采用ATP生物荧光法对46所医院ICU环境物体表面洁净度的检测分析

Application of ATP bioluminescence assay in test of cleanliness of objects surfaces in ICUs of 46 hospitals

目的了解上海市46所医院ICU环境物体表面的洁净度状况,以预防控制多药耐药菌的播散。方法对ICU医务人员手频繁接触的环境物体表面采样,用三磷酸腺苷(ATP)生物荧光法进行检测,评估其洁净度。结果 46所医院共计采集450份标本,ATP读数范围为5~197 584RLU,以<250RLU为洁净度合格标准,本次检测标本的平均合格率为37.1%;按医院类型分类,二级医院合格率37.3%,三级医院36.9%;按环境物体表面类型分类,仪器面板及表面合格率47.3%,各类把手33.8%,电脑键盘及鼠标20.0%,各类台面30.0%,电话机13.8%,水龙头手柄63.2%,其他物体表面39.3%。结论 ATP生物荧光检测法显示,上海市医院ICU环境物体表面洁净度状况不理想,是医院感染管理和多药耐药菌预防控制的重要隐患,如何加强常规清洁消毒工作,有效提高医院环境物体表面的整体洁净度,亟待重视。

OBJECTIVE To investigate the current status of cleanliness of objects surfaces in the ICUs of 46 hospi- tals of Shanghai. so as to prevent the transmission of multi-drug resistant bacteria. METHODS The samples were collected from the objects surfaces that the hands of the ICU medical staff frequently contacted, then the adenosine triphosphate （ATP） bioluminescence assay was performed for the test, and the cleanliness was evaluated. RESULTS A total of 450 samples have been collected from 46 hospitals, the ATP bioluminescence reading ranged from 5 to 197584 RLU, and the average passing rate was 37.1% when the cuff off value of less than 250 RLU was regarded as the eligible criteria for cleanliness. As for the classification of the hospitals, the passing rate of second- ary hospitals reached 37.3~, the tertiary hospitals 36.9%. As for the classification of types of the objects sur- faces, the passing rate of the surfaces of the instrument panel was 47.3 ~z^0, the handles 33.8~/~, the keyboards and mice 20.0%, the countertops 30.0%, the telephones 13.8~, the faucet handles 63.2%, other objects 39.3%. CONCLUSION Given the findings of the ATP bioluminescence assay, the current situation of cleanliness of objects surfaces of the ICUs in Shanghai is not satisfactory, which can turn to be an important hidden trouble for control of nosoeomial infections and prevention of multidrug-resistant bacteria. Great attention should be paid to the rou- tine cleaning and disinfection so as to effectively improve the overall cleanliness of the environmental objects sur- faces.