内镜终末漂洗水的晨间排放时间及其管路消毒频率研究  

Morning discharge time and pipeline disinfection frequency of endoscope final rinse water

作　　者：宋涵 生媛[2] 李雯[1] 吴兆荣 田恬 蔡薇[1] 蔡培[1] SONG Han;SHENG Yuan;LI Wen;WU Zhao-rong;TIAN Tian;CAI Wei;CAI Pei(Digestive Endoscopy Center,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Infection Management Office,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院消化内镜中心,江苏南京210008 [2]南京大学医学院附属鼓楼医院感染管理办公室,江苏南京210008

出　　处：《中国感染控制杂志》2024年第6期750-756,共7页Chinese Journal of Infection Control

摘　　要：目的根据微生物培养结果,探究内镜中心终末漂洗水的最佳晨间排放时间及其管路消毒频率。方法监测江苏省某院内镜中心内镜终末漂洗水不同晨间排放时间及其管路细菌菌落数。对内镜室2个终末漂洗水采样端口排放0、1、3、5、7 min后分别取水样(各100 mL,连续监测35 d,每时间组各70份标本)进行微生物检测,探究最佳排放时间。根据确定的最佳晨间排放时间,探究纯化水管路消毒的最佳频率。管路消毒后每日从2个采样口采样2份,连续监测5周,共70份标本。结果终末漂洗水不同晨间排放时间点采样监测,0、1、3、5、7 min组的菌落中位数分别为745.00(373.00,1452.50)、150.00(96.75,235.75)、44.00(38.00,48.00)、12.00(5.00,18.00)、6.00(4.00,9.00)CFU/100 mL。除5 min组与7 min组间差异无统计学意义(P>0.05)外,其他各组之间差异均有统计学意义(均P<0.05)。0、1、3、5 min组的中位数>10 CFU/100 mL,而7 min组的中位数<10 CFU/100 mL,达到合格范围,确定排放时间为7 min。管路消毒后不同时间点(消毒后1、2、3、4、5周)采样,终末漂洗水细菌菌落数平均值分别为(4.21±0.86)、(4.43±0.71)、(6.00±0.56)、(6.43±0.45)、(13.57±1.03)CFU/100 mL,细菌菌落数合格率分别为100%、100%、100%、100%、28.57%。纯化水管路消毒后不同时间点采样,终末漂洗水细菌菌落数比较,差异存在统计学意义(P<0.001),纯化水管路消毒后1、2、3、4周与5周之间差异均有统计学意义(均P<0.05),其余各组差异均无统计学意义(均P>0.05),纯化水管路最佳消毒频率为每4周一次。结论残留在末端管路内的终末漂洗水存在一定程度的污染,建议晨间排放7 min后再开始用水工作,每隔4周对纯化水管路进行消毒。Objective To explore the optimal morning discharge time and pipeline disinfection frequency of the final rinse water from the endoscopy center according to the microbial culture results.Methods Different morning discharge timing and number of bacterial colonies in the pipeline for the final rinse water from the endoscopy center of a hospital in Jiangsu Province were monitored.Microbial detection was conducted on water samples collected from the two final rinse water sampling sites in the endoscopy room after 0,1,3,5,and 7 minutes of discharge,respectively(100 mL each,continuously monitored for 35 days,with 70 samples at each time point)to explore the optimal discharge timing.The optimal disinfection frequency of pipelines for purified water was explored according to the determined optimal morning discharge timing.Two samples were taken daily from 2 sampling sites after pipeline disinfection and continued for 5 weeks,resulting in 70 samples in total.Results Sampling and monitoring of the final rinse water at different morning discharge time points showed that the median numbers of bacterial colonies at 0,1,3,5,and 7 minutes were 745.00(373.00,1452.50),150.00(96.75,235.75),44.00(38.00,48.00),12.00(5.00,18.00),and 6.00(4.00,9.00)CFU/100 mL,respectively.Except the difference between the 5 minute group and the 7 minute group(P>0.05),differences among all the other groups were statistically significant(all P<0.05).The median of the 0,1,3,and 5 minute groups was>10 CFU/100 mL,while the median of the 7 minute group was<10 CFU/100 mL,within the qualified range.The discharge time was therefore determined to be 7 minutes.The average numbers of bacterial colonies from the final rinse water samples taken at different time points after pipeline disinfection(1,2,3,4,and 5 weeks after disinfection)were(4.21±0.86),(4.43±0.71),(6.00±0.56),(6.43±0.45),and(13.57±1.03)CFU/100 mL,respectively.The qualification rates of pipeline in terms of bacterial colony were 100%,100%,100%,100%,and 28.57%,respectively.The differences of averag

关 键 词：内镜 终末漂洗 水 微生物 消毒 晨间排放时间 

分 类 号：R197.323.4[医药卫生—卫生事业管理]