ICU物体表面的消毒效果监测  

Monitoring the effect of surface disinfection on frequently touched objects in ICU

作　　者：申桂娟[1] 王李华[1] 祝进[1] 沈红艳[1] 陆军[1] 孙平平[1] 

机构地区：[1]衢州市人民医院感染管理科,浙江衢州324000

出　　处：《中华医院感染学杂志》2015年第3期710-712,共3页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金资助项目(LY13H200004)

摘　　要：目的了解ICU医护人员手频繁接触物体表面的消毒质量,提高管理者对ICU物体表面消毒重要性的认识,为加强医院感染的预防与控制提供科学依据。方法 2013年3-8月对重症医学科、急诊和神经外科重症监护病房医务人员手频繁接触物体表面的消毒效果进行目标性监测,数据分析应用SPSS 19.0软件处理。结果共采集各类标本468份,合格393份,合格率84.0%,其中消毒后2h304份,合格249份,合格率81.9%;消毒后8h164份,合格144份,合格率87.8%,二者之间消毒效果差异无统计学意义;目标性病原菌监测结果显示,以多药耐药菌为主,共检出病原菌80株,检出率较高的病原菌为鲍氏不动杆菌39株、金黄色葡萄球菌29株,分别占48.8%、36.3%,其中泛耐药鲍氏不动杆菌34株、MRSA 28株,分别占87.2%、96.6%,肺炎克雷伯菌9株占11.2%。结论 ICU医护人员手频繁接触物体表面的日常清洁消毒质量有待提高,应强化医务人员手卫生管理,制定医务人员手频繁接触物体表面清洁与消毒的标准化操作规程,并加强规范的落实与监管。OBJECTIVE To investigate the effect of surface disinfection on frequently touched objects in ICU and enhance the realization of the importance in surface disinfection on instruments among administrators so as to provide the basis for the scientific prevention and control of nosocomial infections. METHODS The detection of the effect of surface disinfection on frequently touched objects was conducted in Intensive Care Unit, Emergency Department and Neurosurgical Care Unit among medical staff from Mar. to Aug. in 2013. The data were analyzed by SPSS 19.0. RESULTS A total of 468 clinical specimens were monitored with 393 qualified specimens and the average qualified rate was 84.0%. Among them 304 samples had sterilized for 2 hours, while 164 had sterilized for 8 hours and the qualified rates between the two were 81. 9% （249 out of 304） and 87. 8% （144 out of 164） respectively. There was no significant difference between the effects of these two groups. Multidrug resistant or- ganisms took the major part in the surveillance result of target pathogenic microorganisms. There were 80 strains of pathogens detected including 29 strains of Acinetobacter baurnannii and 39 strains of Staphylococcus aureus which accounted 48.8% and 36.3% respectively. And 34 strains of XDRAB, 288 strains of MRAS, and 9 strains of Klebsiella pneumoniae were detected, counting for 87.2%, 96.6% and 11.2% separately. CONCLUSION It is necessary for the hospital to improve the cleaning and sterilization quality of surface of the commonly used medical instruments, and more emphasis should be put on the hand hygiene of medical staff. It should also establish a standardized operating regulation for surface disinfection on frequently touched medical supplies and strengthen the practice and supervision of the regulation.

关 键 词：重症监护病房 物体表面 消毒效果 监测 

分 类 号：R187[医药卫生—流行病学]