. Methods The gastroscopes of a tertiary grade A hospital in Beijing during 2017 were collected and tested. During the procedures of rinsing, before and after the disinfection, the biopsy duct, air duct, and negative pressure suction duct were sampled. And the rinse fluid of the biofilm was collected. All samples were sent to the laboratory within 4 hours to test the total number of colonies and to identify the bacterial species. Results In this study, 56 gastroscopes were included and 168 samples were obtained. Before disinfection, the total qualification rates of gastroscopy, biopsy duct, air duct, and negative pressure suction duct were 7.14%, 28.6%, 35.7% and 57.1%. The overall qualification rate of was 96.4%. Conclusion The disinfection of gastroscopes in the hospital can substantially meet the qualification. The disinfection qualification of the reutilized biofilm rinse fluid is low.
引文
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[2]荣秋华,张莹.消化内镜清洗消毒过程中存在的问题与对策[J].中华医院感染学杂志,2012,22(16):3597-3599.
[3]张俊骥,李新芳,乔美珍,等.苏州市医疗结构消化内镜清洗消毒现状调查[J].2017,16(7):631-634.
[4]黄妮妮,梁燕宓.95个软式内镜室清洗消毒现状调查分析及对策[J].2015,21(5),532-535.
[5]王淑芳.Intercept生物膜特效清洗剂与普通酶洗液在内镜消毒中的应用效果比较[J].当代医学,2015,7(21):19.
[6]赵金秀,魏崇敬.多酶洗剂的温度及浸泡时间对难洗器械清洗质量的影响[J].中国保健营养(中旬刊),2014(7):4595-4596.
[7]秀英,伍燕芳,陈秀霞,等.不同温度多酶清洗剂对内镜生物膜清除效果的影响[J].实用临床医药杂志,2016,20(6):155-156.
[8]焦莉莉,吕艳伟,白晓东,等.改进内镜清洗方法的临床应用研究[J].中华医院感染学杂志,2014(19):4915-4917.
[9]夏瑾,徐虹,赵岚,等.不同检测方法对胃镜复用清洗质量监测的比较研究[J].中华医院感染学杂志,2013(7):1624-1626.
[10]王军,席惠君,李兆申.中国消化内镜清洗消毒专家共识意见[J].中华消化内镜杂志,2014,31(11):617.