消毒湿巾对新生儿病房环境物体表面消毒的效果
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摘要
目的比较消毒湿巾与含氯消毒剂的消毒效果,为改进医院感染防控措施提供依据。方法按消毒方法分为伽玛卫生湿巾组、洁力佳表面消毒巾组和84消毒剂组,分别对新生儿病房床单位进行清洁消毒,在消毒前及消毒后5、10、30、60 min五个时间点对新生儿病房床单位表面采样,每组每个时间点分别采集标本30份,比较组间细菌菌落数、杀灭率和消毒合格率,同时筛查物体表面耐甲氧西林金黄色葡萄球菌(MRSA)检出情况。结果消毒后5、10、30 min,床单位物体表面三组间细菌菌落数及杀灭率比较,差异无统计学意义(P>0.05)。消毒后60 min,细菌菌落数伽玛卫生湿巾组[(2.61±0.41)CFU/cm~2]、洁力佳表面消毒巾组[(2.71±0.42)CFU/cm~2]低于84消毒剂组[(4.08±0.33)CFU/cm~2],差异有统计学意义(P<0.05);细菌杀灭率伽玛卫生湿巾组[(72.36±3.90)%]、洁力佳表面消毒巾组[(71.49±4.77)%]优于84消毒剂组[(55.92±3.22)%],差异有统计学意义(P<0.05)。床单位物体表面消毒合格率伽玛卫生湿巾组(86.67%)优于84消毒剂组(63.33%),差异有统计学意义(P<0.05)。三种消毒方法均能有效清除物体表面MRSA。结论消毒湿巾消毒效果可靠,且能有效杀灭新生儿病房床单位物体表面多重耐药菌,适用于新生儿等高风险环境。
Objective To compare disinfection effect of disinfectant wipes and chlorine-containing disinfectant,provide basis for improving prevention and control measures for healthcare-associated infection.Methods According to disinfection methods,three groups were divided: Clinell Universal Wipes group( Clinell group),Gelica Surface Disinfecting Towelettes group( Gelica group),and 84-disinfectant group,bed units of neonatal ward were cleaned and disinfected,surface sampling of bed units before disinfection,as well as 5,10,30 and 60 minutes after disinfection was performed,30 specimens were taken in each group at each time point,bacterial colony count,bacterial killing rate and qualified rate of disinfection among three groups were compared,methicillin-resistant Staphylococcus aureus( MRSA) on object surface was screened.Results After 5,10,30 minute disinfection,there was no significant difference in bacterial colony count and bacterial killing rate of object surface of bed units among three groups( P>0.05). After 60 minute disinfection,bacterial colony count in Clinell group( [2.61±0.41]CFU/cm~2) and Gelica group( [2.71±0.42]CFU/cm~2) were both lower than 84-disinfectant group( [4.08±0.33]CFU/cm~2),difference was significant( P<0.05); bacterial killing rate in Clinell group( [72.36±3.90]%) and Gelica group( [71.49±4.77]%) were both higher than 84-disinfectant group( [55.92±3.22]%),difference was significant( P<0.05). The qualified rate of disinfection of bed unit surface in Clinell group was higher than84-disinfectant group( 86.67% vs 63.33%,P<0.05). All three disinfection methods can effectively remove MRSA from object surface.Conclusion Disinfection effect of disinfectant wipes is reliable,it can effectively kill multidrug-resistant organisms on bed unit surface in neonatal ward,and is suitable for routine disinfection in high-risk environment,such as neonatal ward.
Objective To compare disinfection effect of disinfectant wipes and chlorine-containing disinfectant,provide basis for improving prevention and control measures for healthcare-associated infection.Methods According to disinfection methods,three groups were divided: Clinell Universal Wipes group( Clinell group),Gelica Surface Disinfecting Towelettes group( Gelica group),and 84-disinfectant group,bed units of neonatal ward were cleaned and disinfected,surface sampling of bed units before disinfection,as well as 5,10,30 and 60 minutes after disinfection was performed,30 specimens were taken in each group at each time point,bacterial colony count,bacterial killing rate and qualified rate of disinfection among three groups were compared,methicillin-resistant Staphylococcus aureus( MRSA) on object surface was screened.Results After 5,10,30 minute disinfection,there was no significant difference in bacterial colony count and bacterial killing rate of object surface of bed units among three groups( P>0.05). After 60 minute disinfection,bacterial colony count in Clinell group( [2.61±0.41]CFU/cm~2) and Gelica group( [2.71±0.42]CFU/cm~2) were both lower than 84-disinfectant group( [4.08±0.33]CFU/cm~2),difference was significant( P<0.05); bacterial killing rate in Clinell group( [72.36±3.90]%) and Gelica group( [71.49±4.77]%) were both higher than 84-disinfectant group( [55.92±3.22]%),difference was significant( P<0.05). The qualified rate of disinfection of bed unit surface in Clinell group was higher than84-disinfectant group( 86.67% vs 63.33%,P<0.05). All three disinfection methods can effectively remove MRSA from object surface.Conclusion Disinfection effect of disinfectant wipes is reliable,it can effectively kill multidrug-resistant organisms on bed unit surface in neonatal ward,and is suitable for routine disinfection in high-risk environment,such as neonatal ward.
引文
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[5]胡丽娅,郑桂爱,缪小红,等.双链季铵盐湿巾对婴儿暖箱消毒效果观察[J].中国消毒学杂志,2017,34(1):86-87.
[6]边方平,冯永莉,陈焕英,等.一次性医用消毒湿巾对新生儿暖箱消毒效果观察[J].中国消毒学杂志,2014,31(9):916-917,920.
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[8]Reshamwala A,Mc Broom K,Choi YI,et al.Microbial colonization of electrocardiographic telemetry systems before and after cleaning[J].Am J Crit Care,2013,22(5):382-389.
[9]Donskey CJ.Does improving surface cleaning and disinfection reduce health care-associated infections[J].Am J Infect Control,2013,41(5 Suppl):S12-S19.
[10]Hayden MK,Bonten MJ,Blom DW,et al.Reduction in acquisition of vancomycin-resistant enterococcus after enforcement of routine environmental cleaning measures[J].Clin Infect Dis,2006,42(11):1552-1560.
[11]Dancer SJ,White LF,Lamb J,et al.Measuring the effect of enhanced cleaning in a UK hospital:a prospective cross-over study[J].BMC Med,2009,7:28.
[12]Fukuzaki S.Mechanisms of actions of sodium hypochlorite in cleaning and disinfection processes[J].Biocontrol Sci,2006,11(4):147-157.
[13]Sattar SA.Current issues in testing,selection and use of microbicides in infection control:a critical review[J].Aust Infect Contorl,2004,9(3):84-100.
[14]Ogbulie JN,Adieze IE,Nwankwo NC.Susceptibility pattern of some clinical bacterial isolates to selected antibiotics and disinfectants[J].Pol J Microbiol,2008,57(3):199-204.
[15]Nandy P,Lucas AD,Gonzalez EA,et al.Efficacy of commercially available wipes for disinfection of pulse oximeter sensors[J].Am J Infect Control,2016,44(3):304-310.
[16]Gonzalez EA,Nandy P,Lucas AD,et al.Ability of cleaning-disinfecting wipes to remove bacteria from medical device surfaces[J].Am J Infect Control,2015,43(12):1331-1335.
[17]Kenters N,Huijskens EGW,de Wit SCJ,et al.Effectiveness of cleaning-disinfection wipes and sprays against multidrug-resistant outbreak strains[J].Am J Infect Control,2017,45(8):e69-e73.
[18]薛文青,薛广波.季铵盐类阳离子表面活性消毒剂研究进展[J].中华医院感染学杂志,2002,12(8):634-636.
[2]Walsh TR,Toleman MA.The emergence of pan-resistant gram-negative pathogens merits a rapid global political response[J].J Antimicrob Chemother,2012,67(1):1-3.
[3]高晓东,胡必杰,沈燕,等.上海市71所医院环境清洁消毒及监测现状调查[J].中华医院感染学杂志,2012,22(12):2606-2608.
[4]徐虹,任淑华,陆群,等.医院环境清洁措施的多中心干预效果研究[J].中华医院感染学杂志,2015,25(11):2620-2622.
[5]胡丽娅,郑桂爱,缪小红,等.双链季铵盐湿巾对婴儿暖箱消毒效果观察[J].中国消毒学杂志,2017,34(1):86-87.
[6]边方平,冯永莉,陈焕英,等.一次性医用消毒湿巾对新生儿暖箱消毒效果观察[J].中国消毒学杂志,2014,31(9):916-917,920.
[7]Anderson RE,Young V,Stewart M,et al.Cleanliness audit of clinical surfaces and equipment:who cleans what?[J].J Hosp Infect,2011,78(3):178-181.
[8]Reshamwala A,Mc Broom K,Choi YI,et al.Microbial colonization of electrocardiographic telemetry systems before and after cleaning[J].Am J Crit Care,2013,22(5):382-389.
[9]Donskey CJ.Does improving surface cleaning and disinfection reduce health care-associated infections[J].Am J Infect Control,2013,41(5 Suppl):S12-S19.
[10]Hayden MK,Bonten MJ,Blom DW,et al.Reduction in acquisition of vancomycin-resistant enterococcus after enforcement of routine environmental cleaning measures[J].Clin Infect Dis,2006,42(11):1552-1560.
[11]Dancer SJ,White LF,Lamb J,et al.Measuring the effect of enhanced cleaning in a UK hospital:a prospective cross-over study[J].BMC Med,2009,7:28.
[12]Fukuzaki S.Mechanisms of actions of sodium hypochlorite in cleaning and disinfection processes[J].Biocontrol Sci,2006,11(4):147-157.
[13]Sattar SA.Current issues in testing,selection and use of microbicides in infection control:a critical review[J].Aust Infect Contorl,2004,9(3):84-100.
[14]Ogbulie JN,Adieze IE,Nwankwo NC.Susceptibility pattern of some clinical bacterial isolates to selected antibiotics and disinfectants[J].Pol J Microbiol,2008,57(3):199-204.
[15]Nandy P,Lucas AD,Gonzalez EA,et al.Efficacy of commercially available wipes for disinfection of pulse oximeter sensors[J].Am J Infect Control,2016,44(3):304-310.
[16]Gonzalez EA,Nandy P,Lucas AD,et al.Ability of cleaning-disinfecting wipes to remove bacteria from medical device surfaces[J].Am J Infect Control,2015,43(12):1331-1335.
[17]Kenters N,Huijskens EGW,de Wit SCJ,et al.Effectiveness of cleaning-disinfection wipes and sprays against multidrug-resistant outbreak strains[J].Am J Infect Control,2017,45(8):e69-e73.
[18]薛文青,薛广波.季铵盐类阳离子表面活性消毒剂研究进展[J].中华医院感染学杂志,2002,12(8):634-636.