【摘要】：目的研究消毒后使用前的十二指腸鏡活檢通道、水氣通道、抬鉗器通道及抬鉗器四個不同位點的微生物污染狀況,初步了解醫(yī)院十二指腸鏡消毒效果。方法 2016年7月-2017年2月對北京市兩所三甲醫(yī)院消毒后使用前的十二指腸鏡進行采樣研究,每條十二指腸鏡采集四個位點,用全管道灌流法采集十二指腸鏡的活檢通道、水氣通道和抬鉗器通道三個位點,用超聲清洗器振蕩法采集十二指腸鏡抬鉗器,4h內(nèi)送實驗室進行菌落總數(shù)計數(shù)和細菌種類分型鑒定。結(jié)果本研究采集十二指腸鏡27條,共108份樣本,十二指腸鏡總合格率為37.0%,水氣通道合格率為77.8%,抬鉗器通道合格率為77.8%,活檢通道合格率為70.4%,抬鉗器合格率僅為48.1%;共分離到182株細菌,其中致病菌9株檢出率為4.9%,分離到的致病菌包括鼠疫耶爾森菌、銅綠假單胞菌和大腸埃希菌。結(jié)論十二指腸鏡消毒后合格率偏低,存在院內(nèi)交叉感染的風險,應(yīng)重視十二指腸鏡消毒效果的監(jiān)測,尤其是抬鉗器的清洗消毒效果。
[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.
【作者單位】： 中國疾病預(yù)防控制中心環(huán)境與健康相關(guān)產(chǎn)品安全所消毒檢測中心;解放軍總醫(yī)院消化內(nèi)鏡中心;
【基金】：中央財政滾動支持基金資助項目(1311500010806)
【分類號】：R446.5

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