结核病专科医院结核分枝杆菌环境监测及消毒设备效果分析  

Environmental monitoring and analysis of Mycobacterium tuberculosis and discussion on the effect of disinfection equipment in a tuberculosis hospital

作　　者：罗艺 陶凤茜 李国飞 张慧慧 彭鹏 任易 刘苏洋 Luo Yi;Tao Fengxi;Li Guofei;Zhang Huihui;Peng Peng;Ren Yi;Liu Suyang(Infection Control Department,Wuhan Pulmonary Hospital(Wuhan Institute for Tuberculosis Control),Wuhan 430030,China;School of Public Health,Wuhan University,Wuhan 430072,China;Infection Control Department,Wuhan NO.4 Hospital,Wuhan 430030,China;Clinical Laboratory Department,Wuhan Pulmonary Hospital(Wuhan Institute for Tuberculosis Control),Wuhan 430030,China;School of Public Health,Shantou University,Shantou 515063,China)

机构地区：[1]武汉市肺科医院(武汉市结核病防治所)院感科,武汉430030 [2]武汉大学公共卫生学院,武汉430072 [3]武汉市第四医院院感科,武汉430030 [4]武汉市肺科医院(武汉市结核病防治所)检验科,武汉430030 [5]汕头大学公共卫生学院,汕头515063

出　　处：《结核与肺部疾病杂志》2023年第2期135-140,共6页Journal of Tuberculosis and Lung Disease

基　　金：2020年武汉市医学科研项目(WG20C05)。

摘　　要：目的:了解武汉市肺科医院(武汉市结核病防治所)院区环境中结核分枝杆菌污染情况,并评价不同类别环境消毒设备效果,为优化院区结核病预防控制措施提供参考。方法:根据医院风险等级,在院区高风险区域的44个场所如呼吸与危重症医学科和结核科病房、污物间、留痰室、内镜中心气管镜诊疗室、清洗消毒室等先后进行2次空气和物表采样。利用实时聚合酶链式反应(qPCR)检测样本中结核分枝杆菌基因组特异性片段IS6110及分枝杆菌培养,并分析阳性检出区域的消毒设备类别,评价其消毒效果。结果:分别连续采样7 d和10 d,共采集到55份空气样本和139份物表样本。经qPCR检测,各2份空气样本和物表样本检出结核分枝杆菌,阳性检出率分别为3.64%(2/55)和1.44%(2/139);但分枝杆菌培养均为阴性。qPCR阳性检出区域的消毒设备均为无空气动力的上层紫外线空气消毒灯和普通悬挂式紫外线灯管,阳性检出率[3.25%(4/123)]与有空气动力的环境消毒设备区域检出率[0.00%(0/71)]差异无统计学意义(χ^(2)=1.022,P>0.05)。结论:结核病专科医院院内环境样本中结核分枝杆菌阳性检出率低,未发现环境消毒设备有无空气动力对环境中结核分枝杆菌消杀效果的影响,但仍需加强污染高风险区域的消毒处理及医院感染控制措施的严格落实。Objective:To understand the pollution of Mycobacterium tuberculosis(MTB)in the Wuhan Pulmonary Hospital(Wuhan Institute for Tuberculosis Control),and evaluate the effects of different types of environmental disinfection equipment,so as to provide reference for optimizing the prevention and control measures of tuberculosis in the hospital area.Methods:According to the risk level of the hospital,air and surface samples were taken twice in 44 places in high-risk areas,such as respiratory and critical care medicine wards and tuberculosis wards,dirt rooms,sputum retention rooms,bronchoscopy clinics in endoscopy centers,and cleaning and disinfection rooms.Real-time polymerase chain reaction(qPCR)was used to detect the genome-specific fragment IS6110 of MTB and the culture of mycobacterium,and the types of disinfection equipment in the positive detection areas were analyzed to evaluate the disinfection effect.Results:After 7 days and 10 days of continuous sampling,55 air samples and 139 surface samples were collected.After qPCR detection,MTB was detected in two air samples and two surface samples respectively,and the positive detection rates were 3.64%(2/55)and 1.44%(2/139),respectively.But the culture of mycobacterium was negative.The disinfection equipments in the qPCR positive detection area were all upper ultraviolet air disinfection lamps without aerodynamic force and ordinary hanging ultraviolet lamps,and the positive rate was 3.25%(4/123)which was not statistically different from that in the area with aerodynamic environmental disinfection equipment(0.00%(0/71))(χ^(2)=1.022,P>0.05).Conclusion:The positive detection rate of MTB in environmental samples was low in the tuberculosis hospital,and there was no influence of aerodynamic force on the disinfection effect of MTB in the environment.But it is still necessary to strengthen disinfection treatment in high-risk areas and to strictly implement hospital control measures.

关 键 词：分枝杆菌 结核 消毒 净化 卫生用具和设备 空气微生物学 

分 类 号：R52[医药卫生—内科学] R378.911[医药卫生—临床医学]