摘要
目的观察和分析强化消毒管理对介入手术室空气菌落数及病原菌分布的影响,旨在为医院感染控制工作提供客观依据。方法选取2015年6月-2017年6月行介入手术的1645例患者作为研究对象,将在2015年6月-2016年6月实施强化消毒管理前行手术的806例患者作为对照组,将在2016年7月-2017年6月的839例患者作为试验组,比较两组患者的医院感染率,比较患者术前10min、手术开始后10min、手术开始后60min、手术结束时的室内菌落数,对空气样本中分离出的病原菌分布进行检测和比较。结果对照组患者和观察患者的医院感染率分别为9.68%和1.07%,两组比较差异有统计学意义(P<0.05);试验组患者和对照组患者在术前10min、手术开始后10min、手术开始后60min、手术结束时的室内菌落数分别为(6.45±5.71)cfu/m3 vs(12.25±6.03)cfu/m3、(25.28±7.26)cfu/m3 vs(47.84±8.19)cfu/m3、(36.34±8.75)cfu/m3 vs(85.56±11.54)cfu/m3、(53.35±9.88)cfu/m3 vs(156.61±14.06)cfu/m3,各个时点,试验组患者的手术室空气菌落数均显著低于对照组,两组比较差异均有统计学意义(P<0.05);在试验组患者手术室空气样本中,分离出革兰阴性菌8株占66.67%、革兰阳性菌4株占33.33%,在对照组患者手术室空气样本中,分离出革兰阴性菌61株占71.76%、革兰阳性菌20株占23.53%、真菌4株占4.71%,主要病原菌均为大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌。结论在介入手术室实施强化消毒管理,能够减少手术期间手术室中空气菌落数,提高空气清洁度,减少病原菌接触,从而降低患者的医院感染风险。
OBJECTIVE To observe the impact of enhancement of disinfection management on bacterial colony counts and distribution of pathogens in air of interventional operating rooms so as to provide objective basis for control of nosocomial infections.METHODS A total of 1645 patients who received interventional surgeries from Jun 2015 to Jun 2017 were recruited as the study objects,806 patients who underwent the surgeries before the disin-fection management was enhanced from Jun 2015 to Jun 2016 were assigned as the control group,while 839 pa-tients who underwent the surgeries from Jul 2016 to Jun 2017 were set as the observation group.The incidence of nosocomial infections was compared between the two groups of patients,the bacterial colony counts in the operat-ing rooms were compared before the surgery for 10 min,10 min after the surgery,60 min after the surgery and at the end of the surgery,and the pathogens that were isolated from air specimens were identified.RESULTS The in-cidence rate of nosocomial infections was 9.68% in the control group,1.07% in the observation group,and there was significant difference between the two groups（P〈0.05）.The bacterial colony counts in the operating rooms were（6.45 ± 5.71）cfu/m3in the observation group at 10 min before the surgery,（12.25 ± 6.03）cfu/m3in the control group;the bacterial colony counts in the operating rooms were（25.28 ± 7.26）cfu/m3in the observation group at 10 min after the surgery,（47.84 ± 8.19）cfu/m3in the control group;the bacterial colony counts in the operating rooms were（36.34 ± 8.75）cfu/m3 in the observation group at 60min after the surgery,（85.56 ± 11.54）cfu/m3in the control group;the bacterial colony counts in the operating rooms were（53.35 ± 9.88）cfu/m3in the observation group at the end of the surgery,（156.61 ± 14.06）cfu/m3in the control group;the bacterial colony counts in air of the operating room were significantly lower in the observation group than in the control group at the time points（P〈 0.05）.Totally 8（66.67%）strains of gram-negative bacteria and 4（33.33%）strains of gram-positive bacteria were isolated from the air specimens of the operating rooms in the observation group;totally 61（71.76%）strains of gram-negative bacteria,20（23.53%）strains of gram-positive bacteria and 4（4.71%） strains of fungi were isolated from the air specimens of the operating rooms in the control group.The Escherichia coli,Pseudomonas aeruginosa and Staphylococcus aureus were the predominant species of the isolated pathogens. CONCLUSION The enhancement of disinfection management in the interventional operating rooms may reduce the bacterial colony counts in air of the operating rooms during the surgery,improve the air cleanliness and reduce the contact with pathogens so as to reduce the risk of nosocomial infection.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第22期5273-5277,共5页
Chinese Journal of Nosocomiology
关键词
强化消毒管理
介入手术室
空气
菌落数
病原菌分布
Enhancement of disinfection management
Interventional operating room
Air
Bacterial colony count
Distribution of pathogen
