口腔综合治疗台的高速手机和三用气枪细菌污染的调查

发布时间：2018-11-05 10:50

【摘要】： 研究背景:口腔科交叉感染的问题已日益受到口腔专业人士和公众的重视,目前国内口腔科感染控制的重点集中在口腔器械的消毒,如高速手机、扩锉针、拔牙钳等的消毒,并已取得了一定的成果。但作为口腔医师诊治病人的基本设备口腔综合治疗台,其内部水路(dental unit waterlines,DUWL)的消毒却被有意无意地忽略了。众所周知,在一个消毒体系中,即便其中一个环节未控制好,将导致整个消毒体系的失败。也就是说,即便手机已彻底消毒,如果DUWL出来的水是污染的,也将导致病人或医师感染。近年来,国内医疗机构对口腔科手机、三用气枪、出水系统等环节污染监测研究较多,尤其是使用带返流阀门和可高温灭菌处理的手机已降低了病人之间相互感染的可能性。三用气枪是口腔科治疗中最常被应用的器械之一,主要用于冲洗口腔和干燥牙体表面及窝洞,直接与医务人员和病人接触,而且三用气枪的金属头反复消毒难以达到规定标准:即使做到每人消毒一次,也很难将细微管道中的血液、细菌清除干净,而且据报道是导致口腔疾病患者医院感染常见因素之一。它与高速手机一样,在停止的瞬间产生虹吸,由此造成的交叉感染已被实验室细菌学、病毒学、传染科实验和临床测试结果所证实,有学者研究表明,三用气枪内部水进行细菌培养,污染率＞92%。并且三用气枪是日常消毒链中最薄弱的环节,因此,三用气枪的消毒灭菌与防污染操作应引起足够的重视。 目的: 本研究的目的是通过调查某大型口腔医院口腔综合治疗台高速手机和三用气枪水路常见口腔细菌的污染情况,了解高速手机和三用气枪细菌污染的现状和进一步改进消毒措施的必要性。 对象与方法: 每个星期五下班后,常规消毒口腔综合治疗台后进行采样。分别采集80台口腔综合治疗台的入水口、医生位三用气枪、护士位三用气枪及高速手机不同出水时段的水样;用酒精灯烧灼已消毒三用气枪出水口和手机出水口,用无菌试管连续接取水样,分别接取三用气枪出水及手机喷水口处取水样,封口,存放4℃待测。 结果: 1.80台口腔综合治疗台的入水口、医生位三用气枪、护士位三用气枪和高速手机中均验出有葡萄球菌、链球菌、放线菌,放线菌在入水口的菌种数最多。 2.三用气枪的菌落数高于高速手机。 3.不同出水时段水样的细菌数不同。三用气枪水样的细菌数量在第一个2ml分布最多,而第二个2ml次之,第三个2ml最少,似有增大的趋势,高速手机在不同时段细菌数量差别无统计学意义。 4.80台口腔综合治疗台的水样标本中不同出水时段检出的细菌种类和阳性率有所不同,其中葡萄球菌各时段差别有统计学意义,以第三个2ml最多,放线菌和链球菌的检出各时段的差异则无统计学意义。 5.80台口腔综合治疗台的水样标本中不同科室的菌落数有所差别,其中牙周科的菌落数最多。 6.三用气枪及高速手机水样的细菌数以外科最高,然后依次为内科、牙周科、正畸科,修复科最低,各科室细菌的差异有统计学意义。在细菌种类方面,各科室均以葡萄球菌检出最多,其次依次为链球菌、放线菌。 结论: 1.在口腔综合治疗台入水口的未经处理的水样中,均含有常见口腔感染菌。因此,牙科用水是一个潜在的感染源。 2.三用气枪的污染比高速手机严重。 3.口腔综合治疗台中三用气枪及高速手机检出细菌主要是葡萄球菌、链球菌和放线菌。 4.医院检测的综合治疗台中三用气枪及高速手机检出细菌主要分布于外科。
[Abstract]:Background: The problem of cross infection in stomatology has been paid more attention to oral professionals and the public. At present, the focus of domestic stomatology infection control focuses on the disinfection of oral instruments, such as disinfection of high-speed mobile phones, extended needles, forceps, etc., and some results have been achieved. However, as the basic equipment oral comprehensive treatment table for the diagnosis and treatment of patients, the disinfection of the internal waterways (DUWL) has been inadvertently omitted. It is well known that in a sterilization system, even if one of the links is not controlled, the entire sterilization system will fail. That is, even if the cell phone has been thoroughly disinfected, if the water out of the DUWL is contaminated, the patient or physician will be infected. In recent years, domestic medical institutions have studied the pollution monitoring of stomatology mobile phones, three air guns and water outlet systems, especially the possibility of using the return flow valve and the mobile phone with high temperature sterilization treatment to reduce the mutual infection among the patients. the three-purpose air gun is one of the most commonly used instruments in the treatment of stomatology, mainly used for washing the surfaces of the oral cavity and the dry tooth body and the cavity, directly contacting the medical personnel and the patient, and repeatedly sterilizing the metal head of the three air guns to achieve the specified standard, It is also difficult to clean the blood and bacteria in the fine pipes, and it is reported that it is one of the common factors leading to nosocomial infection in patients with Parkinson's disease. As with the high-speed mobile phone, it has been proved by laboratory bacteriology, virology, Ames test and clinical test results that the cross infection caused by the siphonage at the stop moment has been confirmed by the laboratory bacteriology, virology, Ames test and clinical test results. The results show that the internal water of three air guns is used for bacterial culture, and the pollution rate is more than 92%. and the three-purpose air gun is the weakest link in the daily disinfection chain, and therefore, the disinfection and sterilization of the three air guns and the pollution prevention operation should be given enough attention. Objective: The purpose of this study is to investigate the status and further improvement of bacterial contamination of high-speed mobile phones and three air guns by investigating the contamination of high-speed mobile phones and three air guns in the oral cavity of a large stomatological hospital. Necessary for Poisonous Measures Sex. Object and Method: After work every Friday, often sampling is carried out after the comprehensive treatment of the oral cavity of the gauge disinfection oral cavity, 80 oral cavity comprehensive treatment stations, three air guns for doctors, three air guns for nurses and water samples of different water discharging periods of the high-speed mobile phone are respectively collected, the water outlets of the sterilized three air guns and the mobile phone are cauterized by using an alcohol lamp, a water outlet is continuously connected with a sterile test tube, a three-purpose air gun water outlet and a mobile phone water spray are respectively connected with the water sample Take out at the mouth Water sample, seal, store 4 鈩，

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