三种吸氧装置在临床使用中微生物污染情况的研究  

Microbial contamination of three types of oxygen inhalers in clinical application

作　　者：欧阳倩 陈华丽[1] 黎婉斌[1] 邝静霞[1] 周林丽[1] 何达秋[1] 邓子德[1] OUYANG Qian;CHEN Huali;LI Wanbin;KUANG Jingxia;ZHOU Linli;HE Daqiu;DENG Zide(Department of Infection Management,the Third Affiliated Hospital of Sun Yat-sen University,Guangdong,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院感染管理科,广东广州510630

出　　处：《中国医药科学》2020年第13期43-47,共5页China Medicine And Pharmacy

基　　金：中山大学附属第三医院管理科研基金资助项目(2019GLMS01)。

摘　　要：目的研究临床使用中零感OT-MI型一次性吸氧装置、传统复用型吸氧装置和另一品牌一体式湿化吸氧装置的湿化液和吸氧管路的微生物检出情况,探讨可能增加污染风险的危险因素。方法将2018年6~10月某三甲医院联盟医院内科、康复科住院患者随机分为三组使用吸氧装置,对吸氧装置从开启到停用时间符合7~14d的样本采样,每套装置采集湿化液、进气口内表面、近湿化瓶吸氧管路端、近患者吸氧管路端4个样本,每组采集60套。送微生物室培养及菌落计数。结果在临床使用中位数7.870~9.000d,医用供氧端无菌条件下:湿化液微生物检出阳性率零感组为6.667%,传统组和某吸氧装置组较其增加8.499倍和4.000倍(χ2=42.712,P<0.05);按照湿化液菌落数≤100cfu/mL的标准计算合格率,零感组、传统组、某吸氧装置组分别为100.000%、53.333%、96.667%,零感组较传统组增加87.501%(χ2=36.522,P<0.017)。近湿化瓶吸氧管路端微生物检出率三组分别为0.000%、10.000%、36.667%,零感组较某吸氧装置组低(χ2=26.939,P<0.017),零感组和传统组的菌落计数均值及四分位数分别为0.00(0.00,0.00)cfu/cm2、某吸氧装置组为0.00(0.00,10.00)cfu/cm2,差异有统计学意义(H=32.770,P<0.05)。近患者吸氧管路端微生物检出率零感组、传统组、某吸氧装置组分别为6.667%、20.000%、13.330%(χ2=4.615,P>0.05),菌落数中位数及四分位数均为0.00(0.00,0.00)cfu/cm2(H=5.422,P>0.05),三者差异均无统计学意义。传统组吸氧装置每天累计使用时间增加1h,湿化液的微生物的检出率增加0.078倍(P<0.05),近患者端吸氧管路微生物的检出率增加0.129倍(P<0.05)。结论零感OT-MI型一次性吸氧装置的抗污染性能具有优越性,使用超过一周微生物检出情况仍较理想,可在临床选择使用。Objective To investigate microbial contamination of humidifier solutions and inhaler pipes in the zero sense OT-MI disposable soft inhaler,conventional reusable inhaler and 2-in-1 humidifier and inhaler,and to explore the risk factors that may aggravate microbial contamination.Methods Inpatients from departments of internal medicine and rehabilitation at grade III-A hospitals from June to October 2018,in the hospital alliance were randomly divided into three groups and used the inhalers.Inhalers continuously used for 7-14 days were eligible for sampling.Samples from 4 sites including the humidifier solution,the internal surface of the air intake pipe,one end of the inhaler pipe connecting the humidifier,and another end for inhalation only of each device were collected,and samples of 60 devices were obtained in each group and cultured in the microbiology laboratory.The colony forming unit(CFU)count was calculated.Results The median duration of clinical inhaler use was 7.870-9.000 days.Based on pathogen-free oxygen supplies,the positive rate of microbial contamination in humidifier solutions was 6.667%in the soft inhaler group,and the positive rates in the conventional inhaler group and the 2-in-1 inhaler group increased 8.499 and 4.000 folds respectively compared with the soft inhaler group(χ2=42.712,P<0.05).Passing rates in the soft inhaler,conventional inhaler and 2-in-1 inhaler groups,calculated according to the criteria of humidifier solutions(≤100 cfu/mL),were 100.000%,53.333%and 96.667%,respectively.The soft inhaler group showed an increasing rate of 87.501%over the conventional inhaler group(χ2=36.522,P<0.017).Positive rates of microbial contamination in the humidifier end of the inhaler pipe were 0.000%,10.000%and 36.667%in the three groups respectively;the soft inhaler group presented a significantly lower rate than the 2-in-1 inhaler group (χ2=26.939, P < 0.017). Therewere significant differences in average and quartile CFU counts [0.00 (0.00, 0.00)cfu/cm2 vs 0.00(0.00, 0.00) cfu/cm2 vs.0.00 (0.00,

关 键 词：氧气湿化 气溶胶 微生物 菌落计数 医院感染 

分 类 号：R183[医药卫生—流行病学]