医院床头柜表面病原菌污染调查分析

Investigation and analysis of bacterial contamination on surfaces of bedside cabinets

目的探讨医院床头柜的带菌状况,了解床头柜病原菌与医院感染的关系,为医院感染的预防控制提供依据。方法采用棉拭子倾注法分别选取有细菌感染患者的床头柜表面(1组)、有细菌感染患者的相邻床头柜或同一病房内的床头柜表面(2组)、无细菌感染患者的床头柜表面(3组)及用"84"消毒液消毒后的床头柜表面(4组)进行采样,计算菌落数及进行病原菌检测,并同时进行药物敏感性试验。结果 1、2、3组细菌总数平均值均>10CFU/cm2,4组细菌总数均达标;各组病原菌检出率分别为1组41.4%、2组40.0%、3组31.1%、4组5.0%,3组低于1、2组,4组明显低于1、2、3组,各组之间差异有统计学意义(P<0.05);各组病原菌以鲍氏不动杆菌检出率最高,占50.82%,其次为金黄色葡萄球菌,占18.03%,与同时期患者感染的菌种相比,床头柜革兰阴性菌的耐药率普遍低于临床患者。结论应重视环境的清洁和消毒工作,加强卫生学监测,有效预防与控制因环境污染所造成的医院感染的发生。

OBJECTIVE To investigate the status of bacterial contamination on the surfaces of bedside cabinets and understand the correlation between the pathogens and the nosocomial infections so as to provide basis for the prevention and control of nosocomial infections. METHODS The surfaces of bedside cabinets of the patients with bacterial infections （group 1）, the surfaces of bedside cabinets near those of the patients with bacterial infections （group 2）, and the surfaces of bedside cabinets of the patients without bacterial infections were sampled with the use of cotton swab pour method, and the surfaces of bedside cabinets were disinfected by using 84 disinfectant （group 4）, then the bacterial colony counts were calculated, the pathogens were detected and identified, and the drug susceptibility testing was performed. RESULTS The average bacterial colony counts of the group 1, 2 and 3 were more than 10 CFU/cm2 , the bacterial colony counts of all the four groups were qualified. The isolation rate of the pathogens was 41.4% in the group 1, 40.0% in the group 2, 31.1% in the group 3, 5.0% in the group 4; the isolation rate of the pathogens of the group 3 was lower than that of the group 1 or the group 2, and the isolation rate of the pathogens of the group 4 was significantly lower than that of the group 1, 2 or 3, the difference was statistically significant （P〈0. 05）. The detection rate of the Acinetobacter baumannii was the highest （50.82%）, followed by the Staphylococcus aureus （18. 03%）. As compared with the pathogens causing infections during the same period, the drug resistance rates of the gram-negative bacteria isolated from the bedside cabinets were generally lower than those from the clinical patients. CONCLUSION It is necessary to focus on the environmental cleaning and disinfection and enhance the hygiene monitoring so as to effectively prevent and control the nosocomial infections due to the environmental pollution.