软式内镜一元过氧乙酸消毒液消毒效果

Effect of monobasic peracetic acid on disinfection of flexible endoscopes

目的评价一元低腐蚀性过氧乙酸消毒液对通过建立铜绿假单胞菌生物膜模型的内镜钳子管道的消毒和生物膜去除效果,并观察验证过氧乙酸消毒液消毒的有效性和时效性。方法生物膜去除效果检测选取奥林帕斯内镜售后服务机构集中回收的临床已使用的内镜钳子管10条搭建生物膜模型后采用过氧乙酸浸泡后抽样。临床观察消毒液有效性和时效性,选取2019年1-12月300条胃镜和300条肠镜作为研究对象,采用过氧乙酸消毒液消毒,统计内镜消毒效果;比较每条内镜连续5 d经步骤a、b来采集样本以检测管道表面附着情况。比较连续使用14 d,浸泡212条内镜后消毒效果。结果内镜钳子管道经过刷洗+过氧乙酸杀灭5 min和15 min,细菌培养无菌生长,生物膜有效去除。胃镜消毒后菌落数平均为(9.362±2.621)CFU低于消毒前菌落数(P<0.001),胃镜消毒合格率为100.00%(300/300)。肠镜消毒后菌落数为0 CFU低于消毒前(P<0.001);肠镜消毒合格率为100.00%。连续使用过程中采集天数对菌落数目无明显影响,且采集天数、采集步骤的交互作用对菌落数目无明显影响。连续使用14 d后浓度仍>1 000 mg/L,为有效浓度,消毒后内镜抽样合格率为100.00%。结论过氧乙酸消毒液在软式内镜消毒中具有较好效果,能有效去除生物膜,具有较高安全性。

OBJECTIVE To evaluate the disinfection and biofilm removal effect of unitary low corrosive peracetic acid disinfectant on the endoscopic forceps tube through the establishment of Pseudomonas aeruginosa biofilm model, and to verify the effectiveness and timeliness of disinfection of the peracetic acid disinfection. METHODS Totally 10 pieces of clinically used endoscopic forceps tube collected by Olympus endoscope after-sales service agency were selected to build biofilm model and then sampled after soaking in peracetic acid to test the biofilm removal effect. From Jan. 2019 to Dec. 2019, 300 gastroscopes and 300 colonoscopes were selected as the research objects, peracetic acid disinfectant was used for disinfection, the disinfection effect was calculated and the effectiveness and timeliness of disinfectant was clinically observed. Each endoscope was compared for 5 consecutive days after the steps a, b method of samples collection, and the attachment of the pipe surface was detected. The disinfection efficacy of 212 endoscopes after continuous use for 14 days was compared. RESULTS After 5 min and 15 min of brushing and peracetic acid sterilization of the endoscopic forceps tube, the bacteria grew aseptically and the biofilm was effectively removed. The average number of colonies after disinfection of gastroscope was(9.362±2.621) CFU, significantly lower than that before disinfection(P<0.001), and the qualified rate of gastroscope disinfection was 100.0%(300/300). The colony count after colonoscope disinfection was 0 CFU, significantly lower than before disinfection(P<0.001), and the qualified rate of colonoscope disinfection was 100.00%. During continuous use, the number of collection days had no significant effect on the number of colonies, and the interaction between the number of collection days and the collection steps had no significant effect on the number of colonies. After 14 days of continuous use for, the concentration was still more than 1 000 mg/L, which was the effective concentration, and the qualified rate of endoscope sampling after disinfection was 100.00%. CONCLUSION Peroxyacetic acid disinfectant has a good effect in the disinfection of soft endoscopes and can effectively remove the biofilm, as well as the high safety.