过氧化氢发生器对多重耐药菌消毒效果的meta分析  

Efficiency of hydrogen peroxide vapors in reducing multidrug-resistant organisms:a meta-analysis

作　　者：彭雅兰 林吉[1] 黄文治[1] 乔甫[1] PENG Yalan;LIN Ji;HUANG Wenzhi;QIAO Fu(Department of Infection Control,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院医院感染管理部,成都610041

出　　处：《华西医学》2021年第3期341-347,共7页West China Medical Journal

基　　金：四川省科学技术厅软科学基金资助项目(2017ZR0170);四川省预防医学会医院感染预防与控制研究基金(SCGK201806)。

摘　　要：目的采用meta分析方法,评价过氧化氢发生器对多重耐药菌的消毒效果。方法检索Cochrane Library、PubMed、Embase、Web of Science、中国知网、万方、维普中文科技期刊数据库(检索时间为2010年1月-2020年12月,"滚雪球"文献时间范围延长至2000年1月-2020年12月),收集所有过氧化氢发生器对多重耐药菌消毒效果的前后对照研究、病例对照研究以及队列研究,采用RevMan 5.4、R 4.0.2软件进行meta分析。结果共纳入9篇文献,其中8篇文献为前后对照实验,1篇文献为队列研究。6篇文献结局指标为多重耐药菌环境采样的阳性率,meta分析结果显示:相比于清洁消毒前,人工清洁消毒联合过氧化氢发生器消毒能够有效地杀灭环境中的多重耐药菌[相对危险度(relative risk,RR)=0.03,95%置信区间(confidence interval,CI)(0.01,0.08),P<0.00001];相比于人工清洁消毒,过氧化氢发生器对多重耐药菌的杀灭效果更佳[RR=0.04,95%CI(0.02,0.10),P<0.00001]。3篇文献结局指标为院内多重耐药菌定植/感染率,研究结果趋势一致,过氧化氢发生器能够降低患者定植/感染率。结论过氧化氢发生器能有效杀灭病房环境中的多重耐药菌,降低患者院内获得多重耐药菌的风险。Objective To evaluate the efficiency of hydrogen peroxide vapor(HPV)in disinfecting multidrugresistant organisms(MDROs).Methods We searched Cochrane Library,PubMed,Embase,Web of Science,China National Knowledge Infrastructure,Wanfang,China Science and Technology Journal Database for before-after studies or case-control studies or cohort studies evaluating efficiency of HPV and published from January 2010 to December 2020(the time range was from January 2000 to December 2020 in the snowball searching).RevMan 5.4 and R 4.0.2 softwares were used for meta-analysis.Results A total of 9 studies were included,consisting of 8 before-after studies and 1 cohort study.Six studies evaluated positive rate of environmental samplings,meta-analysis revealed that HPV combined with manual cleaning disinfected the environment efficiently[relative risk(RR)=0.03,95%confidence interval(CI)(0.01,0.08),P<0.00001]and HPV was more efficient than manual cleaning[RR=0.04,95%CI(0.02,0.10),P<0.00001].Three studies evaluated the hospital-acquired MDROs colonization/infection rates,and the results of the 3 studies were consistent,revealing that HPV could reduce hospital-acquired MDROs colonization/infection rates.Conclusion HPV is efficient in reducing MDROs contaminated surfaces and hospital-acquired infection rate.

关 键 词：过氧化氢发生器 多重耐药菌 消毒效果 META分析 

分 类 号：R187[医药卫生—流行病学]