医疗机构内镜终末漂洗水微生物污染调查与风险分析  

Investigation and risk analysis of microbial contamination of endoscopic final rinse water in medical institution

作　　者：曾其莉[1] 江永忠[1] 李艳伟 邹伟 张静玲[1] 余波[1] ZENG Qi-li;JIANG Yong-zhong;LI Yan-wei;ZOU Wei;ZHANG Jing-Ling;YU Bo(Hubei Provincial Center for Disease Control and Prevention,Wuhan Hubei 430079,China)

机构地区：[1]湖北省疾病预防控制中心,湖北武汉430079

出　　处：《中国消毒学杂志》2022年第3期203-205,210,共4页Chinese Journal of Disinfection

基　　金：国家科技重大专项(2018ZX10734401-009)。

摘　　要：目的调查某省医疗机构内镜中心终末漂洗水使用情况,结合微生物监测结果,对终末漂洗水污染进行风险分析并提出应对措施。方法依据WS 507—2016《软式内镜清洗消毒技术规范》,采集38家各级医疗机构消化内镜或支气管镜终末漂洗水97份,包括纯化水出水口、纯化水储水罐、手工洗消台及自动洗消机出水口等采样点,检测菌落总数。结果2019年内镜中心纯化水配备率和终末漂洗水合格率均比2018年有显著提升,仅个别医院仍直接使用自来水。终末漂洗水中,3份纯化水出水口、2份纯化水储水罐、86份手工洗消台和6份自动洗消机出水口合格率分别为100%、0.00%、30.23%和33.33%,手工洗消台与自动洗消机终末漂洗水合格率差异无统计学意义。结论纯化水设备可以提高终末漂洗水质量,但终端合格率仍较低,输水管路的全流程监测和维护至关重要。部分纯化水设备和自动洗消机未设置取样口而影响整体监测溯源性,需多学科多部门联合实施综合性管控。Objective To investigate the use of final rinse water in an endoscopy center of a medical institution in a province,and to analyze the risk of final rinse water pollution and propose countermeasures based on the results of microbial monitoring.Methods According to WS 507—2016“Technical Specifications for Cleaning and Disinfection of Flexible Endoscopes”,97 samples of final rinse water of digestive endoscopes or bronchoscopes in 38 medical institutions at all levels were collected,including sampling points such as purified water outlet,purified water storage tank,manual decontamination station and automatic decontamination machine outlets,to detect the total number of colonies.Results In 2019,the equipment rate of purified water and the qualified rate of final rinse water in the endoscopy center were significantly improved compared with those in 2018,and only a few hospitals still used tap water directly.In various types of final rinse water,the qualified rates of 3 samples of purified water outlet,2 samples of purified water storage tank,86 samples of manual decontamination station and 6 samples of automatic decontamination machine outlets were 100%,0.00%,30.23%and 33.33%,respectively.There was no statistically significant difference in the qualified rates of final rinse water between manual decontamination station and automatic decontamination machine.Conclusion Purified water equipment can improve the quality of the final rinse water,but the qualified rate of the terminal is still low.The whole process monitoring and maintenance of the water pipeline is very importance.Some purified water equipments and automatic decontamination machines are not equipped with sampling ports,which affects the overall monitoring traceability.Multi-disciplinary and multi-department joint implementation of comprehensive management are needed.

关 键 词：医疗机构 内镜中心 终末漂洗水 纯化水 自动洗消机 医院感染 

分 类 号：R187.2[医药卫生—流行病学]