医院环境清洁措施的多中心干预效果研究  

Effects of multi-center interventions to hospital environment cleaning

作　　者：徐虹[1] 任淑华[2] 陆群[3] 干铁儿[4] 赵岚[5] 金慧[1] 沈林海[1] 韦凌娅[1] 陈冰冰[1] 孔庆鑫[1] 倪晓平[1] 

机构地区：[1]杭州市疾病预防控制中心消毒与病媒生物防制所,浙江杭州310021 [2]杭州市第一人民医院院感科,浙江杭州310006 [3]浙江大学医学院附属第二医院院感科,浙江杭州310006 [4]浙江省中医院院感科,浙江杭州310006 [5]杭州市红十字会医院院感科,浙江杭州310006

出　　处：《中华医院感染学杂志》2015年第11期2620-2622,共3页Chinese Journal of Nosocomiology

基　　金：浙江省重点科技创新团队基金资助项目(2011R50021);杭州市医学重点专科专病基金资助项目(20130733Q32)

摘　　要：目的评价医院环境清洁综合干预措施效果,为医院环境感染控制提供依据。方法 2013年7月-2014年12月对4个ICU医护人员、环境清洁人员实施教育培训,采用更换ICU的清洁用品、引入消毒湿巾、改变清洁用品复用方式和结果反馈的综合干预措施,干预前、后共分别采集120份环境样本,分别进行三磷酸腺苷(ATP)相对光单位值及细菌菌落总数的中位数(Md)与四分位数(IQR)及耐甲氧西林金黄色葡萄球菌(MRSA)阳性率监测。结果 4所医院ICU内环境表面采集120份标本,ATP监测的Md和IQR干预前为320.5RLU/100cm2和565RLU/100cm2,干预后分别为33.5RLU/100cm2和70RLU/100cm2,两者差异有统计学意义(P<0.01);干预前、后细菌菌落总数的Md、IQR分别为50、215CFU/cm2和19、84CFU/cm2,差异有统计学意义(P<0.01)。结论实施综合环境感染控制措施,可以有效提高环境清洁程度,降低环境表面耐药菌的检出率。OBJECTIVE To evaluate the effects of the comprehensive interventions to the hospital environment cleaning so as to provide guidance for control of nosocomial infections .METHODS From Jul 2013 to Dec 2014 ,the education training was conducted for the health care workers and environmental cleaning workers of 4 ICUs ,then the comprehensive interventions were taken , including the replacement of cleaning supplies , introduction of disinfectant wipes ,change of re‐use mode of cleaning supplies ,and results feedbacks .Totally 120 environmental specimens were respectively collected before and after the interventions were taken ;the adenosine triphosphate （ATP） median （Md） relative light units value and interquartile range （IQR） bacterial colony counts and positive rates of methicillin‐resistant Staphylococcus aureus （MRSA） were monitored .RESULTS Of 120 specimens collect‐ed from the environmental surfaces of the ICUs in 4 hospitals ,the Md under the monitoring of ATP was 320 .5 RLU/100 cm^2 before the interventions were taken ,33 .5 RLU/100 cm^2 after the interventions were taken ;the IQR was 565 RLU/100 cm^2 before the interventions were taken ,70 RLU/100 cm^2 after the interventions were taken ,and there were significant differences （P〈0 .01） .The Md of the bacterial colony counts was 50 CFU/cm^2 before the intervention ,19 after the intervention ;the IQR of the bacterial colony counts was 215 CFU/cm^2 before the intervention ,84 CFU/cm^2 after the intervention the differences were significant （P〈0 .01） .CONCLUSIONS The comprehensive interventions to the control of the infections may contribute to the improvement of the environ‐mental cleaning and to the reduction of detection rate of drug‐resistant bacteria in the environmental surfaces .

关 键 词：清洁 干预 环境表面 耐甲氧西林金黄色葡萄球菌 

分 类 号：R187[医药卫生—流行病学]