CAJ | 학술논문

目的：比较两种消毒剂对层流综合重症监护病房（GICU）高频接触物体表面的抑菌效果，为层流 GICU选择合理的物体表面消毒方法提供临床依据；了解物体表面细菌的污染情况，为预防控制感染提供理论依据。方法对层流 GICU 住院患者床档、床头桌的物体表面（常规消毒前），采集样本做细菌培养、鉴定，以了解层流 GICU物体表面菌群分布。分别采用含有效氯500 mg/L 消毒剂（常规组）、伽玛TM 消毒湿巾（对照组）对层流 GICU 床单位周围物体表面进行消毒，比较两种消毒方法在消毒后的抑菌率和物体表面细菌总数合格率。结果常规消毒前共采集200份物体表面样本，分离细菌87株，细菌污染率43．50％。检出革兰阳性菌68株（78．16％），以棒状杆菌（18株，26．47％）、金黄色葡萄球菌（16株，23．53％）、表皮葡萄球菌（16株，23．53％）为主；革兰阴性杆菌19株（21．84％），以鲍曼不动杆菌为主（12株，63．16％）。进行物体表面消毒后10 min 的抑菌率，常规组为（94．89±7．72）％，对照组为（96．33±12．88）％，两组差异无统计学意义（P ＞0．05）；两组物体表面细菌总数合格率均为100％。结论定期对层流 GICU 住院患者床单位周围物体表面进行检测、消毒，并规范医护人员的操作及手卫生执行力，是切断细菌传播，预防医院感染简单、有效的方法。
목적：비교량충소독제대층류종합중증감호병방（GICU）고빈접촉물체표면적억균효과，위층류 GICU선택합리적물체표면소독방법제공림상의거；료해물체표면세균적오염정황，위예방공제감염제공이론의거。방법대층류 GICU 주원환자상당、상두탁적물체표면（상규소독전），채집양본주세균배양、감정，이료해층류 GICU물체표면균군분포。분별채용함유효록500 mg/L 소독제（상규조）、가마TM 소독습건（대조조）대층류 GICU 상단위주위물체표면진행소독，비교량충소독방법재소독후적억균솔화물체표면세균총수합격솔。결과상규소독전공채집200빈물체표면양본，분리세균87주，세균오염솔43．50％。검출혁란양성균68주（78．16％），이봉상간균（18주，26．47％）、금황색포도구균（16주，23．53％）、표피포도구균（16주，23．53％）위주；혁란음성간균19주（21．84％），이포만불동간균위주（12주，63．16％）。진행물체표면소독후10 min 적억균솔，상규조위（94．89±7．72）％，대조조위（96．33±12．88）％，량조차이무통계학의의（P ＞0．05）；량조물체표면세균총수합격솔균위100％。결론정기대층류 GICU 주원환자상단위주위물체표면진행검측、소독，병규범의호인원적조작급수위생집행력，시절단세균전파，예방의원감염간단、유효적방법。
Objective To compare the bacteriostasis effect of two disinfectants on frequently touched object sur-faces in laminar flow general intensive care unit (GICU),and investigate bacterial contamination on the object sur-faces,so as to provide reference for proper disinfection method and control of infection.Methods Specimens from surfaces of bed rails and bedside tables were taken for bacterial culture before being disinfected.Then object sur-faces around bed units were disinfected with disinfectant containing 500 mg/L of available chloride (routing group) and GammaTM disinfecting wet wipes (control group)respectively,bacteriostasis rate and qualified rate of bacterial count on object surfaces between two kinds of disinfection methods were compared.Results Before routine disinfec-tion,a total of 87 pathogens were isolated from 200 specimens of object surfaces,bacterial contamination rate was 43.50%. Detection rate of gram-positive bacteria was 78.16%% (n =68),the major were Corynebacterium (26.47%,n = 18), Staphylococcus aureus (23.53%,n=16)and Staphylococcus epidermidis (23.53%,n=16);detection rate of gram-nega-tive bacteria was 21.84%(n=19),the major was Acinetobacter baumannii (63.16%,n=12).After a 10-minute disinfec-tion on surfaces,bacteriostasis rate of routine group and control group was (94.89±7.72)% and(96.33 ±12.88)% re-spectively,there was no significant difference between two groups(P >0.05);qualified rates of bacterial count of object surfaces of two groups were both 100%.Conclusion Regular disinfection of object surfaces around bed units,stand-ardization of the manipulation and hand hygiene compliance of medical personnels are simple and effective method of cutting off bacteria dissemination and preventing healthcare-associated infection.