新建内镜中心终末漂洗水异常情况分析与对策  

Analysis and countermeasures for abnormal final rinse water in a newly-built endoscopy center

作　　者：赵静 任晓蕊[1] 何子阳 孟祥雨[3] 郭泽 周春莲[1] ZHAO Jing;REN Xiaorui;HE Ziyang;MENG Xiangyu;GUO Ze;ZHOU Chunlian(Department of Disease Prevention and Control and Infection Management,Beijing Friendship Hospital,Capital Medical University,Beijing 101300,China;Digestive Endoscopy Center,Beijing Friendship Hospital,Capital Medical University,Beijing 101300,China;Department of Medical Engineering,Beijing Friendship Hospital,Capital Medical University,Beijing 101300,China;Department of Planning and Construction,Beijing Friendship Hospital,Capital Medical University,Beijing 101300,China)

机构地区：[1]首都医科大学附属北京友谊医院疾病预防控制与感染管理处,北京101300 [2]首都医科大学附属北京友谊医院消化内镜中心,北京101300 [3]首都医科大学附属北京友谊医院医学工程处,北京101300 [4]首都医科大学附属北京友谊医院规划建设处,北京101300

出　　处：《中国感染控制杂志》2025年第3期336-342,共7页Chinese Journal of Infection Control

摘　　要：目的在新建内镜中心纯化水处理系统投入使用前开展微生物学监测,综合分析终末漂洗水微生物检测结果超标的原因并给予解决方案,为今后处置该类事件提供参考依据。方法监测2024年4—7月北京市某三级甲等综合医院新建消化内镜中心终末漂洗水的微生物检测数据,分别从内镜中心纯化水处理系统设备维护管理和纯化水给水管路清洗消毒方法改进等角度逐步分析终末漂洗水微生物检测超标的潜在原因,并提出针对性的改进措施。结果2024年4月该新建消化内镜中心终末漂洗水微生物监测结果为1400 CFU/100 mL,主要细菌类型为少见贪铜菌,经过五轮措施改进和复查之后,新建内镜中心终末漂洗水微生物监测结果为0 CFU/100 mL,合格率为100%。经分析,RO反渗透膜损坏、纯水储水罐使用前未清洁和纯水给水管路清洗消毒流程不规范是此次新建消化内镜中心终末漂洗水微生物检测超标的主要原因,针对性改进后问题得到解决。结论医疗机构应持续对内镜用水进行周期性监测,定期执行纯化水处理系统的清洗和消毒,规范清洁消毒流程,保障医疗质量和患者安全。Objective To conduct microbiological monitoring before the operation of the purified water treatment system in a newly-built endoscopy center,comprehensively analyze the causes for the standard-exceeding results of microbial detection of final rinse water,propose solutions,and provide reference for handling similar events in the future.Methods Microbial detection data of the final rinse water in the newly-built digestive endoscopy center of a tertiary first-class general hospital in Beijing from April to July 2024 were monitored.The potential causes for standard-exceeding results of microbial detection of final rinse water were analyzed from the perspectives of equipment maintenance and management of the purified water treatment system as well as the improvement of cleaning and disinfection methods for the purified water supply pipeline in the endoscopy center,targeted improvement mea-sures were proposed accordingly.Results The microbial monitoring result of final rinse water in the newly-built digestive endoscopy center built in April 2024 was 1400 CFU/100 mL,with the main bacterial type being Cupriavidus pauculus.After five rounds of improvement measures and rechecks,microbial monitoring result of the final rinse water in the newly-built endoscopy center was 0 CFU/100 mL,with a qualification rate of 100%.Analysis suggested that the main causes for the standard-exceeding results of microbial detection of final rinse water were due to the damage of the reverse osmosis membrane,lack of cleaning for the pure water storage tank before use,and non-standard cleaning and disinfection process for the pure water supply pipeline,after targeted improvement,the problem was solved.Conclusion Medical institutions should continuously conduct periodic monitoring on water used for endoscope,regularly perform cleaning and disinfection of the purified water treatment system,standardize cleaning and disinfection procedures,ensure medical quality and patient safety.

关 键 词：新建内镜中心 终末漂洗水 微生物 消毒 内镜清洗消毒中心 

分 类 号：R181.32[医药卫生—流行病学]