模拟空调卫生列车温度和湿度条件下手术血性敷料细菌繁殖与消毒效果研究

Study on reproduction state of bacteria in bloody dressings and disinfection effects of operation under temperature and humidity of simulated air-conditioned health train

[目的]探讨卫生列车上无菌手术血性敷料细菌的繁殖状况与消毒处理的效果。[方法]收集剖宫产、肾切除、直肠癌根治手术台上使用的无菌血性敷料,模拟空调卫生列车温度、湿度条件下观察48h敷料细菌繁殖状态,放置0h、2h、5h、10h、17h、24h、36h、48h取样行细菌培养,然后将敷料分装在4个桶内,分别采用二氧化氯、二氯异氰脲酸钠、戊二醛、二溴海因4种消毒剂进行处理,在消毒前、消毒后2h、5h、10h、17h、24h、36h、48h取样再行细菌培养,同时进行储物桶和空气细菌培养,将培养的细菌进行菌种鉴定。[结果]血性手术敷料实验开始无菌生长,2h出现细菌,17h菌落数>108个/皿,消毒后2h 4种消毒处理敷料均无菌生长,二氧化氯、二氯异氰脲酸钠、戊二醛消毒的敷料和储物桶保持48h无菌生长,二溴海因消毒的敷料5h有菌生长,36h菌落数>108个/皿;消毒前培养的细菌,敷料为肺炎克雷伯菌肺炎亚种、大肠埃希菌、山羊葡萄球菌,空气为沃氏葡萄球菌;消毒后敷料为肺炎克雷伯菌肺炎亚种、弗氏柠檬酸杆菌、大肠埃希菌、克氏葡萄球菌解脲亚种,空气为肺炎克雷伯菌肺炎亚种、藤黄微球菌、表皮葡萄球菌。[结论]模拟空调列车温湿度条件有利于手术血性敷料细菌的大量繁殖,二氧化氯、二氯异氰脲酸钠、戊二醛是卫生列车上血性敷料初步处理较为理想的消毒剂。

Objective： To probe into the reproduction state of bacteria in bloody dressings and disinfection effects of operation under temperature and humidity of air - conditioned health train. Methods：Three kinds of sterilization surgical bloody dressings （cesarean section, nephrectomy, resection of rectal cancer） were collected. Under temperature and humidity of air - conditioned health train, reproduction states of bacteria in bloody dressings were observed within 48 hours. Samples were put there and on the time of 0 h, 9 h, 5 h,10 h,17 h,24 h,36 h and 48 h, were collected for bacterial culture respectively. Then dressings were put in 4 aseptic barrels separately. And dressings were disinfected respectively by chlorine dioxide, sodium dichloroisocyanurate, glutaraldehyde, di - bromo - glycollylurea. Then samples of dressings were collected for bacterial culture on the time of before disinfection,2 h,5 h,10 h,17 h,24 h,36 h and 48h after disinfection. So did the aseptic barrels and ambient air. The cultured bacteria were carried out strain identification. Results： There was no bacteria growth in the bloody surgical dressings at the beginning of the experiment. Bacteria appeared on the time of 2 h. And the colony counted over 108 at 17 h. In the time of 2 h after disinfection,there were no bacteria grew in the disinfection dressings of the 4 ways of disinfection. In the dressings disinfected separately with chlorine dioxide, sodium diehloroisocyanurate, glutaraldehyde, three barrels were kept no bacteria grew for 48 h. While bacteria appeared in the dressing disinfected with di- bromoglycollylurea on the time 5 h, and the colony counted were over 108 on the time of 36 h. Before disinfection, strains identified in dressings were klebsiella pneumoniae subspecies, escherichia coli and staphylococcus goat. The strain identified in the ambient air was wolfowitz staphylococcus. After disinfection, strains identified in the dressings were klebsiella pneumoniae subspecies, eitrobacter freundii, escherichia coli and staphylococcus ureaplasma clinton subspecies. Strains identified in the ambient air were klebsiella pneumoniae subspecies,microcoecus luteus and staphylococcus epidermidis. Conclusion： The temperature and humidity conditions of air - conditioned trains were in favor of the growth of bacteria in bloody surgical dressings. Chlorine dioxide, sodium dichloroisocyanurate and glutaraldehyde are ideal initial handling disinfectants of bloody surgical dressings on the health train.