口腔综合治疗台用水微生物标准制定探讨
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摘要
目的为制定天津市地方标准《口腔综合治疗台用水微生物标准》提供参考依据。方法 2012-2017年对天津市64家医疗机构的318台口腔综合治疗台水路(DUWLs)水样进行细菌菌落总数检测和致病菌分离鉴定。结果共采集DUWLs出水水样611份,其中牙科手机出水293份,三用枪出水318份。以≤500 cfu/ml为合格标准,DUWLs出水总合格率为56. 14%,牙科手机出水样本和三用枪出水样本合格率分别为53. 58%和58. 49%,两者无统计学差异(χ~2=1. 491,P=0. 222)。从DUWLs出水中分离到的病原菌主要为蜡样芽胞杆菌、洋葱伯克霍尔德菌和铜绿假单胞菌。结论 DUWLs出水污染严重,需要制定相关标准进行规范管理;将天津市DUWLs出水微生物限值设定为500 cfu/ml有助于国内外内镜消毒合格率的比较。
Objective To provide scientific hasis for formulating local standards for Tianjin: "The microbiological standards for dental unit waterlines( DUWLs) ". Methods From 2012 to 2017,318 dental chair unit in 64 medical institutions were selected for sampling the DUWLs output water to culture bacteria and separate pathogenic bacteria. Results 611 DUWLs output water samples were collected,including 318 water samples collected from 3-in-1 syringe and 293 from dental handpiece. The qualified rate was 56. 14%,if the threshold was set to ≤500 cfu/ml. The qualified rates of the dental handpiece water samples and the 3-in-1 syringe water samples were 53. 58% and 58. 49%,respectively. There was no statistical difference between the two groups( χ2= 1. 491,P = 0. 222). The main pathogens isolated from the DUWLs output water were Bacillus cereus,Burkholderia cepacia and Pseudomonas aeruginosa. Conclusion Due to the serious contamination of the DUWLs output water,it is necessary to formulate relevant standards for management. Setting the microorganism threshold value of the DUWLs output water to 500 cfu/ml is based on the research results and is helpful for comparison between domestic and foreign results on the qualified rate of endoscope reprocessing.
Objective To provide scientific hasis for formulating local standards for Tianjin: "The microbiological standards for dental unit waterlines( DUWLs) ". Methods From 2012 to 2017,318 dental chair unit in 64 medical institutions were selected for sampling the DUWLs output water to culture bacteria and separate pathogenic bacteria. Results 611 DUWLs output water samples were collected,including 318 water samples collected from 3-in-1 syringe and 293 from dental handpiece. The qualified rate was 56. 14%,if the threshold was set to ≤500 cfu/ml. The qualified rates of the dental handpiece water samples and the 3-in-1 syringe water samples were 53. 58% and 58. 49%,respectively. There was no statistical difference between the two groups( χ2= 1. 491,P = 0. 222). The main pathogens isolated from the DUWLs output water were Bacillus cereus,Burkholderia cepacia and Pseudomonas aeruginosa. Conclusion Due to the serious contamination of the DUWLs output water,it is necessary to formulate relevant standards for management. Setting the microorganism threshold value of the DUWLs output water to 500 cfu/ml is based on the research results and is helpful for comparison between domestic and foreign results on the qualified rate of endoscope reprocessing.
引文
[1]纪学悦.口腔综合治疗台水路污染与生物膜研究进展[J].中国消毒学杂志,2012,29(11):1016-1018.
[2]Francolini I,Donelli G.Prevention and control of biofilm-based medical-device-related infections[J].FEMS Immunol Med Microbiol,2010,59(3):227-238.
[3]徐燕,王玲,张伟,等.口腔科综合治疗台水系统细菌污染状况及消毒效果研究[J].中国消毒学杂志,2014,31(12):1291-1294.
[4]纪学悦,费春楠,沈芃,等.口腔综合治疗台水路回吸检测器的研制与应用[J].中国医学装备,2016,13(6):8-11.
[5]Australian Dental Association.ADA's Guidelines for Infection Control Third Edition[EB/OL].https:∥www.ada.org.au/DentalProfessionals/Publications/Infection-Control/Guidelines-for-Infection-Control/1ADA_GuidelinesforInfectionControl_3,2018/6/28.
[6]FDI World Dental Federation.FDI policy statement on Dental Unit Water Systems and microbial contamination[J].Int Dent J,2017,67(1):4-5.
[7]CDC,ADA.Statement on dental unit waterlines[S].2004.
[8]ADA.Statement on dental unit waterlines.Adopted by the ADABoard of Trustees,December 13,1995 and the ADA Council on Scientific Affairs,September 28,1995[J].Northwest Dent,1996,75(2):25-26.
[9]American Dental Association.Statement on Dental Unit Waterlines[EB/OL].www.ada.org/1856.aspx,2018/6/28.
[10]British Dental Association.Advice Sheet A12 Infection Control in Dentistry[EB/OL].http:∥www.virox.com/files_docs/content/pdf/msds/bda-cross-infection.pdf,2018/6/28.
[11]Ji X,Fei C,Zhang Y,et al.Evaluation of bacterial contamination of dental unit waterlines and use of a newly designed measurement device to assess retraction of a dental chair unit[J].Int Dent J,2016,66(4):208-214.
[12]O’Donnell MJ,Boyle MA,Russell RJ,et al.Management of dental unit waterline biofilms in the 21st century[J].Future Microbiol,2011,6(10):1209-1226.
[13]纪学悦,费春楠,沈芃,等.天津市口腔综合治疗台水路细菌污染影响因素研究[J].中国消毒学杂志,2014,31(1):30-32.
[14]纪学悦,费春楠,沈芃,等.天津市口腔综合治疗台水路细菌污染及耐药性研究[J].中国消毒学杂志,2014,31(12):1280-1281.
[15]纪学悦,费春楠,沈芃,等.诊疗之间冲洗对口腔综合治疗台水路污染影响的研究[J].中国消毒学杂志,2015,32(3):225-227.
[16]纪学悦,费春楠,沈芃,等.天津市口腔综合治疗台水路回吸调查[J].中国感染控制杂志,2015,14(11):743-745.
[17]纪学悦,费春楠,沈芃,等.天津市医疗机构口腔综合治疗台水路消毒管理现状分析[J].中国消毒学杂志,2016,33(4):348-350.
[2]Francolini I,Donelli G.Prevention and control of biofilm-based medical-device-related infections[J].FEMS Immunol Med Microbiol,2010,59(3):227-238.
[3]徐燕,王玲,张伟,等.口腔科综合治疗台水系统细菌污染状况及消毒效果研究[J].中国消毒学杂志,2014,31(12):1291-1294.
[4]纪学悦,费春楠,沈芃,等.口腔综合治疗台水路回吸检测器的研制与应用[J].中国医学装备,2016,13(6):8-11.
[5]Australian Dental Association.ADA's Guidelines for Infection Control Third Edition[EB/OL].https:∥www.ada.org.au/DentalProfessionals/Publications/Infection-Control/Guidelines-for-Infection-Control/1ADA_GuidelinesforInfectionControl_3,2018/6/28.
[6]FDI World Dental Federation.FDI policy statement on Dental Unit Water Systems and microbial contamination[J].Int Dent J,2017,67(1):4-5.
[7]CDC,ADA.Statement on dental unit waterlines[S].2004.
[8]ADA.Statement on dental unit waterlines.Adopted by the ADABoard of Trustees,December 13,1995 and the ADA Council on Scientific Affairs,September 28,1995[J].Northwest Dent,1996,75(2):25-26.
[9]American Dental Association.Statement on Dental Unit Waterlines[EB/OL].www.ada.org/1856.aspx,2018/6/28.
[10]British Dental Association.Advice Sheet A12 Infection Control in Dentistry[EB/OL].http:∥www.virox.com/files_docs/content/pdf/msds/bda-cross-infection.pdf,2018/6/28.
[11]Ji X,Fei C,Zhang Y,et al.Evaluation of bacterial contamination of dental unit waterlines and use of a newly designed measurement device to assess retraction of a dental chair unit[J].Int Dent J,2016,66(4):208-214.
[12]O’Donnell MJ,Boyle MA,Russell RJ,et al.Management of dental unit waterline biofilms in the 21st century[J].Future Microbiol,2011,6(10):1209-1226.
[13]纪学悦,费春楠,沈芃,等.天津市口腔综合治疗台水路细菌污染影响因素研究[J].中国消毒学杂志,2014,31(1):30-32.
[14]纪学悦,费春楠,沈芃,等.天津市口腔综合治疗台水路细菌污染及耐药性研究[J].中国消毒学杂志,2014,31(12):1280-1281.
[15]纪学悦,费春楠,沈芃,等.诊疗之间冲洗对口腔综合治疗台水路污染影响的研究[J].中国消毒学杂志,2015,32(3):225-227.
[16]纪学悦,费春楠,沈芃,等.天津市口腔综合治疗台水路回吸调查[J].中国感染控制杂志,2015,14(11):743-745.
[17]纪学悦,费春楠,沈芃,等.天津市医疗机构口腔综合治疗台水路消毒管理现状分析[J].中国消毒学杂志,2016,33(4):348-350.