医院呼吸机管路污染及病原菌分布现状调查

发布时间：2019-06-28 19:50

【摘要】：目的了解医院呼吸机管路污染和病原菌分布状况,为提出呼吸机相关性肺炎防控措施的提供依据。方法对两种不同配置的呼吸机管路进行调查采样,对管路内不同部位进行细菌总数检测和细菌鉴定,并进行比较。结果呼吸机管路越靠近患者端污染越重,两种配置呼吸机管路使用7 d近患者端污染状况有明显差异,使用30 d的管路细菌总数明显高于使用7 d的管路。湿化水污染严重,呼吸机送气口污染较轻,但不使用细菌过滤器的回气口有明显污染。管路内细菌种类鉴定次数排名前3的是铜绿假单胞菌、粘质沙雷菌和洋葱伯克霍尔德菌,两医院优势菌不同。结论国内不同配置的呼吸机管路均存在明显污染,尤其是呼吸机近患者端污染严重,对没有气道阻塞性疾病的患者,应考虑使用细菌过滤型湿热交换器替代加湿器;湿化水应为无菌水并每天更换,并加强监测;应加强患者呼吸道分泌物的检验和近患者端管路污染的监测,设置适宜的换管周期。
[Abstract]:Objective to investigate the pollution of ventilator pipeline and the distribution of pathogenic bacteria in hospital, and to provide the basis for the prevention and control of ventilator-associated pneumonia. Methods two kinds of ventilator pipelines were investigated and sampled, and the total number of bacteria was detected and identified in different parts of the pipeline, and the results were compared. Results the closer the ventilator line was to the patient's end, the more serious the pollution was. There was significant difference in the pollution status between the two kinds of ventilator pipeline for 7 days. The total number of bacteria in the pipeline with 30 days was significantly higher than that in the 7 day pipeline. Humidification water pollution is serious, ventilator air supply port pollution is light, but the return port without bacterial filter has obvious pollution. Pseudomonas aeruginosa, Serratia vulgaris and Burkholderia onions were the top three bacteria in the pipeline, and the dominant bacteria in the two hospitals were different. Conclusion there is obvious pollution in different ventilator pipelines in China, especially in the near patient end of ventilator. For patients without airway obstruction, bacterial filter wet heat exchanger should be used to replace humidifier; humidified water should be replaced by aseptic water every day, and monitoring should be strengthened; the inspection of respiratory tract secretions and the monitoring of near patient end pipeline pollution should be strengthened, and the appropriate tube changing cycle should be set up.
【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;安徽省疾病预防控制中心;
【分类号】：R197.39

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