医务人员手术鞋血液及微生物污染情况调查

Blood and microbial contamination of surgical shoes of health care workers

目的对医务人员手术鞋的血液及微生物污染情况进行调查,为手术鞋的清洗消毒提供理论依据。方法2020年4—5月,连续3周从某院手术室内随机挑选清洗消毒后的手术鞋共80双,按照鞋子所属工作人员的类别(手术医生、护士、麻醉师和保洁人员)分为4类,采用肉眼观察与隐血测试两种方法调查鞋面血渍污染情况,以及采用接触印迹法对鞋底采样进行细菌和真菌培养。结果隐血测试结果显示50.00%(40/80)的手术鞋被血液污染,其中手术医生的鞋面被血液污染的比率最高,达63.33%。细菌菌落计数显示保洁人员的手术鞋微生物污染严重,细菌和真菌计数均位于首位,分别为93、58 CFU/cm^(2)。评估隐血测试与肉眼观察两种方法,结果显示胶体金免疫层析隐血测试方法的灵敏度为85.00%,特异度为70.00%。有6只鞋为假阴性,12只鞋为假阳性。肉眼观察的阳性率为57.50%,隐血试验的阳性率为50.00%,两种方法的阳性率比较,差异无统计学意义(P>0.05)。结论医务人员手术鞋血液和微生物污染严重,需加强清洁与消毒,重视手术鞋作为病原微生物隐匿宿主传播的风险。

Objective To investigate blood and microbial contamination of surgical shoes of health care workers(HCWs),and provide theoretical basis for the cleaning and disinfection of surgical shoes.Methods From April to May in 2020,80 pairs of surgical shoes after cleaning and disinfection were randomly selected from the operating room of a hospital for three consecutive weeks,according to shoes used by different staff(surgeons,nurses,anesthesiologists and cleaners),shoes were divided into four categories,blood contamination on instep of shoes was investigated by naked eye observation and occult blood test,specimen of sole taken by contact imprinting method were performed bacterial and fungal culture.Results Occult blood test result showed that 50.00%(40/80)of the surgical shoes were contaminated by blood,contamination rate of instep of surgeons’shoes were the highest,accounting for 63.33%.Bacterial colony count showed that operating shoes of the cleaners were seriously contaminated by microorganisms,bacterial and fungal counts were the highest,which were 93 CFU/cm2 and 58 CFU/cm^(2) respectively.Occult blood test and naked eye observation were evaluated,thee results showed that sensitivity and specificity of detection of occult blood by colloidal gold immunochromatography assay were 85.00%and 70.00%respectively.Six shoes were false negative and 12 shoes were false positive.The positive rate of naked eye observation was 57.50%,and that of occult blood test was 50.00%,there was no significant difference between two methods(P>0.05).Conclusion Blood and microbial contamination of HCWs’operating shoes is serious,it is necessary to strengthen cleaning and disinfection,and pay attention to the risk that operating shoes may be the hidden host of pathogenic microbial transmission.