上海虹口区医疗机构冰箱卫生及管理现况

Hygiene and management status of refrigerators in medical institutions in Hongkou District of Shanghai

目的了解上海虹口区医疗机构医用冰箱的微生物污染及管理情况。方法采用问卷调查法了解各医疗机构的冰箱管理制度,并对冰箱表面进行卫生学采样,计算菌落总数,鉴定微生物种类。结果共调查13所医疗机构71个科室的71台医用冰箱,三级医疗机构30台,二级医疗机构21台,一级及民营医疗机构各10台。71个科室中,制定医用冰箱管理制度的仅占63.38%(45/71);医用冰箱采用数字化温控系统的仅占25.35%(18/71);使用电话/短信报警的占28.17%(20/71);在人员培训方面,进行过冰箱管理培训的科室占49.30%(35/71),15.49%(11/71)的科室未记录冰箱的运行情况,80.28%(57/71)的科室对冰箱实施定期消毒。71台医用冰箱中,2台冰箱表面菌落总数超过10 CFU/cm^2,分别来自检验科和门诊药房;27台冰箱检出真菌,5台冰箱检出金黄色葡萄球菌;4台冰箱检出鲍曼不动杆菌;均未检出大肠菌群。药房、检验科和普通病房医用冰箱表面均检出真菌,并且在药房和普通病房冰箱表面检出金黄色葡萄球菌和鲍曼不动杆菌,ICU1台冰箱表面检出真菌、1台冰箱检出金黄色葡萄球菌。结论医疗机构医用冰箱的管理存在欠缺,应针对不同级别、不同科室、冰箱不同使用情况制定完善的管理制度,加强温度监控及记录,明确医用冰箱的清洁消毒措施与频率。

Objective To understand microbial contamination and management of medical refrigerators in medical institutions in Hongkou District of Shanghai. MethodsA questionnaire survey was conducted to understand the refrigerator management system of various medical institutions, hygienic sampling on refrigerator surface was performed, bacterial colony forming unit was calculated and microbial species were identified. ResultsA total of 71 medical refrigerators in 71 departments of 13 medical institutions were investigated, tertiary, secondary, first level, and private medical institutions were 30, 21, 10, and 10 sets respectively. Of 71 departments, 63.38%（45/71）established medical refrigerator management system; only 25.35% （18/71） of medical refrigerators used digital temperature control system; 28.17% （20/71） used telephone/short message alarming; in terms of staff training, 49.30% （35/71） of departments conducted refrigerator management training, 15.49% （11/71） didn’t record the operation condition of refrigerators, 80.28% （57/71） regularly disinfected refrigerators. Of 71 medical refrigerators, the total number of colonies on surface of 2 refrigerators exceeded 10 CFU/cm2, which was from clinical laboratory and outpatient pharmacy; 27 refrigerators were isolated fungus, 5 isolated Staphylococcus aureus, and 4 isolated Acinetobacter baumannii; coliform group was not found in all refrigerators. Fungus was isolated on surface of medical refrigerators in pharmacy, laboratory, and general wards, Staphylococcus aureus and Acinetobacter baumannii were isolated from surface of refrigerators in pharmacy and general wards, one refrigerator in intensive care unit was detected fungus, and another was detected Staphylococcus aureus. ConclusionManagement of medical refrigerators in medical institutions is not sufficient, perfect management system for different levels, different departments, and different use condition of refrigerators should be formulated, monitoring and recording of temperature should be strengthened, measures and frequency of cleaning and disinfection of medical refrigerators should be clarified.