康威达消毒剂杀灭医院感染菌的效果及其杀菌机理的研究
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摘要
目的：测定康威达消毒片溶液对医院感染菌的杀灭效果，为其应用提供参考。同时，研究康威达消毒片溶液对大肠杆菌杀灭机理，为其全面、合理推广使用提供理论依据。
方法：
1、采用悬液定量杀菌试验来观察杀菌效果。
2、在扫描电镜下观察菌体超微结构的变化。
3、计算检测样本的丙二醛含量。
结果：
1、用0.2％和0.1％康威达消毒片溶液对阴沟肠杆菌作用1、3、10分钟，杀灭率分别为99.94％、99.96％、99.99％和99.91％、99.94％、99.96％；对鲍曼氏不动杆菌杀灭率分别为99.99％、100％、100％和99.98％、99.99％、100％；对肺炎克雷伯菌杀灭率分别为99.95％、99.97％、99.99％和99.93％、99.97％、99.99％；对表皮葡萄球菌杀灭率分别为99.73％、99.97％、100％和99.66％、99.93％、100％；对白色念珠菌杀灭率分别为99.93％、99.99％、100％和99.87％、99.98％、99.99％；对铜绿假单胞菌杀灭率分别为99.96％、99.97％、99.99％和99.92％、99.97％、99.98％；对热带假丝酵母菌杀灭率分别为99.98％、100％、100％和99.95％、99.98％、100％；对费劳地椐橼酸杆菌杀灭率分别为99.81％、99.90％、99.99％和99.80％、99.88％、99.96％；对甲
重庆医科大学硕士学位论文
型副伤寒沙门菌杀灭率分别为99.95%、99.98%、100%和99.91%、
99.95%、99.99%;对产气肠杆菌杀灭率分别为99.90%、99.96%、100%
和99.83%、99.94%、99.99%;对奇异变形杆菌杀灭率分别为99.95%、
99.97%、99.99%和99.90%、99.95%、99.98%;对嗜麦芽黄单胞菌杀
灭率分别为99.94%、99.99%、100%和99.85%、99.92%、100%。
2、一定浓度的康威达消毒片溶液作用后，大肠杆菌细胞壁与细
胞膜间隙增宽、分离，胞壁凹凸不平，胞浆淡染且内容物不均匀;正
常大肠杆菌脂质过氧化物MDA含量为0.35士0.29 n mol/m1;1 min后，
MDA含量为4.65士1 .52 n mol/ml;3 min后，MDA含量为6.59士2.52n
mol/m1。两处理组与对照组MDA含量均有显著的差异(P<0.01，p<
0.01)o
结论:
1、在20士2℃，0.2%和0.1%康威达消毒片溶液对鲍曼氏不动杆菌、
肺炎克雷伯菌、表皮葡萄球菌、白色念珠菌、热带假丝酵母菌、甲型
副伤寒沙门菌、产气肠杆菌、嗜麦芽黄单胞菌作用10 min，杀灭率均
达99.99%以上;对阴沟肠杆菌、铜绿假单胞菌、费劳地据椽酸杆菌、
奇异变形杆菌用0.2%和0.1%康威达消毒片溶液作用10 min，杀灭率均
达99.90%以上。均符合消毒要求。
2、康威达消毒片溶液使大肠杆菌的超微结构改变和使其脂质过氧
化是大肠杆菌死亡的重要原因。
objective:The aim of this study is to understand germicidal efficacy of Kangweida disinfectant on hospital infection bacteria and its bactericidal mechanism on Escherichia coli. The results could provide scienfic basis for rational use and popularization of this disinfectant. Methods:
1, suspension quantitative bactericidal tests were carried out to observe the Germicidal Efficacy.
2, Bacterial ultrastructure were observed by transmission electron microscope.
3, peroxidization of liqid were calculated. Results:
1, The killing rates of E.cloacae exposed to the solution containing 0.2% and 0.1% Kangweida disinfectant for 1, 3, 10 min were99. 94 %, 99. 96% , 99. 99% and 99. 91%, 99. 94% , 99. 96%; The killing rates of A. baumannii exposed to the solution containing 0/2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99. 99%, 100% , 100% and 99. 98%, 99.99% , 100%; The killing rates of K. pneumoniae exposed to the solution containing 0. 2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99.95%, 99.97% , 99. 99% and 99. 93%, 99.97% , 99.99%; The killing rates
of S. schleiferi exposed to the solution containing 0. 2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99. 73%, 99.97% , 100% and 99. 66%, 99.93% , 100%; The killing rates of C. albicans exposed to the solution containing 0.2% and 0. 1% Kangweida disinfectant for 1, 3,10 min were 99. 93%, 99. 99%, 100% and 99. 87%, 99. 98% , 99. 99%; The killing rates of P. aeruginosa exposed to the solution containing 0. 2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99. 96%, 99.97% , 99. 99% and 99. 92 %, 99.97% , 99.98%; The killing rates of C. tropicalis exposed to the solution containing 0. 2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99.98%, 100% , 100% and 99.95%, 99.98% , 100%; The killing rates of C. freundii exposed to the solution containing 0. 2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99. 81%, 99. 90% , 99. 99% and 99. 80 %, 99. 88% , 99. 96%; The killing rates of S . paratyphi-A exposed to the solution containing 0. 2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99. 95%,99. 98% ,100% and 99. 91%,99. 95% ,99. 99%; The killing rates of E. aerogenes exposed to the solution containing 0.2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99.90%, 99.96% , 100% and 99. 83%, 99.94% , 99.99%; The killing rates of P. mirabilis exposed to the solution containing 0.2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99.95%, 99.97% , 99.99% and 99.90%, 99.95% , 99.98%; The killing rates of P. maltophilia exposed to the solution containing 0.2% and 0. 1% Kangweida disinfectant for 1, 3,10 min were 99. 94%, 99. 99% ,
100% or 99. 85%, 99.92% , 100%.
2, The results showed that The ultrastructure alteration of Escherichia coli was found as follow:the wided space between cell wall and cell membrace, the loosened, thickened and uneven cell wall and diluted cytoplasm were seen with transmission electron microscope.In normal Escherichia coli,MDA content was 0. 35 0. 29 n mo 1/ml. After 1 min, MDA content was 4.65 1.52 n mol/ml. After 3 min, MDA content was 6. 59 2. 52n mol/ml. There was significant difference between the normal Escherichia coli and the other two group (p < 0. 01, p < 0. 01).
Conclusion:
1, 20 2 , its solution containing 0.2% and 0. 1%Kangweida with a 10 min contact time could kill at least 99.99% of A. baumannii , K. pneumoniae, S. schleiferi, C. albicans, C. tropical is, S . paratyphi-A, E. aerogenes and P. maltophilia and kill at least 99.90% of E. cloacae, P. aeruginosa , C. freundii and P. mirabilis in suspension.
2, the bactericidal mechanism on Escherichia coli was mainly destruction of permeability barrier of the cells and peroxidization of lipids, leading to death of bacteria.
方法：
1、采用悬液定量杀菌试验来观察杀菌效果。
2、在扫描电镜下观察菌体超微结构的变化。
3、计算检测样本的丙二醛含量。
结果：
1、用0.2％和0.1％康威达消毒片溶液对阴沟肠杆菌作用1、3、10分钟，杀灭率分别为99.94％、99.96％、99.99％和99.91％、99.94％、99.96％；对鲍曼氏不动杆菌杀灭率分别为99.99％、100％、100％和99.98％、99.99％、100％；对肺炎克雷伯菌杀灭率分别为99.95％、99.97％、99.99％和99.93％、99.97％、99.99％；对表皮葡萄球菌杀灭率分别为99.73％、99.97％、100％和99.66％、99.93％、100％；对白色念珠菌杀灭率分别为99.93％、99.99％、100％和99.87％、99.98％、99.99％；对铜绿假单胞菌杀灭率分别为99.96％、99.97％、99.99％和99.92％、99.97％、99.98％；对热带假丝酵母菌杀灭率分别为99.98％、100％、100％和99.95％、99.98％、100％；对费劳地椐橼酸杆菌杀灭率分别为99.81％、99.90％、99.99％和99.80％、99.88％、99.96％；对甲
重庆医科大学硕士学位论文
型副伤寒沙门菌杀灭率分别为99.95%、99.98%、100%和99.91%、
99.95%、99.99%;对产气肠杆菌杀灭率分别为99.90%、99.96%、100%
和99.83%、99.94%、99.99%;对奇异变形杆菌杀灭率分别为99.95%、
99.97%、99.99%和99.90%、99.95%、99.98%;对嗜麦芽黄单胞菌杀
灭率分别为99.94%、99.99%、100%和99.85%、99.92%、100%。
2、一定浓度的康威达消毒片溶液作用后，大肠杆菌细胞壁与细
胞膜间隙增宽、分离，胞壁凹凸不平，胞浆淡染且内容物不均匀;正
常大肠杆菌脂质过氧化物MDA含量为0.35士0.29 n mol/m1;1 min后，
MDA含量为4.65士1 .52 n mol/ml;3 min后，MDA含量为6.59士2.52n
mol/m1。两处理组与对照组MDA含量均有显著的差异(P<0.01，p<
0.01)o
结论:
1、在20士2℃，0.2%和0.1%康威达消毒片溶液对鲍曼氏不动杆菌、
肺炎克雷伯菌、表皮葡萄球菌、白色念珠菌、热带假丝酵母菌、甲型
副伤寒沙门菌、产气肠杆菌、嗜麦芽黄单胞菌作用10 min，杀灭率均
达99.99%以上;对阴沟肠杆菌、铜绿假单胞菌、费劳地据椽酸杆菌、
奇异变形杆菌用0.2%和0.1%康威达消毒片溶液作用10 min，杀灭率均
达99.90%以上。均符合消毒要求。
2、康威达消毒片溶液使大肠杆菌的超微结构改变和使其脂质过氧
化是大肠杆菌死亡的重要原因。
objective:The aim of this study is to understand germicidal efficacy of Kangweida disinfectant on hospital infection bacteria and its bactericidal mechanism on Escherichia coli. The results could provide scienfic basis for rational use and popularization of this disinfectant. Methods:
1, suspension quantitative bactericidal tests were carried out to observe the Germicidal Efficacy.
2, Bacterial ultrastructure were observed by transmission electron microscope.
3, peroxidization of liqid were calculated. Results:
1, The killing rates of E.cloacae exposed to the solution containing 0.2% and 0.1% Kangweida disinfectant for 1, 3, 10 min were99. 94 %, 99. 96% , 99. 99% and 99. 91%, 99. 94% , 99. 96%; The killing rates of A. baumannii exposed to the solution containing 0/2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99. 99%, 100% , 100% and 99. 98%, 99.99% , 100%; The killing rates of K. pneumoniae exposed to the solution containing 0. 2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99.95%, 99.97% , 99. 99% and 99. 93%, 99.97% , 99.99%; The killing rates
of S. schleiferi exposed to the solution containing 0. 2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99. 73%, 99.97% , 100% and 99. 66%, 99.93% , 100%; The killing rates of C. albicans exposed to the solution containing 0.2% and 0. 1% Kangweida disinfectant for 1, 3,10 min were 99. 93%, 99. 99%, 100% and 99. 87%, 99. 98% , 99. 99%; The killing rates of P. aeruginosa exposed to the solution containing 0. 2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99. 96%, 99.97% , 99. 99% and 99. 92 %, 99.97% , 99.98%; The killing rates of C. tropicalis exposed to the solution containing 0. 2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99.98%, 100% , 100% and 99.95%, 99.98% , 100%; The killing rates of C. freundii exposed to the solution containing 0. 2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99. 81%, 99. 90% , 99. 99% and 99. 80 %, 99. 88% , 99. 96%; The killing rates of S . paratyphi-A exposed to the solution containing 0. 2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99. 95%,99. 98% ,100% and 99. 91%,99. 95% ,99. 99%; The killing rates of E. aerogenes exposed to the solution containing 0.2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99.90%, 99.96% , 100% and 99. 83%, 99.94% , 99.99%; The killing rates of P. mirabilis exposed to the solution containing 0.2% and 0. 1% Kangweida disinfectant for 1, 3, 10 min were 99.95%, 99.97% , 99.99% and 99.90%, 99.95% , 99.98%; The killing rates of P. maltophilia exposed to the solution containing 0.2% and 0. 1% Kangweida disinfectant for 1, 3,10 min were 99. 94%, 99. 99% ,
100% or 99. 85%, 99.92% , 100%.
2, The results showed that The ultrastructure alteration of Escherichia coli was found as follow:the wided space between cell wall and cell membrace, the loosened, thickened and uneven cell wall and diluted cytoplasm were seen with transmission electron microscope.In normal Escherichia coli,MDA content was 0. 35 0. 29 n mo 1/ml. After 1 min, MDA content was 4.65 1.52 n mol/ml. After 3 min, MDA content was 6. 59 2. 52n mol/ml. There was significant difference between the normal Escherichia coli and the other two group (p < 0. 01, p < 0. 01).
Conclusion:
1, 20 2 , its solution containing 0.2% and 0. 1%Kangweida with a 10 min contact time could kill at least 99.99% of A. baumannii , K. pneumoniae, S. schleiferi, C. albicans, C. tropical is, S . paratyphi-A, E. aerogenes and P. maltophilia and kill at least 99.90% of E. cloacae, P. aeruginosa , C. freundii and P. mirabilis in suspension.
2, the bactericidal mechanism on Escherichia coli was mainly destruction of permeability barrier of the cells and peroxidization of lipids, leading to death of bacteria.
引文
[1]刘育京，袁朝森主编．医用消毒学简明教程．北京：中国科学技术出版社，1989：229-237
[2]陈胤忠，袁朝森，胡琳，等．过氧化氢复方消毒剂杀灭微生物效果的实验观察[J]．中国消毒学杂志，1998；15(2)：70
[3]廖如燕，林锦炎，陈文胜，等．复方过氧乙酸溶液杀灭微生物效果的实验观察[J]．中国消毒学杂志，2001；18(1)：6
[4]杨华明，易滨主编．现代医院消毒学．北京：人民军医出版社，2002：47
[5]Eriksen, -H-M; Iversen, -B-G;Aavitsland, -P. Sykehusinfeksjoner i Norge 1999 og 2000[J]. Tidsskr-Nor-Laegeforem. 2002, 122(25): 2440-3
[6]Bilski,-B;Wysocki,-J. Czy pracownik sluzby zdrowia zakazony wirusami wirusowego zapalenia watroby moze stanowic zagrozenie dla pacjenta?proba oceny w odnieesieniu do polskich warunkow2000[J]. Med-Pr. 2002;52(4): 339-42
[7]Knor,-K-L; Holmes,-A-H. Regulation of antimicrobial prescribing practices a strategy for controlling nosocomial antimicrobial resisistance[J]. Int-J-Infect-Dis, 2002, 6(1):8-13
[8]徐启茂．医院感染管理工作中6个不相适应的问题[J]．中华医院感染学杂志，2000，10(1)：58
[9]胡艳红．医院感染的控制与管理[J]．中华医院感染学杂志，2000，10(2)：136-137
[10]王宝珍．搞好医院控制工作[J]．中华医院感染学杂志，2002，12(6)：452-453
[11]胡秀华，冯少玲．常用消毒剂知识问卷调查分析[J]．中华医院感染学杂志，2001，6：454
[12]凌美华．医院感染中卫生员工作存在的问题及建议[J]．中华医院感染学杂志，1991：1(1)：32
[13]王云芳，任丽娟，张军．医院病夹HBsAg污染调查[J]．中国消毒学杂志，1997，14(2)：113
[14]呂树杰，张晓梅，邬长兴，等．医院部分公用物表面HbsAg污染及其消毒[J]．中国消毒学杂志，1997,14(3)：186
[15]Heir,-E;Langsrud,-S;Sidhu,-M-S, et al. Kan desinfeksjonsmidler bidratil bakteriell antibiotikaresistens?[Can disinfectants contribut to antibioticresistance?][J].Tidsskr-Nor-Laegeforem, 2001,121(27):3201-6
[16]吴爱平，吴学贵，章勇．医院消毒方法的评价与思考[J]．中华医院感染学杂志，2000，10(2)：172
[17]薛广波．实用消毒学[M]．北京：人民军医出版社，1999，425-429
[18]李晓青．细菌对消毒剂抗性机理研究进展[J]．中国消毒学杂志，1998，15(4)：218-221
[19]文细毛，黄勋，徐秀华，等．消毒剂对产超广谱-内酰胺酶阳性菌株的杀灭试验观察[J]．中华医院感染学杂志,2002，12(9)：683-685
[20]张亚莉，耿穗娜，陈进华，等．三氯消毒剂杀菌效果试验观察[J]．第一军医大学学报，2001，21(4)307-308
[2]陈胤忠，袁朝森，胡琳，等．过氧化氢复方消毒剂杀灭微生物效果的实验观察[J]．中国消毒学杂志，1998；15(2)：70
[3]廖如燕，林锦炎，陈文胜，等．复方过氧乙酸溶液杀灭微生物效果的实验观察[J]．中国消毒学杂志，2001；18(1)：6
[4]杨华明，易滨主编．现代医院消毒学．北京：人民军医出版社，2002：47
[5]Eriksen, -H-M; Iversen, -B-G;Aavitsland, -P. Sykehusinfeksjoner i Norge 1999 og 2000[J]. Tidsskr-Nor-Laegeforem. 2002, 122(25): 2440-3
[6]Bilski,-B;Wysocki,-J. Czy pracownik sluzby zdrowia zakazony wirusami wirusowego zapalenia watroby moze stanowic zagrozenie dla pacjenta?proba oceny w odnieesieniu do polskich warunkow2000[J]. Med-Pr. 2002;52(4): 339-42
[7]Knor,-K-L; Holmes,-A-H. Regulation of antimicrobial prescribing practices a strategy for controlling nosocomial antimicrobial resisistance[J]. Int-J-Infect-Dis, 2002, 6(1):8-13
[8]徐启茂．医院感染管理工作中6个不相适应的问题[J]．中华医院感染学杂志，2000，10(1)：58
[9]胡艳红．医院感染的控制与管理[J]．中华医院感染学杂志，2000，10(2)：136-137
[10]王宝珍．搞好医院控制工作[J]．中华医院感染学杂志，2002，12(6)：452-453
[11]胡秀华，冯少玲．常用消毒剂知识问卷调查分析[J]．中华医院感染学杂志，2001，6：454
[12]凌美华．医院感染中卫生员工作存在的问题及建议[J]．中华医院感染学杂志，1991：1(1)：32
[13]王云芳，任丽娟，张军．医院病夹HBsAg污染调查[J]．中国消毒学杂志，1997，14(2)：113
[14]呂树杰，张晓梅，邬长兴，等．医院部分公用物表面HbsAg污染及其消毒[J]．中国消毒学杂志，1997,14(3)：186
[15]Heir,-E;Langsrud,-S;Sidhu,-M-S, et al. Kan desinfeksjonsmidler bidratil bakteriell antibiotikaresistens?[Can disinfectants contribut to antibioticresistance?][J].Tidsskr-Nor-Laegeforem, 2001,121(27):3201-6
[16]吴爱平，吴学贵，章勇．医院消毒方法的评价与思考[J]．中华医院感染学杂志，2000，10(2)：172
[17]薛广波．实用消毒学[M]．北京：人民军医出版社，1999，425-429
[18]李晓青．细菌对消毒剂抗性机理研究进展[J]．中国消毒学杂志，1998，15(4)：218-221
[19]文细毛，黄勋，徐秀华，等．消毒剂对产超广谱-内酰胺酶阳性菌株的杀灭试验观察[J]．中华医院感染学杂志,2002，12(9)：683-685
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