内镜消毒质量对降低胃肠镜室医院感染的影响

Influence of disinfection quality of endoscopes on reduction of incidence of nosocomial infections in gastrointestinal endoscopy room

目的探讨内镜消毒质量对降低胃肠镜室医院感染率的影响,为临床内镜消毒工作的开展予以合理的指导。方法按照《消毒技术规范》及《内镜清洗消毒技术操作规范》对胃肠镜室进行整改,并对整改前后胃肠镜室内胃肠镜及相关物品与环境采样检测,分析整改前后于医院治疗的100例患者医院感染发生率。结果整改后消毒与诊疗分室、专人消毒、消毒人员培训、使用防护用具方面有了较大改善(P<0.05),合格率从原来的56.9%、64.6%、20.0%、27.7%均提升至100.0%;整改后内镜室胃肠镜、其他辅助器械、消毒液、清洗用水、无菌水、消毒槽、空气的消毒合格率显著提高,整改后除空气合格率为93.3%外,其余均>95.0%,其中消毒槽与清洗用水最显著(P<0.05);整改后内镜室消毒槽的大肠菌群及其他细菌的检测合格率显著提高(P<0.05),合格率从原有的81.7%、88.3%、91.7%均提升至100.0%;整改后患者细菌感染的发生率显著下降至2.0%(P<0.05)。结论内镜消毒质量直接影响医院感染的发生,由于整改后内镜消毒质量的大幅提高,接受内镜检查的患者医院感染发生率显著下降。

OBJECTIVE To explore the impact of disinfection quality of endoscopes on reduction of incidence of nosocomial infections in gastrointestinal endoscopy room so as to provide guidance for reasonable clinical disinfection of endoscopes.METHODS The gastrointestinal endoscopy room was rectified according to the Technical standards for disinfection and Technical standards for cleaning and disinfection of endoscopes;the gastrointestinal endoscopes,relevant objects,and environment of the gastrointestinal endoscopy room were respectively sampled before and after the rectification,and the incidence of nosocomial infections in 100 patients who were treated in the hospital was observed and compared before and after the rectification.RESULTS The allocation of disinfection room and treatment room,disinfection by specially-assigned person,training of disinfection personnel,and use of protective equipments were improved significantly after the rectification（P〈0.05）,with the qualified rates respectively increasing from 56.9%,64.6%,20.0%,and 27.7%to 100.0%.The qualified rates of disinfection of the gastrointestinal endoscopes,relevant assistive equipments,disinfectants,cleaning water,sterile water,disinfection tank,and air in the gastrointestinal endoscopy room were remarkably increased after the rectification,all of which were more than 95.0%except for the qualified rate of disinfection of air（93.3%）,and the qualified rates of disinfection of the disinfection tank and cleaning water were improved most significantly（P〈0.05）.The qualified rates of detection of the coliforms and other bacteria in the disinfection tank were remarkably increased after the rectification of the gastrointestinal endoscopy room（P〈0.05）,with the qualified rates increasing from 81.7%,88.3%,and91.7%to 100.0%.The incidence of bacterial infections significantly decreased to 2.0% after the rectification（P〈0.05）.CONCLUSION The disinfection quality of endoscopes can directly influence the incidence of nosocomial infections,and the substantial improvement of the disinfection quality of endoscopes may contribute to the significant reduction of incidence of nosocomial infections in the patients undergoing endoscopy.