现用手臂皮肤碘伏消毒方式对不同献血人群消毒效果的研究

Study on disinfection effect of Povidone-iodine disinfection method of arm skin on different donors

目的评价现用手臂皮肤消毒方式对不同献血人群消毒前与消毒后表面微生物分布特征和变化特点,为制定合适的消毒方式或标准提供依据。方法利用接触皿采样法采集200名献血者手臂消毒前后的皮肤表面标本,进行细菌培养,分离纯化后通过基质辅助激光解吸电离飞行时间质谱仪(MALDI-TOF MS)鉴定分析。结果200名献血者皮肤消毒监测结果符合标准;消毒前样本中共检测到49种细菌,其中革兰阳性菌、革兰阴性菌占比分别为75.51%(37/49)和24.49%(12/49),在消毒后样本中共检测到19种细菌,其中革兰阳性菌、革兰阴性菌占比分别为84.21%(16/19)和15.79%(3/19);室内组消毒后细菌残留率明显低于室外组,P<0.05,室内组消毒后残留率最高是鲍曼不动杆菌、洛菲不动杆菌、腐生葡萄球菌、枯草芽孢杆菌、短芽孢杆菌、弯曲芽孢杆菌、疮疱丙酸杆菌。室外组消毒后残留率最高是环状芽孢杆菌、头葡萄球菌、溶血葡萄球菌。组间比较表明,室外组皮肤消毒后头葡萄球菌和表皮葡萄球菌的残留率明显高于室内组,P均<0.05。结论尽管现用手臂皮肤消毒方式能获得符合标准的消毒效果,但消毒后仍有细菌残留,细菌残留率及残留微生物种类可能与献血者的工作环境相关,本研究也可为相关标准或规程的制定提供参考依据。

Objective To evaluate the characteristics and changes of microbial distribution on the surface before and after disinfection of different donor populations with the existing blood donor arm skin disinfection methodand to provide a basis for the development of appropriate disinfection methods or standards.Methods The skin surface specimens of 200 blood donors before and after disinfection were collected by contact dish sampling,cultured and purified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS).Results The results of skin disinfection monitoring of 200 donors met the criteria;A total of 49 bacterial species were detected in the pre-disinfection samples,of which Gram-positive and Gram-negative bacteria accounted for 75.51%(37/49)and 24.49%(12/49),respectively,and 19 bacterial species were detected in the post-disinfection samples,of which Gram-positive and Gram-negative bacteria accounted for 84.21%(16/19)and 15.79%(3/19),respectively;the indoor group The residual rate of bacteria after disinfection was significantly lower than that of the outdoor group,P<0.05.The highest residual rates after disinfection in the indoor group were Acinetobacter baumannii,Acinetobacter loftii,Staphylococcus saprophyticus,Bacillus subtilis,Campylobacter and Propionibacterium spp.The highest residual rates after disinfection in the outdoor group were Bacillus cereus,Staphylococcus cephalosus and Staphylococcus haemolyticus.Comparison between groups showed that the residual rates of Cephalococcus and Staphylococcus epidermidis after skin disinfection in the outdoor group were significantly higher than those in the indoor group,and the P values were<0.05.Conclusion Although the current arm skin disinfection method can achieve the standard disinfection effect,there are still bacterial residues after disinfection,and the bacterial residue rate and residual microbial species may be related to the working environment of donors,this study can also provide a reference basis for the development of relevant standards or protocols.