医用超声探头及耦合剂微生物污染调查及分析

Investigation and analysis on bacterial contamination of medical ultrasound probes and coupling agents

目的 了解超声探头及耦合剂的微生物污染状况及存在的问题。方法 通过现场抽样检测方法,对广州市21家省市级医院的体外超声探头、阴道超声探头、阴道超声探头覆盖物及不同类型耦合剂进行采样,实验室进行活菌计数和致病菌鉴定。通过问卷调查方式,了解超声探头在使用过程中的感染防控措施。结果 抽检71份体外超声探头、16份阴超探头和16份避孕套样品,合格率分别为98.6%、85.7%和100%。使用中、未开启非消毒型耦合剂和21份消毒/灭菌型耦合剂,合格率分别为21.7%、38.1%和100%。非消毒型耦合剂中的污染菌主要为黏质沙雷菌和洋葱伯克霍尔菌,2份使用中非消毒型耦合剂检出铜绿假单胞菌。体外超声探头和阴道超声探头在临床使用中选用含消毒剂纸巾擦拭的分别占38.1%和61.5%,有30.8%的医院阴道超声探头未使用无菌型耦合剂。结论 非消毒型耦合剂细菌、真菌含量超标严重,存在院内感染的风险。

Objective To investigate the microbial contamination status and problems of ultrasonic probes and coupling agents. Methods Through field sampling methods, in vitro ultrasound probes, vaginal ultrasound probes, covers of vaginal ultrasound probe and different types of couplants in 21 provincial and municipal hospitals in Guangzhou were sampled, and viable bacteria counting and pathogenic bacteria identification were carried out in the laboratory. The infection prevention and control measures of ultrasound probes were investigated by questionnaire survey. Results 71 ultrasound probes in vitro, 16 vaginal ultrasound probes and 16 condom samples were collected. The pass rates were 98.6%, 85.7% and 100%, respectively. Samples including 23 non-disinfecting couplants in use, 21 sealed non-disinfecting couplants and 21 disinfectant/sterilization couplants were collected, and the qualification rates were 21.7%, 38.1% and 100%, respectively. The contaminating bacteria in the non-disinfectant couplant were mainly Serratia marcescensis and Burkhallella cepacia, and Pseudomonas aeruginosa was detected in 2 batches using non-disinfectant couplant. In vitro ultrasound probes and vaginal ultrasound probes, 38.1% and 61.5% of them used disinfectant-containing wipes in clinical use, and 30.8% of hospital vaginal ultrasound probes did not use sterile couplant. Conclusion The contents of bacteria and fungi in non-disinfectant couplant exceed the standard seriously, and there is a risk of nosocomial infection.