2015—2023年乌鲁木齐市哨点医院内镜清洗消毒质量和管理现况调查  

Quality of cleaning and disinfection of endoscopes in sentinel hospitals of Urumqi and prevalence survey of management from 2015 to 2023

作　　者：张段段 赵国玉[1] 雒涛[1] 肖锦秀 吾力肯·吐尔达力 杨洪彩[1] 傅虹[1] 艾山江·哈得尔[1] ZHANG Duan-duan;ZHAO Guo-yu;LUO Tao;XIAO Jin-xiu;WULIKEN-Tuerdali;YANG Hong-cai;FU Hong;AISHANJIANG-Hadeer(The Center for Disease Control and Prevention of Xinjiang Urgur Autonomous Region,Urumqi,Xinjiang 830002,China)

机构地区：[1]新疆维吾尔自治区疾病预防控制中心,新疆乌鲁木齐830002

出　　处：《中华医院感染学杂志》2024年第18期2853-2857,共5页Chinese Journal of Nosocomiology

基　　金：中国疾病预防控制中心“消毒与感染控制专项”项目(102393220020080000016)。

摘　　要：目的调查乌鲁木齐市哨点医院内镜室工作人员构成和内镜室设置情况,了解哨点医院内镜消毒质量,为内镜消毒工作和内镜室管理提供参考和改进方向。方法2015年-2023年3月,对新疆乌鲁木齐市9家哨点医院清洗消毒后内镜合格率、细菌污染情况进行监测,同时对内镜室工作人员构成和设备配置情况进行调查,监测频率为每季度一次。结果2015年-2023年3月对9家哨点医院共采集内镜样本425份,合格413份,合格率为97.18%,2018年合格率最低为79.31%,不同年份合格率差异有统计学意义(χ^(2)=24.241,P<0.001);除2023年外,其他年份内镜均有菌落检出,2019年内镜检出菌量在1~20 CFU/件的内镜占比达到66.67%,占比较高,对部分样本进行微生物鉴定,共检测样本96份,1份检出致病菌铜绿假单胞菌,检出率为1.03%;内镜手工清洗消毒和机械清洗消毒合格率差异无统计学意义(χ^(2)=3.049,P=0.081),二级医院和三级医院内镜消毒合格率差异无统计学意义(χ^(2)=2.391,P=0.122);对哨点医院内镜室设备设施配备情况和工作人员学历职称等内容进行调查,内镜室超声清洗器和终末漂洗水净化设备配备率为71.43%,其他设备设施配备率均为100%;内镜室工作人员普遍存在学历和职称偏低情况。结论乌鲁木齐市哨点医院内镜整体消毒状况较好,但部分医院内镜消毒仍旧存在不合格情况,需要积极采取干预措施,提高内镜消毒质量,避免医院感染发生,同时要加强对工作人员清洗消毒过程中的培训和管理,确保内镜清洗消毒工作规范开展。OBJECTIVE To understand the composition of staff and status of endoscopy root setting in the sentinel hospitals of Urumqi and understand the quality of disinfection of endoscopes so as to provide bases for the disinfection of endoscopes,management of endoscopy rooms and improvement of the disinfection.METHODS From 2015 to Mar 2023,totally 9 sentinel hospitals of Urumqi,Xinjiang Urgur Autonomous Region were enrolled in the study,the qualified rate of cleaning and disinfection of endoscopes and bacterial contamination rate were monitored.The composition of staff of the endoscope rooms and equipping status of devices were investigated,and the frequency of monitoring was once a quarter.RESULTS A total of 425 samples were collected from the endoscopes of the 9 sentinel hospitals from 2015 to Mar 2023,413 of which were qualified,with the qualified rate 97.18%,and the qualified rate was the lowest(79.31%)in 2018;there was significant difference in the qualified rate among the years(χ^(2)=24.241,P<0.001).Bacterial colonies were detected in all of the years except 2023.The proportion of endoscopes detected with bacterial colony counts ranging between 1 and 20 cfu/piece reached to 66.67%.The microorganisms isolated from some of the samples were identified.Totally 96 samples were detected,and Pseudomonas aeruginosa was isolated from 1 sample,with the isolation rate 1.03%.There was no significant difference in the qualified rate of endoscopes between the manual cleaning and disinfection and the mechanical cleaning and disinfection(χ^(2)=3.049,P=0.081);there was no significant difference in the qualified rate of disinfection of endoscopes between the secondary hospitals and the tertiary hospitald(χ^(2)=2.391,P=0.122).The status of equipping devices and facilities in endoscopy rooms,education background and titles of the endoscopy room staff were investigated,the equipping rate of ultrasonic cleaner and purification device for terminal rinse water was 71.43%in the endoscopy rooms,and the equipping rate of other devices and

关 键 词：哨点医院 内镜消毒 消毒质量管理 微生物污染 铜绿假单胞菌 内镜室管理 现况调查 乌鲁木齐 

分 类 号：R187[医药卫生—流行病学]