无针输液接头表面多药耐药菌的生存期及其消毒效果  

Lifetime of multidrug-resistant organisms adhered to surfaces of needle-free infusion connectors and effect of disinfection

作　　者：刘亭婷 张佳彬 万玉英 LIU Ting-ting;ZHANG Jia-bin;WAN Yu-ying(School of Public Health,Nanchang University,Nanchang,Jiangri 330006,China;不详)

机构地区：[1]南昌大学公共卫生学院江西省预防医学重点实验室,江西南昌330006 [2]南昌大学第二附属医院医院感染管理科,江西南昌330008

出　　处：《中华医院感染学杂志》2024年第2期299-303,共5页Chinese Journal of Nosocomiology

基　　金：江西省卫生厅中医药课题(2019B012)。

摘　　要：目的探讨不同无针输液接头表面附着的多药耐药菌(MDRO)的生存周期及不同消毒剂对其消毒的效果。方法严格按照无菌操作规程,将4种MDRO分别均匀涂抹于临床上常用的五款无针输液接头表面(A、B、C、D、E款),于附着后24 h、48 h、72 h、1周、2周、3周、4周采样做活菌计数培养,监测MDRO在接头表面的存活情况;评价75%酒精、0.5%碘伏、2%洗必泰醇3种消毒剂对不同无针输液接头表面附着的MDRO的消毒效果。结果实验发现35℃下A、B、C、D四款无针输液接头表面附着的耐甲氧西林金黄色葡萄球菌(MRSA)菌落生长较多且存活时间均超过4周,耐碳青霉烯类肺炎克雷伯菌(CRKP)在A款无针输液接头表面存活时间最长且超过4周,耐碳青霉烯类鲍氏不动杆菌(CRAB)在C款无针输液接头表面存活时间最长且超过4周,E款无针输液接头表面附着的MDRO在4周时均无存活;3种消毒剂分别作用不同的无针输液接头5 min、10 min,对4种MDRO均有杀灭效果,但作用时间10 min效果更好,且E款无针输液接头的MDRO杀灭效果优于其他四款。结论合理的接头设计有利于减少MDRO的定植和残留,提高消毒效果,选择表面平整光滑、密闭性好、透视性高、材质不利于病原菌生长的输液接头,并严格按照消毒规范进行有效消毒,可减少医院因输液接头引发的MDRO感染。OBJECTIVE To explore the lifetime of multidrug-resistant organisms(MDROs)adhered to surfaces of needle-free infusion connectors and observe the effects of disinfectants on disinfection of the MDROs.METHODS In strict accordance with aseptic operation regulations,four types of MDROs were evenly smeared on 5 types of commonly used needle-free infusion connectors,respectively(type A,B,C,D and E).The samples were col-lected for culture of viable counts after the attachment for 24 hours,48 hours,72 hours,1 week,2 weeks,3 weeks and 4 weeks.The survival status of the MDROs on the connector surfaces was monitored.The effects of 75%alcohol,0.5%iodophor and 2%chlorhexidine on disinfection of the MDROs that adhered to the surfaces of needle-free infusion connectors were evaluated.RESULTS The experiment showed that the colony counts of methi-cillin-resistant Staphylococcus aureus(MRSA)strains that adhered to the surfaces of type A,B,C and D needle-free infusion connectors were relatively great when temperature was 35℃,and the survival time exceeded 4 weeks;the survival time of carbapenem-resistant Klebsiella pneumoniae(CRKP)that adhered to the surfaces of type A needle-free infusion connectors was the longest and exceeds 4 weeks;the survival time of carbapenem-re-sistant Acinetobacter baumannii(CRAB)that adhered to the surfaces of type C needle-free infusion connectors was longest and exceeded 4 weeks.The MDROs that adhered to the surfaces of type E needle-free infusion connec-tors did not survive after the attachment for 4 weeks.All of the three types of disinfectants could achieve killing effect on the four types of MDROs when they acted on the surfaces of the infusion connectors for 5 and 10 min,and the killing effect was even better when the acting time was 10min;the killing effect on the MDROs that ad-hered to the type E needle-free infusion connectors was better than that on the MDROs that adhered to other four types of connectors.CONCLUSION The reasonable design of connectors may reduce the colonized and residual MDR

关 键 词：无针输液接头 多药耐药菌 消毒剂 生存期 消毒效果 

分 类 号：R187[医药卫生—流行病学]