十二指肠镜消毒后微生物污染调查

发布时间：2018-10-14 21:00

【摘要】：目的研究消毒后使用前的十二指肠镜活检通道、水气通道、抬钳器通道及抬钳器四个不同位点的微生物污染状况,初步了解医院十二指肠镜消毒效果。方法 2016年7月-2017年2月对北京市两所三甲医院消毒后使用前的十二指肠镜进行采样研究,每条十二指肠镜采集四个位点,用全管道灌流法采集十二指肠镜的活检通道、水气通道和抬钳器通道三个位点,用超声清洗器振荡法采集十二指肠镜抬钳器,4h内送实验室进行菌落总数计数和细菌种类分型鉴定。结果本研究采集十二指肠镜27条,共108份样本,十二指肠镜总合格率为37.0%,水气通道合格率为77.8%,抬钳器通道合格率为77.8%,活检通道合格率为70.4%,抬钳器合格率仅为48.1%;共分离到182株细菌,其中致病菌9株检出率为4.9%,分离到的致病菌包括鼠疫耶尔森菌、铜绿假单胞菌和大肠埃希菌。结论十二指肠镜消毒后合格率偏低,存在院内交叉感染的风险,应重视十二指肠镜消毒效果的监测,尤其是抬钳器的清洗消毒效果。
[Abstract]:Objective to study the microbial contamination at four different sites of duodenoscope biopsy channel, water air channel, forceptor channel and forceptor before disinfection, and to understand the disinfection effect of duodenoscope in hospital. Methods from July 2016 to February 2017, the duodenoscopy samples were collected from two third Class A hospitals in Beijing before disinfection. Four sites were collected from each site, and the biopsy channels of duodenoscope were collected by the method of total pipe perfusion. The duodenoscope forceps were collected by ultrasonic cleaning device oscillating method. The total number of bacteria and the types of bacteria were counted and identified in the laboratory within 4 hours. Results in this study, 27 duodenoscopy samples were collected, 108 samples were collected. The total qualified rate of duodenoscopy was 37.0, the qualified rate of water passage was 77.8, the pass rate of forceptor passage was 77.8, the pass rate of biopsy channel was 70.4 and the qualified rate of forceptor was only 48.1. 182 strains of bacteria were isolated. The detection rate of 9 strains of pathogenic bacteria was 4.9. The pathogenic bacteria isolated included Yersinia pestis, Pseudomonas aeruginosa and Escherichia coli. Conclusion the qualified rate of duodenoscopy is low and there is a risk of cross infection in hospital. The monitoring of disinfection effect of duodenoscope, especially the cleaning and disinfection effect of forceptor, should be paid attention to.
【作者单位】：中国疾病预防控制中心环境与健康相关产品安全所消毒检测中心;解放军总医院消化内镜中心;
【基金】：中央财政滚动支持基金资助项目(1311500010806)
【分类号】：R446.5

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