两种清洗消毒方式对消化内镜消毒的效果

Effects of two kinds of cleaning and disinfection methods on digestive endoscope disinfection

目的观察过氧乙酸对模拟内镜管腔和软式内镜现场的消毒效果。方法采用悬液定量杀菌试验、模拟现场消毒试验和现场消毒试验方法,研究过氧乙酸对细菌繁殖体和细菌芽孢的消毒效果,同时对消化内镜模拟现场和现场消毒效果进行观察。结果过氧乙酸消毒液原液含过氧乙酸2 000mg/L。以过氧乙酸浓度为2 000mg/L的消毒液作用0.5min,过氧乙酸浓度为50mg/L的消毒液作用1min,过氧乙酸浓度为25mg/L的消毒液作用3min,对悬液内铜绿假单胞菌作用2.5min,杀灭对数值均>5.00。以过氧乙酸浓度为2 000 mg/L的消毒液作用1min,对悬液内枯草杆菌黑色变种芽胞的杀灭对数值>4.00。以过氧乙酸浓度为2 000mg/L的消毒液,手工清洗蠕动泵消毒和内镜清洗机上运行一个消毒周期(总运行时间为15 min,含消毒程序5 min),对模拟管腔内铜绿假单胞菌杀灭对数值均>5.00;对模拟管腔内枯草杆菌黑色变种芽胞杀灭对数值均>4.00。以过氧乙酸浓度为2 000 mg/L的消毒液消毒消化内镜,手工清洗的合格率为75.56%,内镜清洗机的合格率为100.00%。过氧乙酸消毒液对不锈钢片、铝片、铜片基本无腐蚀,对碳钢片有轻度腐蚀。结论该过氧乙酸消毒液可快速杀灭悬液内细菌繁殖体、细菌芽胞,并能快速杀灭模拟管腔内壁上的微生物。使用过氧乙酸消毒液清洗消毒机现场消毒试验消毒效果比手工清洗更可靠。

OBJECTIVE To observe the disinfection effect of peracetic acid on analog endoscopic lumen and the scene of soft endoscope.METHODS The suspension quantitative germicidal test and simulated field disinfection test and on-site disinfection test method were used to study the disinfection effect of peracetic acid on bacterial reproductive body and spore,and to observe the disinfection effect on simulated and actual site of digestive endoscope.RESULTS Disinfectant stock solution contained 2 000 mg/L of peracetic acid.Disinfection with 2 000 mg/L of peracetic acid for 〉0.5 min,or 50 mg/L of acetic acid peroxide for 1 min,or 25 mg/L of acetic acid peroxide for 3 min all gave a killing log value of 5.0 for the Pseudomonas aeruginosa suspension.Disinfection with 2 000 mg/L of peracetic acid for 1 min resulted in a killing log value of〉4.00 for the spore suspension of Bacillus subtilis var.niger.Concentration of 2000 mg/L with peracetic acid detergent,Disinfection of peristaltic pump by manual cleaning running a sterilization cycle on the endoscope cleaning machine（with a total running time of 15 min,including 5 min of disinfection）with 2 000 mg/L of peracetic acid both led to killing log values of respectively 〉5.00 and〉4.00 for P.aeruginosa and spores of B.subtilis var.niger in simulated pipe cavity.Disinfection of digestive endoscopy using2 000 mg/L of peracetic acid gave a percent of pass of 75.56% in manual cleaning,whereas the rate reached 100.00% when an endoscope cleaning machine was used.Peracetic acid was non-corrosive for stainless steel,aluminum,and copper sheets,whereas caused mild corrosion for carbon steel sheets.CONCLUSION The peracetic acid disinfectant can quickly kill the vegetative forms and spores of bacteria in suspension,as well as the microorganisms on the lumen of simulated cavity.Disinfection with a cleaning machine using peracetic acid as the disinfectant showed better effect than manual cleaning in field tests.