二氧化氯消毒剂用于重症监护室鲍氏不动杆菌终末消毒的效果

Effect of chlorine dioxide disinfectant on terminal disinfection of Acinetobacter baumannii in intensive care unit

目的 探讨次氯酸消毒剂与二氧化氯消毒剂对重症监护室(ICU)鲍氏不动杆菌(Ab)的杀灭效果。方法 2019年2月-12月按照安徽医科大学第一附属医院ICU环境左右格局分为对照组与研究组,选择鲍氏不动杆菌感染患者出院或转科后床单位周围环境进行消毒前后采样,共随机采样200份。对照组采用500 mg/L次氯酸消毒剂进行终末清洁消毒,研究组采用100 mg/L二氧化氯消毒剂进行终末清洁消毒,消毒前后30 min,对对照组与研究组周围环境进行采样,比较两组消毒液对Ab的清除效果。另外,通过悬液定量杀菌实验,研究两种消毒剂对Ab的杀灭作用,并与Ab的标准菌株进行比较。结果 对照组在消毒前、消毒后分别采样100份标本,结果Ab检出率分别是33.00%、15.00%,细菌检出率呈下降趋势,差异有统计学意义(P<0.05),研究组在消毒前、消毒后分别采样100份标本,Ab检出率分别是36.00%、9.00%,检出率呈降低的趋势,差异具备统计学意义(P<0.05)。消毒后研究组Ab检出率低于对照组,差异具备统计学意义(P<0.05)。对照组作用5 min对Ab的平均杀灭对数值>5.00,比标准菌株高。研究组3 min对Ab的平均杀灭对数值>5.00,与标准菌株一致。结论 次氯酸消毒剂与二氧化氯消毒剂在终末消毒中均具有良好的消毒效果,但二氧化氯对Ab的杀灭率高于次氯酸。Ab对二氧化氯未形成抗性,对次氯酸则可能形成抗性。二氧化氯消毒剂是一类高效、安全的杀菌剂,适合用于医院耐药菌的感染控制。

OBJECTIVE To explore the effects of hypochlorous acid disinfectant and chlorine dioxide disinfectant on disinfection of Acinetobacter baumannii in intensive care unit(ICU). METHODS From Feb 2019 to Dec 2019, the ICUs were divided into the study group and the control group by the First Affiliated Hospital of AnHui Medical University according to the left-right pattern of ward environment. The surroundings of bedsheets were sampled from patients with A.baumannii infection who were discharged or transferred before and after the disinfection, and totally 200 samples were randomly collected. The control group was treated with 500 mg/L of hypochlorous acid disinfectant for terminal disinfection, the study group was treated with 100 mg/L of chlorine dioxide disinfectant for terminal disinfection. The surroundings were sampled from the control group and the study group before the disinfection and after the disinfection for 30 min. The eradication rate of A.baumannii was compared between the two groups. The effects of the two types of disinfectants on eradication of A.baumannii were observed by suspension quantitative bactericidal test and were compared with the standard strain of A.baumannii. RESULTS Totally 100 samples were respectively collected from the control group before and after the disinfection, the isolation rates of bacteria were respectively 33.00% and 15.00%, which showed downward trends, and there was significant difference(P<0.05). Totally 100 samples were respectively collected from the study group before and after the disinfection, the isolation rates of bacteria were respectively 36.00% and 9.00%, which showed downward trends, and there was significant difference(P<0.05). The isolation rate of A.baumannii of the study group was lower than that of the control group after the disinfection, and there was significant difference(P<0.05). The average killing logarithm of the disinfectant on A.baumannii by acting for 5 min was more than 5.00 in the control group, higher than that the standard strain. The average killing logarithm of the disinfectant on A.baumannii by acting for 3 min was more than 5.00, consistent with the standard strain. CONCLUSION Both hypochlorous acid and chlorine dioxide can achieve favorable effects on the terminal disinfection, the eradication rate of A.baumannii of the chlorine dioxide is higher than that of the hypochlorous acid. The A.baumannii is not resistant to chlorine dioxide but may be resistant to chlorine-containing disinfectant. The chlorine dioxide disinfectant is a safe and highly effective bactericide and is suitable for control of drug-resistant bacteria infections in hospitals.