嗜热脂肪杆菌芽孢极速生物监测在手术器械管理中的应用

Application of rapid biological monitoring for bacillus stearothermophilus spore in the management of surgical instruments

目的对4种类型的嗜热脂肪杆菌芽孢试剂进行应用对比，为手术器械的安全管理提供依据。方法2015年9—12月对河南省焦作市人民医院消毒供应中心常用的4种类型的嗜热脂肪杆菌芽孢试剂进行研究，包括北京四环SSI．K31型嗜热脂肪杆菌芽孢菌片（普通菌片类）、北京四环自含式嗜热脂肪杆菌芽孢试剂（48h自含式试剂）、美国3M公司1292生物指示剂（3M1292）、美国3M公司1492生物指示剂（3M1492），经132℃、480s压力蒸汽灭菌后进行培养，根据不同试剂类型，在不同时间得出培养结果，调整抽真空次数和灭菌时间，记录分析芽孢杀灭情况。结果在4种类型实验管培养中，普通菌片易受其他因素影响出现差异性，其他3种自含式试剂的培养结果一致；普通菌片用时最长，3M1492用时最短。结论普通菌片利用7d菌片培养细菌，在移植过程中有潜在污染机会，易造成假阳性结果。利用自含式芽孢生物指示剂可避免假阳性结果产生，方便快捷。极速生物监测能在最短时间判读监测结果，可以实现手术器械的无缝对接，加快周转，实用价值更高。

Objective To compare the applications of four types of bacillus stearothermophilus spore reagents, in order to provide basis for the safe management of surgical instruments. Methods From September to December 2015, four types of bacillus stearothermophilus spore reagents that were often used in the disinfection supply center of Jiaozuo People＇s Hospital of He＇nan province were investigated. They were SSI. K31 type bacillus stearothermophilus spore tablet of Beijing Sihuan （common bacterial tablet）, self-contained Bacillus stearothermophilus spore reagent of Beijing Sihuan （48 h self-contained agent）, 1292 biological reagent of American 3M company （3M1292）, and 1492 biological reagent of American 3M company （3M1492）. They were cultured by steam sterilization of 132℃ for 480 seconds. The culture results were obtained at different time according to the different types of reagents. The number of vacuum and sterilization time were adjusted. The spore killing situation was recorded and analyzed. Results In the experimental tube culture of four types bacillus stearothermophilus spore reagents, the difference occurred in the common bacterial tablets because they were susceptible to other factors. The culture results of three self-contained reagents were in agreement. The time of common spore tablets was the longest. The time of 3M1492 was the shortest. Conclusions For common bacterial tablets, 7 days is needed for the bacterial culture. In the transplantation process there is potential contamination chance, which might result in false positive results. The application of self-contained spore biological reagents can avoid false positive results and it is convenient and fast. The super rapid biological monitoring can interpret monitoring results in the shortest time so that the seamless joint of the surgical instruments can be achieved, which speeds up the turnover and produces higher practical value.