综合干预前后ICU床旁笔记本电脑键盘及鼠标细菌学监测

Bacterial monitoring on ICU bedside notebook computer keyboards and mice before and after comprehensive intervention

目的探讨综合干预措施对减少重症监护病房（ICU）工作用床旁笔记本电脑键盘及鼠标细菌定植的效果。方法针对ICU工作用床旁笔记本电脑键盘及鼠标污染情况,制定相应综合干预措施（包括每日两次用乙醇定期擦拭消毒电脑键盘及鼠标,强化手卫生,监控洗手依从性）,对干预前后的笔记本电脑键盘及鼠标进行环境卫生学采样,并对比分析细菌检测结果。结果干预前ICU床旁笔记本电脑键盘和鼠标菌落计数,8份样本〉5 CFU/cm2,其中枯草杆菌检出率为64.71%,微球菌、凝固酶阴性葡萄球菌、鲍曼不动杆菌、肺炎克雷伯菌等检出率为17.65%~58.82%;大肠埃希菌和醋酸钙不动杆菌各占5.88%。通过采取综合干预措施后,笔记本电脑的键盘和鼠标样本菌落计数,仅2份〉5 CFU/cm2,干预后监测合格率为88.24%,显著高于干预前的52.94%（χ2=5.10,P〈0.05）。结论综合干预措施可明显减少ICU工作用床旁笔记本电脑键盘及鼠标的细菌数,减少医院感染发生。

Objective To evaluate the effect of comprehensive intervention measures on reducing the bacterial colonization of the intensive care unit（ICU）bedside notebook computer keyboards and mice.Methods According to bacterial contamination of ICU bedside notebook computer keyboards and mice,comprehensive intervention measures were taken（including wiping computer keyboards and mice with alcohol twice a day,intensifying hand hygiene,and monitoring hand-washing compliance）,specimens of keyboards and mice were taken,bacterial detection results were analyzed.Results Before intervention,bacterial counts of keyboards and mice of 8 specimens were all5 CFU/cm2,detection rate of Bacillus subtilis was 64.71%,Micrococcus,coagulase negative staphylococcus,Acinetobacter baumannii,and Klebsiella pneumoniae were 17.65%-58.82%,Escherichia coli and Acinetobacter calcoaceticus were both 5.88%.After comprehensive intervention measures were taken,bacterial counts of only two specimens of keyboards and mice were 5 CFU/cm2,the qualified rate of monitoring result after intervention was significantly higher than before intervention（88.24% vs 52.94%;χ2=5.10,P0.05）.Conclusion Comprehensive intervention measures can significantly reduce bacterial count on ICU bedside notebook computer keyboards and mice,and decrease the occurrence of healthcare-associated infection.