ATP生物荧光法在ICU环境物体表面清洁消毒效果评价中的应用

Application of ATP bioluminescence method in the evaluation of surface cleaning and disinfection in ICU

目的采用ATP生物荧光法检测ICU环境物体表面清洁消毒质量,探讨集束化干预措施的效果,以预防多药耐药菌的传播。方法 2013年6月-2016年7月对某三级医院ICU医务人员手高频接触物体表面(各类仪器面板及表面,各类台面,门把手,电脑鼠标及键盘等)的清洁消毒效果进行采样监测,2015年1月起依据ATP生物荧光法检测数据,在ICU实行集束化干预措施,比较干预前后物体表面清洁消毒效果,应用SPSS16.0软件进行统计分析,率的比较采用χ2检验。结果采用集束化干预后,ICU物体表面ATP生物荧光检测合格率由20.8%提高至44.0%,差异有统计学意义(P<0.05);共采样147份标本,ATP读数以<100RLU/100cm2为洁净度合格标准,按环境物体表面类型分类,各类仪器面板及表面合格率33.3%,各类台面52.4%,门把手33.3%,电脑鼠标及键盘15.5%,电话机0,其他表面38.5%,四类物体表面洁净度最差的前3位采样点数据范围为377~9740RLU/100cm2。结论 ATP生物荧光法监测数据显示,集束化干预在ICU环境物体表面清洁消毒中的应用效果显著,但整体清洁效果仍不理想,是医院感染管理和多药耐药菌预防控制的重要隐患,应加强常规清洁消毒工作,提高环境物体表面整体洁净度。

OBJECTIVE By application of ATP bioluminescence method in detection of the quality of surface cleaning and disinfection in ICU,to investigate the effect of cluster intervention,so as to prevent the spread of multidrug resistant bacteria.METHODS From Jun.2013 to Jul.2016,the cleaning and disinfection effects of the surfaces which ICU medical staff in a tertiary hospital touched with high frequency by hands（various types of instrument panel and surface,all kinds of countertops,door handles,computer mouse and keyboard,etc.）were sampled and monitored,and were detected by ATP biological fluorescence from Jan.2015.Cluster intervention measures were implemented in ICU.The cleaning and disinfection effects before and after the intervention were compared,SPSS16.0software was used for statistical analysis,and the rates were compared byχ2-test.RESULTS After the use of cluster intervention measures,the qualified rate of surfaces in ICU by ATP biofluorescence was increased from 20.8%to 44.0%,and the difference was significant（P〈0.05）.A total of 147 samples were sampled.Using ATP scores〈100RLU/100cm2 as cleanliness criteria,and classifying by environmental object surface,the qualified rates of instrument panel and surface,countertop,door handles,computer mouse and keyboard,telephone,and other surfaces were 33.3%,52.4%,33.3%,15.5%,0%,and 38.5%,respectively.The top three sampling sites with the worst surface cleanliness of the four types of objects were 377~9740RLU/100cm2.CONCLUSION ATP bioluminescence monitoring data show that,the effects of application of cluster intervention in the cleaning and disinfection of ICU environmental object surface are significant,but the overall cleaning effect is still not ideal,and it is the important hidden danger for hospital infection management and multidrug resistance prevention and control.How to strengthen routine cleaning and disinfection work to improve the overall surface cleanliness of environmental objects still needs to explore.