医院二次供水系统检出快速生长分枝杆菌的应对策略与实践探索  

Strategies and practice of the detection of rapidly growing mycobacteria in secondary water supply in a hospital

作　　者：李娜[1] 蔡虻[1] 张建港 孙梦楠 李俊 胡云建[1] Li Na;Cai Meng;Zhang Jiangang;Sun Mengnan;Li Jun;Hu Yunjian(Hospital Infection Control Department,National Center of Gerontology/Beijing Hospital/Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院国家老年医学中心医院感染管理处,北京100730

出　　处：《中国医疗管理科学》2023年第2期65-70,共6页Chinese Journal Of Medical Management Sciences

摘　　要：目的对医院二次供水系统快速生长分枝杆菌(rapidly growing mycobacteria,RGM)检出情况进行分析,探讨改进策略及实施效果。方法于2021年3月—4月对医院二次供水系统进行目标性监测,监测内容包括不同采样点的物表和水龙头放水30秒及10分钟后的水样RGM检出率。根据监测结果于2021年9月—11月采取改进措施。改进前、后各采集168份水样,其中放水30秒和10分钟各52份,手术室管路水64份。比较改进措施实施前后的水样和物表RGM检出率。结果改进前、后水龙头放水30秒水样的RGM检出率分别为44.2%和7.7%,改进前、后水龙头放水10分钟水样的RGM检出率分别为25.0%和0%,差异具有统计学意义(P<0.05);改进前后各采集96个物表进行培养,RGM的检出率由改进前的8.3%下降到0%,差异具有统计学意义(P<0.05),且改进前RGM阳性检出点均位于水龙头。结论水龙头是医院二次供水系统的重要感染源,加强水龙头周围清洁消毒等改进措施,可以使医院二次供水系统的RGM检出率得到有效控制,从而降低医院感染发生率。Objective To analyze the detection of rapidly growing mycobacteria(RGM)in the secondary water supply in a hospital and to explore the improvement strategies and their effectiveness.Methods From March to April 2021,the secondary water supply of our hospital was monitored in a targeted manner,including the positive rate of RGM on the surfaces of objects at different sampling points and in water samples obtained 30s and 10min after the faucets were turned on.Based on the monitoring results,improvement measures were taken from September to November 2021.A total of 168 water samples were collected before and after the improvement,including 52 water samples after the faucets were running for 30s and 10min,respectively,and 64 water samples from the operating room pipelines.The positive rates of RGM in water samples and on object surfaces before and after the implementation of the improvement measures were compared.Results The positive rates of RGM before and after improvement were 44.23%and 7.69%,respectively,in the 30-s water samples and 25%and 0%,respectively,in the 10-min water samples(P<0.05).The positive rate of RGM on 96 object surfaces decreased from 8.3%before the improvement to 0%after the improvement(P<0.05),and all the positive sites before improvement was located at the faucets.Conclusions Faucet is a major source of secondary water supply contamination in hospitals.Cleaning and disinfection around faucets can effectively lower the RGM positive rate in hospital secondary water supply system,thereby reducing the incidence of nosocomial infections.

关 键 词：快速生长分枝杆菌 二次供水系统 水龙头 医院感染 二代测序 改进策略 

分 类 号：R378.91[医药卫生—病原生物学] R197[医药卫生—基础医学]