基于集束化检测方法的软式内镜清洗消毒质量评估  

Assessment of effectiveness of a cluster-testing method for cleaning and disinfection of flexible endoscopes

作　　者：赵会杰[1] 王力红[1] 赵霞[1] 杨洋[1] 马文晖[1] 王允琮 韩叙[1] 赵中晶 王薇[1] ZHAO Hui-jie;WANG Li-hong;ZHAO Xia;YANG Yang;MA Wen-hui;WANG Yun-zong;HAN Xu;ZHAO Zhong-jing;WANG Wei(Xuan Wu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院医院感染管理处,北京100053

出　　处：《中华医院感染学杂志》2024年第12期1889-1893,共5页Chinese Journal of Nosocomiology

基　　金：北京市卫生健康委高层次公共卫生技术人才建设项目培养计划基金资助项目(学科骨干-01-007)。

摘　　要：目的 调查应用集束化检测方法对软式内镜内腔及各接口的清洗消毒质量,对内镜清洗消毒质量的有效性进行评估.方法 应用集束化检测方法,即目视检查法、三磷酸腺苷(ATP)检测法、微生物培养法及便携式管腔可视系统观察法同时对85条清洗消毒后内镜进行检测.结果 目视检查管腔外部85条内镜外表面3条外表面有轻度磨损;ATP检测内镜内腔不合格率由高到低依次为支气管镜、胃镜、肠镜;细菌学检测内镜内腔、活检口、注水注气口和负压吸引口部位标本327件其中46件呈阳性,内镜内腔检出阳性率最高34.12%,各部位细菌检测阳性率差异有统计学意义(P<0.05);便携式管腔可视系统观察后发现内腔存在划痕内镜78条,其中胃镜划痕最高94.29%;划痕与ATP检测、细菌学检测呈正相关.结论 应用集束化检测方法可弥补单一检测方法对内镜检测的局限性,对内镜清洗消毒的有效性进行评估,为内镜相关医院感染防控工作提供指导.OBJECTIVE To investigate the quality of cleaning and disinfection of the internal channel and each interface of flexible endoscopes by applying cluster-testing methods,and to evaluate the effectiveness of endoscopic cleaning and disinfection quality.METHODS Eighty-five cleaned and disinfected endoscopes were examined simultaneously using a cluster testing method,visual inspection of the exterior of the lumen,adenosine triphosphate(ATP)testing,microbial culture,and portable lumen instrument visualization system observation.RESULTS Visual inspection of the 85 endoscopic external surface found that the external surface of 3 endoscopes had mild abrasion.The endoscopic lumen failure rates detected by ATP test from high to low order were bronchoscopy,gastroscopy,and enteroscopy.327 specimens collected from endoscopic lumen,biopsy channel,air/water channel,and suction channel were tested by bacteriological detection,of which 46 were positive,with the highest positive rate of 34.12%being detected in endoscopic lumen,and the difference between the positive rate of bacterial detection of various parts was statistically significant(P<0.05).Portable tube lumen instrument visualization system showed that 78 endoscopes had scratched lumen,with the top scratches rate of 94.29%in gastroscopes.Scratches were positively correlated with ATP detection and bacteriological detection.CONCLUSION The application of the cluster-based detection method could compensate for the limitations of single detection methods for endoscopy detection,evaluate the effectiveness of endoscopy cleaning and disinfection,and provide guidance for endoscopy-related hospital infection prevention and control.

关 键 词：集束化检测 软式内镜清洗消毒 质量评估 

分 类 号：R187[医药卫生—流行病学]