ATP生物荧光检测法在软式内镜清洗质量监测中的应用研究

Study on the Application of ATP Bioluminescence Technology in the Cleaning Quality Monitoring of Flexible Endoscope

目的探究三磷酸腺苷(adenosine-triphosphate,ATP)生物荧光检测技术评价软式内镜清洗质量的可行性。方法随机抽取2019年5—9月皖南医学院第二附属医院内镜中心处于使用状态的胃镜、支气管镜,每种内镜随机分为A组和B组,A组检测方法为ATP生物荧光检测法,采样时间点为预处理后、漂洗后;B组检测方法为菌落计数法,采样时间点为漂洗后;采样部位为每条内镜的外表面、活检孔、管腔。结果按照软式内镜清洗消毒规范进行预处理和清洗后,两种软式内镜的外表面、活检孔、管腔等部位的ATP值显著下降(P<0.05),合格率均由0上升至90.0%~100%;ATP生物荧光检测法与菌落计数法对软式内镜外表面、活检孔、管腔等部位的检测结果之间秩相关系数rs均在0.4以下,且差异均无统计学意义(P>0.05)。结论ATP生物荧光检测法可作为一种快速、定量的评价方法应用于胃镜、支气管镜等不同系统软式内镜的清洗质量现场评价,但无法确切反映软式内镜清洗后的微生物污染情况。

Objective To explore the feasibility of adenosine triphosphate(ATP)bioluminescence technology to evaluate the cleaning quality of flexible endoscope.Methods Gastroscopes and bronchoscopes in use at the endoscopic center in the The Second Affiliated Hospital of Wannan Medical College from May to September 2019 were randomly selected.Endoscopes were randomly divided into group A and B.The detection method of group A was ATP biofluorescence detection,and the sampling time point was after pretreatment and rinsing;the detection method of group B was colony counting,and the sampling time point was after rinsing;the sampling site was the outer surface,biopsy hole and lumen of each endoscope;recorded and analyzed the data.Results After standard cleaning,ATP values of the outer surfaces,biopsy holes and lumens of the soft endoscopes decreased significantly(P<0.05).The pass rate had increased from 0 to 90.0%~100%.The rank correlation coefficient rs between the detection results of the outer surface,biopsy hole and lumen by the two detection methods was below 0.4,and there was no statistical significance(P>0.05).Conclusion ATP biofluorescence technology can be used as a rapid and quantitative evaluation method for the on-site evaluation of the cleaning quality of soft endoscopes of different systems such as gastroscopes and bronchoscopes,but it can not accurately reflect the microbial contamination after cleaning.