ICU物体表面消毒方法优选试验研究

Study on optimized method for disinfection of object surface in ICU

目的比较不同消毒剂在消毒后不同时刻对ICU高频接触物体表面的抑菌效果,结合成本分析,探讨合理的消毒方法与消毒频率。方法分别采用500mg/L含氯消毒液、洁力佳消毒湿巾、卡瓦布消毒湿巾和酸性氧化电位水,对ICU 4个高频接触物体表面分别进行擦拭前、擦拭后15min、1、2、4h和6h采样及培养,比较不同消毒方法在消毒后不同时刻的抑菌率和物体表面细菌总数合格率。结果酸性氧化电位水组在5个时间的抑菌率均低于其他3组(P<0.001);其他3种消毒方法消毒后4h内的抑菌率均>90.0%,消毒后6h时,4种消毒方法的抑菌率均<60.0%;消毒后4h内,物体表面细菌计数合格率均为酸化水组低于其他3组(P<0.001);其他3组在擦拭后2h内物体表面细菌计数合格率均>90.0%,而在4h时,均<40.0%;4种消毒方法每次消毒成本由大到小依次为卡瓦布消毒湿巾、含氯消毒液、洁力佳消毒湿巾、酸性氧化电位水。结论有效成分为双链季铵盐的佳力佳消毒湿巾可作为医院病房物体表面消毒的理想选择,在诊疗操作较频繁的ICU使用,建议擦拭消毒频率以4h1次为宜。

OBJECTIVE To compare bacteriostatic effect of different disinfectants acting on frequently-touched surfaces in ICUs at different time points after disinfection so as to put forward the reasonable disinfection method and disinfection frequency combined with cost analysis. METHODS We wiped the four frequently-touched surfaces in ICUs with disinfectant containing 500mg/L chlorine, the electrolyzed oxidizing water（EOW）, antiseptic wipe from Jielijia and CaviWipes respectively. The culture samples were collected from the surfaces before wiping, after wiping for 15 min, 1 h, 2 h, 4 h and 6 h respectively. The bacterial clearance rate and the qualified rate of bacteri- al colony counts on the surfaces were compared between the difference disinfectants at different time points after the disinfection. RESULTS The bacteriostatic rate in the EOW group was lower than that in the other three groups at five time points after disinfection （P〈0. 001）, Whereas, the bacteriostatic rate at 4 h after disinfection was more than 90.0% with other three methods of disinfection, the bacteriostatic rates of four different disinfection methods were all less than 60.0% at 6 h after disinfection. The qualified rate of the bacterial colony counts on the surfaces in the EOW group was lower than that in other groups at 4 h after disinfection（P〈0. 001）, similarly, the qualified rate of total bacterial colony counts on the surfaces was more than 90.0% in other three groups at 2 h after disinfection and was less than 40.0% in all the four methods at 4h after disinfection. The cost of the four dis- infection methods for each time in a descending order were as follows ： CaviWipes, chlorine-containing disinfect- ant , antiseptic wipe from Jielijia, and EOW. CONCLUSION Antiseptic wipe containing the effective ingredients of alkyl bis-ammonium salts can be chosen as a preferred method for the disinfection of object surfaces in the hospital wards, it is suggested that this method should be used in the ICU with the frequency of wiping disinfection of every four hours.