病区水龙头相关物表铜绿假单胞菌污染分析

An analysis of pseudomonas aeruginosa contamination in faucet related surface in 31 wards

目的 了解中山市中医院31个住院病区医生办公室水池相关物表污染情况,分析相关危险因素,为医院水源性感染防控措施提供科学依据。方法 按国家规范采集医院住院大楼31个病区医生办公室水池相关样本,包括水龙头相关物表、水池旁饮水机相关物表、水样本等三种类型共201份样本。记录每个采集部位特征,包括水龙头采样部位、有无安装起泡器、朝向、环境类型、龙头类型、手柄特征等信息。采用微生物法检测样本和进行铜绿假单胞菌的鉴定来掌握物表污染情况。结果 201份样本三种类型物表检出铜绿假单胞菌的阳性率有统计学意义(用Fisher精确独立性检验P <0. 001),其中水龙头相关物表铜绿假单胞菌检出的阳性率最高16. 216%。对水龙头相关物表进行单因素分析,显示水龙头不同采样部位的铜绿假单胞菌检出的阳性率有差异,结果有统计学意义(χ^(2)=4. 874,P <0. 050),水龙头体的污染风险最高。将龙头类型、手柄特征、朝向、科室类型、菌落数是否合格、龙头口无安装起泡器等因素作为自变量进行非条件Logistic回归分析,发现这些因素对铜绿假单胞菌检出的阳性率,无统计学意义(Fisher精确独立性检验P>0. 05)。但水龙头不同采样部位、龙头口有无安装起泡器两个自变量同时加入Logistic模型,拟合优度检验AIC值最低61. 696,显示没有安装起泡器的水龙头体容易检出铜绿假单胞菌。结论 病区医生办公室内水龙头污染严重,清洁易被忽视。制定规范的水源性相关感控措施,切断医院感染传播途径有必要。

Objective To investigate the contamination of water source related surfaces from doctors’offices in 31 wards of a third-grade hospital of Traditional Chinese Medicine in Zhongshan.To analyze risk factors and provide evidence for preventing and controlling of hospital waterborne infections.Methods A total of 201 samples were collected from doctors’offices in 31 wards of the inpatient building,including faucet-related surfaces,water-dispenser related surfaces and water samples.The information of faucets,including the sampling sites,whether the numbers of colonies were qualified,whether aerators were installed,the orientations of faucets,environment types of wards,faucets’types,and handles’types,was collected.Microbiological method was used to count bacterial colony numbers and identify Pseudomonas aeruginosa from samples.Results In 201 samples,the positive rate of Pseudomonas aeruginosa from the faucet-related samples was the highest,16.216%.The positive rate between different types of surfaces was detected by Fisher’s exact independence test(P<0.01),showing statistical difference.The results of single factor analysis showed that there were statistically significant differences in the positive rate of different faucets’sampling sites(Pearson’s Chi-squared test with Yates’continuity correction χ^(2)=4.874,P<0.050),and the risk of faucets’surface contamination was higher.Multiple Logistic regression analysis showed that there was no statistical significance on the independent variables for the positive rates(Fisher exact independence test P>0.05).However,two independent variables,namely the sampling site of faucets’surface and no aerator,were added into the Logistic model at the same time,and the goodness of fit test AIC value was the lowest 61.696.Conclusion The faucet in the doctors’office of the ward is polluted seriously and the cleanliness is easy to be neglected.It is necessary to develop standard waterbrone infection control measures to cut off the route of nosocomial infection transmission.