Ⅲ型过氧乙酸消毒液用于消化内镜的消毒效果观察  

Disinfection efficacy of peracetic acid disinfectant (type Ⅲ) on gastrointestinal endoscopy

作　　者：顾娇阳 刘岚[1] 辛玉 任静敏 王莉[2] 张楠[1] 吴洪磊[1] 林兴凤[2] 郭建强[1] Gu Jiaoyang;Liu Lan;Xin Yu;Ren Jingmin;Wang Li;Zhang Nan;Wu Honglei;Lin Xingfeng;Guo Jianqiang(Department of Gastroenterology, the Second Hospital of Shandong University, Jinan 250033, China;Department of Nosocomial Infection Control, the Second Hospital of Shandong University, Jinan 250033, China)

机构地区：[1]山东大学第二医院消化内科,济南250033 [2]山东大学第二医院医院感染管理科,济南250033

出　　处：《中华消化内镜杂志》2019年第10期741-745,共5页Chinese Journal of Digestive Endoscopy

基　　金：山东省重点研发计划(2015GSF118101).

摘　　要：目的评估Ⅲ型过氧乙酸消毒液的内镜消毒效果。方法按照2016版《软式内镜清洗消毒技术规范》规定的内镜清洗消毒流程,分别使用2%戊二醛和Ⅲ型过氧乙酸消毒液对内镜进行消毒,在指定步骤通过内镜活检通道采样,对采样标本进行细菌培养计数和致病菌检测。采用化学免疫发光法检测Ⅲ型过氧乙酸消毒液消毒后样本的乙型肝炎病毒表面抗原(HBsAg)、丙型肝炎病毒抗体(抗-HCV)及梅毒螺旋体特异性抗体(TP-Ab)水平。选取部分使用Ⅲ型过氧乙酸消毒液进行消毒的内镜连续采集样本5 d。结果使用2%戊二醛消毒剂的胃镜56条、肠镜16条(戊二醛组),使用Ⅲ型过氧乙酸消毒液的胃镜46条、肠镜15条(过氧乙酸组),戊二醛组及过氧乙酸组消毒后胃、肠镜菌落计数均明显减少(P<0.05),过氧乙酸组胃镜消毒合格率和总合格率均高于戊二醛组[胃镜消毒合格率:97.83%(45/46)比92.86%(52/56),P>0.05;总合格率:98.36%(60/61)比94.44%(68/72),P>0.05],2组肠镜消毒合格率均为100.00%(15/15,16/16)。Ⅲ型过氧乙酸消毒液消毒后胃、肠镜取样样本中HBsAg、抗-HCV及TP-Ab均为阴性;连续采样5 d的内镜在各时间点测得的菌落数目差异无统计学意义(P>0.05)。结论Ⅲ型过氧乙酸消毒液能够达到对消化内镜高水平消毒标准,且经Ⅲ型过氧乙酸消毒后的内镜活检管道内壁无明显不易清除的细菌残留附着,可安全应用于临床。Objective To evaluate the disinfection efficacy of peracetic acid disinfectant (type Ⅲ) on gastrointestinal endoscopy. Methods Endoscopes were disinfected respectively by 2% glutaraldehyde (GA group) and peracetic acid disinfectant (type Ⅲ)(PAA group) according to the process by the 2016 version of "Regulation for cleaning and disinfection technique of flexible endoscope", and then samples were collected through biopsy channel at the specified steps. The bacterial count and pathogenic bacteria of these samples were detected. Hepatitis B virus surface antigen (HBsAg), hepatitis C virus (HCV) antibody and Treponemia pallidum antibody (TP-Ab) were detected by chemiluminesent microparticle immunoassay (CMIA) in the PAA group. The PAA group were continuously sampled for 5 days. Results A total of 56 gastroscopes and 16 colonoscopes were disinfected in the GA group, and 46 gastroscopes and 15 colonoscopes were disinfected in the PAA group. Compared with pre-disinfection, the bacterial count was both significantly reduced in the two groups after disinfection (P<0.05). The qualified rate of gastroscopes disinfection and total qualified rate of the PAA group were higher than those of the GA group [the qualified rate of gastroscopes: 97.83%(45/46) VS 92.86%(52/56), P>0.05;total qualified rate: 98.36%(60/61) VS 94.44%(68/72), P>0.05]. The qualified rate of colonoscopes in the two groups were both 100.00%(15/15, 16/16). After disinfecting by peracetic acid disinfectant (Type Ⅲ), HBsAg, anti-HCV and TP-Ab were negative. There were no significant differences on colonies number at different steps in a 5-day continuous sampling (P>0.05). Conclusion Peracetic acid disinfectant (type Ⅲ) can provide a satisfied disinfectant effect, and be applied in clinic to meet the requests of high-level disinfection for gastrointestinal endoscopy.

关 键 词：胃肠内窥镜 消毒剂 Ⅲ型过氧乙酸消毒液 

分 类 号：R1[医药卫生—公共卫生与预防医学]