血液透析室空气微生物气溶胶分布与医院感染的相关性及健康风险评价  

Distribution characteristics of microbial aerosol in air of hemodialysis room and its correlation with nosocomial infection and health risk assessment

作　　者：张静[1] 徐武敏[1] 张兰珍[1] 黄佩佩[1] 陈冬蔚[1] 金领微[1] ZHANG Jing;XU Wu-min;ZHANG Lan-zhen;HUANG Pei-pei;CHEN Dong-wei;JIN Ling-wei(The Second Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325003,China)

机构地区：[1]温州医科大学附属第二医院血透室,浙江温州325003

出　　处：《中华医院感染学杂志》2022年第8期1261-1265,共5页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2020KY648)。

摘　　要：目的 监测血液透析室空气微生物气溶胶的分布特性及其与医院感染的相关性分析,并评价环境健康风险。方法 选取2020年1月-2021年1月温州医科大学附属第二医院血液透析室收治的血液透析患者194例,根据是否发生感染分为研究组(n=10)和对照组(n=184),对血液透析室空气环境中的微生物进行采样,计算微生物气溶胶浓度与粒子中值直径。结果 两组的年龄、身体质量指数(BMI)、血液透析(HD)时间比较差异有统计学意义(P<0.05)。透析时,两组的微生物气溶胶浓度高于透析前和透析后(P<0.05);透析时和透析后,研究组的微生物气溶胶浓度高于对照组(P<0.05)。研究组透析时,血液透析室中不同等级的微生物气溶胶浓度、微生物气溶胶总浓度与粒子中值直径高于对照组(P<0.05);相关性分析结果显示,微生物气溶胶总浓度、不同种类微生物气溶胶浓度、微生物气溶胶粒子中值直径与血液透析患者医院感染相关(P<0.05)。患者经呼吸发生感染的风险大于经皮肤,且男性经呼吸、皮肤感染的风险大于女性(P<0.05)。结论 血液透析室空气环境中微生物气溶胶浓度在患者透析时浓度最高,微生物气溶胶浓度及粒子中值直径与血液透析患者医院感染相关,且血液透析室中男性呼吸和皮肤感染风险高于女性。OBJECTIVE To monitor the distribution characteristics of microbial aerosol in air of hemodialysis room, and to analyze their correlation with nosocomial infection, assessing the environmental health risk. METHODS A total of 194 patients who underwent hemodialysis in hemodialysis room of the Second Affiliated Hospital of Wenzhou Medical University between Jan 2020 and Jan 2021 were recruited. According to weather the infection occurred, the patients were divided into the study group(n=10) and control group(n=184). Microorganisms in Environment air samples of the hemodialysis room were collected to detect microorganisms to evaluate the concentration of microbial aerosol and mid-value diameter of particle. RESULTS There were significant differences in age, BMI, and HD time between the two groups(P<0.05). The concentration of microbial aerosol during dialysis in both groups was significantly higher than before and after dialysis(P<0.05). The concentration of microbial aerosol in the study group was significantly higher than that in the control group during and after dialysis(P<0.05). The concentrations of different levels of microbial aerosols, total concentration of microbial aerosol and mid-value diameter of particle in the observation group during dialysis were significantly higher than those in the control group(P<0.05). Correlation analysis found that the total concentration of microbial aerosol, the concentrations of different types of microbial aerosols, and the mid-value diameter of microbial aerosol particles were associated with nosocomial infection in hemodialysis patients(P<0.05). The risk of respiratory infection was significantly higher than that of precutaneous infection, and males had a higher risk of respiratory and precutaneous infections than females(P<0.05). CONCLUSION The concentration of microbial aerosol in air environment of hemodialysis room was the highest during dialysis. The total concentration of microbial aerosol and mid-value diameter of particle are related to nosocomial infection in h

关 键 词：血液透析室 气溶胶 微生物 医院感染 相关性分析 健康风险评价 

分 类 号：R446[医药卫生—诊断学]