重症监护病房呼吸机管路中冷凝水细菌污染及其影响分析  

Analysis of bacterial contamination of condensed water in ventilator pipeline in intensive care unit and its impact

作　　者：时粉娟 王蔚 步惠琴 黎梦笋 贾利霞 居俏艳 SHI Fen-juan;WANG Wei;BU Hui-qin;LI Meng-sun;JIA li-xia;JU Qiao-yan(The First Hospital of Jiaxing,Jiaxing Zhejiang 314000,China)

机构地区：[1]嘉兴市第一医院,浙江嘉兴314000

出　　处：《中国消毒学杂志》2023年第10期764-766,770,共4页Chinese Journal of Disinfection

基　　金：浙江省医药卫生平台项目(2021KY350)。

摘　　要：目的了解重症监护病房(ICU)呼吸机管道中冷凝水细菌污染情况及其对周围环境的影响。方法采用现场采样和细菌定量检测的方法,对机械通气患者使用的呼吸机呼气端集水杯中冷凝水细菌污染情况及其对周围环境的影响进行调查与分析。结果患者使用的呼吸机呼气端集水杯中冷凝水细菌污染量随时间的延长而增加,当滞留时间≥2 h时细菌量显著增多,冷凝水细菌培养阳性率100.00%。150份冷凝水样本中共检测出16种246株致病菌,以革兰阴性菌为主(80.49%)。其中12种细菌与下呼吸道分泌物检出菌种相一致。冷凝水滞留2 h倾倒后的环境表面细菌培养阳性率为78.00%,检出细菌分布与冷凝水细菌分布基本一致。结论ICU患者使用的呼吸机集水杯中冷凝水细菌量与滞留时间有关,倾倒冷凝水时易污染环境物体表面,应制定针对性的改进措施。Objective To understand the bacterial contamination of condensed water in ventilator pipeline in intensive care units(ICU)and its impact on the surrounding environment.Methods Field sampling and quantitative bacterial detection were used to investigate and analyze the bacterial contamination of condensed water in the exhalation cup of mechanical ventilation patients and its impact on the surrounding environment.Results The number of contaminated bacteria in the condensed water in the exhalation cup of the ventilator used by patients increased with time.When the retention time was≥2 h,the bacterial amount significantly increased,and the positive rate of bacterial culture in condensed water was 100.00%.A total of 246 strains of pathogenic bacteria of 16 species were detected in 150 samples of condensed water,which were mainly Gram-negative bacteria(80.49%).Among them,12 types of bacteria were consistent with those detected in lower respiratory tract secretions.When condensed water was dumped 2 h of condensate retention,the positive rate of bacterial culture on the surface of the environment was 78.00%,and the distribution of detected bacteria was basically consistent with that of the condensed water.Conclusion The bacterial count of condensed water in the exhalation cup of the ventilator used by ICU patients is related to the retention time.When dumping condensed water,it is easy to comtaminate the surface of environmental objects,and targeted improvements should be made.

关 键 词：重症监护室病房 呼吸机 冷凝水 细菌污染 

分 类 号：R187[医药卫生—流行病学] R183[医药卫生—公共卫生与预防医学]