中华医院感染学杂志
中華醫院感染學雜誌
중화의원감염학잡지
Chinese Journal of Nosocomiology
2015年
9期
2151-2153
,共3页
医源性感染%内镜%清洗%消毒%检查
醫源性感染%內鏡%清洗%消毒%檢查
의원성감염%내경%청세%소독%검사
Iatrogenic infection%Endoscope%Cleaning%Disinfection%Examination
目的：研究内镜清洗消毒过程中发生医源性感染的危险因素，并提出相对的预防策略，降低内镜使用引发的感染率。方法通过现场检查总结内镜清洗消毒过程中发生医源性感染的危险因素，并随机抽检184件处于临用状态的内镜，通过内腔取样及外表面取样检测内镜清洗、消毒质量。结果184份样本检查合格169份，合格率为91．85％；胃镜、支气管镜、肠镜、喉镜合格率分别为86．00％、95．56％、89．36％、97．62％；15份标本检验菌落数超标，共检测出26株病原菌，其中幽门螺杆菌14株、大肠埃希菌8株、铜绿假单胞菌2株、金黄色葡萄球菌及结核分枝杆菌各1株；15份标本检查不合格原因中，清洗不彻底占40．00％、消毒液使用不当占40．00％、个人防护不当占13．33％、特殊感染者内镜未特殊处理占6．67％。结论内镜清洗、消毒过程中引发医源性感染的危险因素复杂，临床应加强对内镜清洗、消毒工作人员的教育、培养，规范内镜清洗、消毒流程，建立科学化监测模式，杜绝医源性感染。
目的：研究內鏡清洗消毒過程中髮生醫源性感染的危險因素，併提齣相對的預防策略，降低內鏡使用引髮的感染率。方法通過現場檢查總結內鏡清洗消毒過程中髮生醫源性感染的危險因素，併隨機抽檢184件處于臨用狀態的內鏡，通過內腔取樣及外錶麵取樣檢測內鏡清洗、消毒質量。結果184份樣本檢查閤格169份，閤格率為91．85％；胃鏡、支氣管鏡、腸鏡、喉鏡閤格率分彆為86．00％、95．56％、89．36％、97．62％；15份標本檢驗菌落數超標，共檢測齣26株病原菌，其中幽門螺桿菌14株、大腸埃希菌8株、銅綠假單胞菌2株、金黃色葡萄毬菌及結覈分枝桿菌各1株；15份標本檢查不閤格原因中，清洗不徹底佔40．00％、消毒液使用不噹佔40．00％、箇人防護不噹佔13．33％、特殊感染者內鏡未特殊處理佔6．67％。結論內鏡清洗、消毒過程中引髮醫源性感染的危險因素複雜，臨床應加彊對內鏡清洗、消毒工作人員的教育、培養，規範內鏡清洗、消毒流程，建立科學化鑑測模式，杜絕醫源性感染。
목적：연구내경청세소독과정중발생의원성감염적위험인소，병제출상대적예방책략，강저내경사용인발적감염솔。방법통과현장검사총결내경청세소독과정중발생의원성감염적위험인소，병수궤추검184건처우림용상태적내경，통과내강취양급외표면취양검측내경청세、소독질량。결과184빈양본검사합격169빈，합격솔위91．85％；위경、지기관경、장경、후경합격솔분별위86．00％、95．56％、89．36％、97．62％；15빈표본검험균락수초표，공검측출26주병원균，기중유문라간균14주、대장애희균8주、동록가단포균2주、금황색포도구균급결핵분지간균각1주；15빈표본검사불합격원인중，청세불철저점40．00％、소독액사용불당점40．00％、개인방호불당점13．33％、특수감염자내경미특수처리점6．67％。결론내경청세、소독과정중인발의원성감염적위험인소복잡，림상응가강대내경청세、소독공작인원적교육、배양，규범내경청세、소독류정，건립과학화감측모식，두절의원성감염。
OBJECTIVE To explore the risk factors for iatrogenic infections during the cleaning and disinfection of endoscopes and put forward corresponding prevention countermeasures so as to reduce the incidence of infections due to the use of endoscopes .METHODS The risk factors for the iatrogenic infections were observed through onsite examination during the cleaning and disinfection of endoscopes ,totally 184 endoscopes in use were randomly ex‐tracted .The quality of cleaning and disinfection of the endoscopes was determined through the sampling of lumens and surfaces of the endoscopes .RESULTS Of 184 samples ,169 were qualified with the qualified rate of 91 .85% ;the qualified rates of the gastroscopes ,bronchoscopes ,colonoscopes ,and laryngoscopes were 86 .00% ,95 .56% , 89 .36% ,and 97 .62% ,respectively .The bacterial colony counts of 15 samples exceeded the standard .A total of 26 strains of pathogens have been isolated ,including 14 strains of Helicobacter pylori ,8 strains of Escherichia coli ,2 strains of Pseudomonas aeruginosa ,1 strain of Staphylococcus aureus ,and 1 strain of Mycobacterium tu‐berculosis .Among the causes of unqualified cleaning and disinfection of the 15 samples ,the incomplete cleaning ac‐counted for 40 .00% ,the inappropriate use of disinfectants 40 .00% ,the inappropriate self‐protection 13 .33% , not taking special treatment for patients with special infections 6 .67% .CONCLUSION The risk factors for the iat‐rogenic infections during the cleaning and disinfection of endoscopes are complicated .It is necessary for the hospital to strengthen the cleaning of endoscopes ,education of disinfection staff ,and culture ,standardize the cleaning and disinfection procedure ,and establish scientific surveillance mode so as to prevent the iatrogenic infections .
