医院感染调查环境表面微生物采样技术应用现状与研究进展  

Application status and research advances in sampling technique of environmental surface microorganisms in nosocomial infection investigation

作　　者：金慧[1] 王慧敏 孔庆鑫[1] 陈冰冰[1] 倪晓平[1] JIN Hui;WANG Hui-min;KONG Qing-xin;CHEN Bing-bing;NI Xiao-ping(Hangzhou Center for Disease Control and Prevention,Hangzhou,Zhejiang 310021,China)

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

出　　处：《中华医院感染学杂志》2018年第16期2555-2560,共6页Chinese Journal of Nosocomiology

基　　金：国家卫计委卫生标准项目(20131302);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：医疗机构环境表面微生物学监测是医院感染调查和卫生学评价的重要手段。环境表面的微生物学监测涉及采样工具的准备、采样液的选择、表面采样的实施,以及采样后实验室微生物的培养、分离、鉴定等环节。如何提高环境表面病原微生物的检出率,正确反映环境表面微生物的污染状况等,是医院感染管理和微生物实验室人员应该深思的问题。然而,在医疗机构环境表面微生物学监测的整个过程中,采样技术是所有环节的关键点,一旦采样步骤失败则无后续实验成功的可能性,甚至会出现因检测结果的假阴性报告而误导临床科室的情况。对比国内相对单一的环境表面微生物采样技术,国际上在环境表面采样技术领域中发展较快,对于采样工具的研发也比较深入,并在医院感染调查、感染来源追踪、卫生学评价,以及环境控制对医院感染影响等方面的研究中发挥了积极的作用。为此,本文检索了近年来国内外有关医疗机构环境表面微生物学监测采样技术的文献,结合本实验室多年来参与医院感染调查、卫生学评价等实践经验,综述并分析了国内外文献报道的环境表面微生物监测采样技术,包括环境表面微生物采样技术的种类与优缺点,以及使用中的注意事项等,为医疗机构提高环境表面微生物的检出率提供参考。Microbiological monitoring of environmental surfaces in hospitals is an important means for the investigation of nosocomial infection outbreaks and the evaluation of hygiene,including preparation of sampling tools,selection of sampling fluid,implementation of surface sampling,and a series of laboratory experiments such as cultivation,isolation and identification of microorganisms.Improvement of the detection rate of pathogens on environmental surfaces and correctly reflection of the microbial contamination status of environmental surfaces may be a challenge for hospital infection managers and microbiology laboratory researchers.The microorganism sampling technology is the key point in the whole process of microbiological monitoring of environmental surfaces.If the sampling procedure fails,success in subsequent experiments would be impossible.The false negative report of the detection results would mislead the clinical department.Microbiological sampling technology in China is relatively limited,whereas the technology has been rapidly developed in U.S.and Europe,especially in the development of sampling tools,which has played a critical role in the nosocomial infection investigation,infection sources tracking,hygienic evaluation,and the impact research of environmental control on nosocomial infection.Thus,this study reviewed literatures regarding microbiological sampling techniques of environmental surface monitoring in hospitals in recent year,and summarized the practical experience in the investigation of nosocomial infection and hygienic evaluation in our laboratory.The monitoring and sampling techniques of environmental surface microorganisms were reviewed and analyzed,including advantages and drawbacks of different microbial sampling techniques,how and when to use these means,so as to provide the reference for hospitals to improve the detection rate of environmental surface microorganisms.

关 键 词：医院感染 微生物学 环境表面 表面采样 

分 类 号：R181.3[医药卫生—流行病学]