ATP生物荧光法检测手术器械清洗质量效果评价

Evaluation on the effect of ATP bioluminescence method in detecting the cleaning quality of surgical instruments

目的探讨ATP生物荧光法对手术器械清洗质量的评价及其影响因素。方法采用ATP生物荧光法测定大肠杆菌悬液样本、金黄色葡萄球菌悬液样本、白色念珠菌悬液样本、鲜羊血样本、ATP标准溶液5种样本的相对光度值(RLU),并比较ATP生物荧光法和显微镜观察法,监测常见污染手术器械清洗质量的缺陷率,分析ATP生物荧光检测对清洗质量监测的灵敏度和重复性。结果ATP生物荧光法测定5种样本的RLU,ATP检测各种样品具有较高的灵敏度。检测10 fmol ATP(n=10)时平均值为89.1,变异系数为7.4,95%CI为76.2~101.9。虽然不同设备检测的RLU值不同,但其具有较高的重复性。采用ATP生物荧光法检测手术器械清洗的不合格率(12.4%)高于显微镜观察法(5.6%),差异有统计学意义(χ^(2)=11.646,P<0.001)。结论ATP生物荧光检测法具有良好的灵敏度和重复性,对污染手术器械清洗效果评价具有重要作用,可有效评价结构复杂的精密手术器械的清洗质量,从而预防医院感染发生。

Objective To explore the evaluation of cleaning quality of surgical instruments by ATP bioluminescence method and its influencing factors.Methods ATP bioluminescence method was used to determine suspension sample,staphylococcus aureus,escherichia coli suspension sample,candida albicans suspension sample,the fresh sheep blood samples,ATP standard solution of 5 kinds of sample relative luminosity values(RLU),and compare the ATP bioluminescence method and microscope observation,monitoring common pollution surgical instruments cleaning quality defect rate.The sensitivity and repeatability of ATP bioluminescence detection for cleaning quality monitoring were analyzed.Results ATP bioluminescence method was used to determine the RLU of 5 samples,and it showed high sensitivity.When 10 fmol ATP(n=10)was detected,the mean value was89.1,the coefficient of variation was 7.4 and the 95%CI was 76.2-101.9.Although the RLU value of different equipment was different,but it had a high repeatability.The disqualification rate of cleaning surgical instruments detected by ATP bioluminescence method(12.4%)was significantly higher than that by microscope observation method(5.6%),with statistical significance(χ^(2)=11.646,P<0.001).Conclusion ATP bioluminescence assay has good sensitivity and repeatability,which plays an important role in evaluating the cleaning effect of contaminated surgical instruments,and can effectively evaluate the cleaning quality of sophisticated surgical instruments with complex structures,thus preventing nosocomial infection.