医院环境、物品的细菌学监测结果分析  

The analysis of the result to monitor the bacteria in environment and instruments in hospital

作　　者：罗淑兰[1] 周华[1] 王红旗[1] 钟彦伟[1] 

机构地区：[1]解放军第三○二医院,北京100039

出　　处：《传染病信息》1999年第4期179-180,共2页Infectious Disease Information

摘　　要：目的:为监测医院空气、环境、物品、医疗器械等细菌污染状况,评价消毒灭菌质量及医院环境物品的洁净度,有效地控制医院感染。方法:对某传染病专科医院的空气、环境、物品、氧气湿化瓶、雾化吸入装置、工作人员手,洗手肥皂及水龙头缠绕的纱布等,随机进行了细菌学监测研究。采样方法详见《消毒技术规范》。空气采样用Cwc-Ⅰ型离心式空气微生物样器。结果:空气细菌学监测合格率为87.7％,无菌区合格率为100％,污染区为78.4％。以季度分,三季度合格率最低,为67.7％。气管切开病人室内环境及用物达标,而空气、陪伴用物和手超标,暖气上放置的湿毛巾细菌量达161.8CFU/cm^2。存放的24件未过期灭菌物品和30件一次性无菌器具均未见细菌生长,而24件过期灭菌物品中7件(29.17％)检出细菌。氧气湿化瓶、雾化吸入装置细菌量为273～4238cfu/cm^2,其优势种有莫拉氏菌、紫色色杆菌、黄杆菌及枯草杆菌。护士、医生、卫生员手细菌数合格率分别为80.3％、70％和63.6％。水龙头缠绕纱布细菌量在650～29800cfu/cm^2之间。干净、干燥放置的2处洗手肥皂细菌数均低于15cfu/cm^2,而放置在潮湿的6处却大大超标,其中一处多达4000cfu/cm^2。结论:氧化湿化瓶、雾化吸人装置细菌污染严重,且多为非发酵菌,故每周一次消毒,多人共用或雾化药液不消毒的做法极需纠正。水龙头缠绕纱布,细菌污染极为严重。盛放于存水肥皂盒中的肥皂,其菌量是干燥、干净处肥皂的500～2000倍。潮湿环境为绿脓杆菌等阴性杆菌生长提供了条件,提示水龙头上不应缠绕纱布,洗手肥皂亦应置于干净、干燥处。空气监测结果表明,自二季度开始,合格率下降(88％),三季度最低(67.7％),在炎热潮湿的夏季,尤以注意消毒灭菌和管理。陪伴用物的菌量是病人的7倍多,手和湿毛巾中更多,警示对气管切开等院内感染的Objective In order to control the infection in hospital, we monitor the contamination of the air, the environment, the goods and the medical instruments in hospital. We also evaluate the quality of disinfection and the sterility of environment and goods so that we can control the disinfection efficiently. Methods We monitor the bacteria in the air, the enviroment, the goods, the hands of staff and gauze on the hydrant. Result We find the qualified rate of the air is 87.7%, the disinfected area is 100% and the infected area is 78.4%. On the other hand, the qualified rate of third season is only 67.7%. The bacteria in surroudings and instruments of wards can match the standard. But the air, the partner's goods is beyond the standard. The number of bacteria of moisted-oxygen bottles and hebulizens is from 273 to 4328 cfu/cm^2. The main species are Moraxella, Flavobacterium and Subtlis etc. The qualified rate of doctors, nurses and assistants's hands are respectivcly 70%, 80.3%, 63.6%. The gauze is infected seriously. The bacteria attached to soap which is in the dirty, moisted place is as five hundreds times as in the clean, dried place. Conclusion We should avoid to share the goods and disinfect the liquid medicine. We also put the soap in clean, dried place and undo the gauze to keep them from infection. In the hot, muggy summer, we should put a high value on the disinfection. The patient partners goods and hands are noticed particularly because of their high bacteria quantity. It can decrease the level of infection by wsshing hands.

关 键 词：医院 环境 物品 细菌学监测 灭菌 

分 类 号：R181.34[医药卫生—流行病学] R187[医药卫生—公共卫生与预防医学]