重症监护病房环境二氧化氯消毒的效果评价

Effect of chlorine dioxide on cleaning and disinfection of ICU environment

目的 评价二氧化氯溶液对重症医学监护病房(ICU)环境的清洁消毒效果。方法 采用实验研究方法,以2019年3-4月ICU的多药耐药隔离区域环境为基线期,使用500 mg/L含氯消毒剂对物表擦拭清洁消毒;2019年5-6月为干预过渡期,2019年7-12月为干预期,均使用二氧化氯消毒液制取设备制备的80 mg/L~100 mg/L二氧化氯溶液对物表擦拭清洁消毒。对三个阶段该区域高频接触的环境物体表面采样,分析消毒合格率及病原菌检出情况。结果 研究期间,ICU多药耐药菌隔离区域高频接触物表监测合格率均高于92%,过渡期和干预期均高于基线期,呈上升趋势,但比较无统计学差异;基线期、干预过渡期、干预期分别采样266份、364份、450份标本,细菌检出率分别为5.26%、1.92%、1.56%,呈下降趋势(P<0.05);研究期间ICU病房隔离区周围环境中共检出病原菌29株,其中耐碳青霉烯鲍氏不动杆菌17株占58.62%。结论 二氧化氯消毒液制取设备操作简便,制备的80 mg/L~100 mg/L二氧化氯溶液对环境表面具有良好的消毒效果。

OBJECTIVE To investigate the effect of chlorine dioxide solution on cleaning and disinfection of ICU environment. METHODS Using experimental research methods, the environment of multi-drug resistant isolation area in ICU from March to April 2019 was assignedas the baseline period, and 500 mg/L chlorine-containing disinfectant was used for cleaning and disinfection, that from May to June in 2019, the area was considered as the transitional period of intervention, and that from July to December in 2019 was taken as the period of intervention, the 80 mg/L-100 mg/L chlorine dioxide solution prepared by chlorine dioxide disinfectant preparation equipment was used to wipe, clean and disinfect the surface. The surface of environmental objects with high frequency contact in the area at three stages was sampled, the qualification rate of disinfection was analyzed, and the pathogenic bacteria were detected. RESULTS During the study period, the qualified rate of high-frequency exposure monitoring in the isolation area of ICU multidrug-resistant bacteria was higher than 92%, and the transition period and intervention period were higher than the baseline period, showing an upward trend, but the difference was not significant. 266, 364, and 450 samples were taken during the baseline period, the intervention transition period, and the intervention period. The bacteria detection rates were 5.26%, 1.92%, and 1.56%, respectively, showing a downward trend(P<0.05). A total of 29 strains of pathogens were detected in the surrounding environment of the district, of which 17 strains of carbapenem-resistant Acinetobacter baumannii accounted for 58.62%. CONCLUSION The equipment for preparing the chlorine dioxide disinfectant was simple and convenient to operate, and the prepared 80 mg/L-100 mg/L chlorine dioxide solution hadgood disinfection effect on the surface of the environment.