压力蒸汽灭菌器生物监测结果异常分析  

Abnormal results analysis and quality control of biological monitoring by pressure steam sterilizer

作　　者：刘明秀 王玲 范洪玲 

机构地区：[1]重庆市璧山区人民医院消毒供应中心,重庆402760 [2]重庆市璧山区人民医院手术室,重庆402760 [3]重庆市璧山区人民医院内镜中心,重庆402760

出　　处：《医疗卫生装备》2017年第5期110-112,共3页Chinese Medical Equipment Journal

摘　　要：目的 :探讨压力蒸汽灭菌生物监测结果异常的原因,以规避生物监测过程的不规范操作及隐患因素。方法 :采用随机抽样方法抽取重庆市34所二级以上医疗机构,通过问卷调查方式统计2013—2015年导致压力蒸汽灭菌器生物监测结果异常情况,并对主要影响因素进行分析。结果:在126例压力蒸汽灭菌器生物监测异常中,阳性结果63例,占50%,主要影响因素有灭菌器超过使用期限、密封圈老化、真空泵抽空效率低、消毒员不规范装载、生物指示剂灭菌前已失效、假阳性、湿性培养箱被污染等;快读阅读器不显示35例,占27.78%,影响因素有阅读灯出现故障、指示剂插入不到位、阅读孔有灰尘等;生物指示剂培养前已变色18例,占14.28%,原因是芽孢灭菌前已繁殖;阳性对照不变色10例,占7.94%,影响因素有指示菌管未压碎直接置于培养器里培养、指示菌管压碎后未充分振摇等。结论:导致压力蒸汽灭菌生物监测异常的主要原因可归纳为设备因素、人员因素、材料因素,应从这3个方面进行环节质量控制,保障压力蒸汽灭菌效果。Objective To analyze the causes for the biological monitoring abnormal results of the pressure steam sterilizer to eliminate non-standard operation and hidden risks during biological monitoring. Methods Totally 34 secondary or above medical institutions in Chongqing were selected randomly, and questionnaire survey was carried out over biological monitoring abnormal results and main influencing factors of the pressure steam sterilizer. Results Of the 126 abnormal results, there were 63 positive results （accounting tor 50%） and the main influencing factors included expiration, aged seal ring, low-efficiency vacuum pump, nonstandard loading, bioindicator reproduction before sterilization, false positive result, polluted moist incubator and etc; There were 35 cases of results related to fast reader （accounting for 27.78%） and the main factors consisted of failure of reading light, improper input of bioindicator, dusts in the reading hole and etc; There were 18 cases of bioindicator discoloration before culture （accounting for 14.28%） and the main factor was reproduction occurred before the gemma was inactivated; There were 10 cases of nondiscoloring in case of positive control （accounting for 7.94%） and the main factors included non-crushed indicating mediostratum cultured in the incubator, insufficient shaking after crushing mediostratum and etc. Conclusion The main factors for abnormal biological monitoring of the sterilizer involve in equipment, personnel and material, and the quality control has to be executed from the three aspects. [Chinese Medical E- quipment Journal ,2017,38（5） ：110-112]

关 键 词：压力蒸汽灭菌器 生物监测 生物指示剂 灭菌效果 质量控制 

分 类 号：R197.39[医药卫生—卫生事业管理]