全国492所医疗机构胃肠镜微生物学监测现况调查

Current status of microbiological monitoring of gastroenteroscopes in 492 medical institutions of China

目的调查全国医疗机构胃肠镜微生物学监测现况。方法采用便利抽样法,于2022年11月27日-2022年11月30日对全国492所医疗机构消化内镜中心的胃肠镜微生物学监测执行情况、监测频率、采样方法以及结果判定等方面进行问卷调查。结果492所医疗机构覆盖我国27个省级行政区,79.07%为三级医疗机构,20.93%为二级医疗机构。98.37%医疗机构对内镜执行了微生物学监测,其中2.89%机构执行每年1次,54.13%机构每季度1次监测,40.50%机构每月1次,1.86%机构每周1次。各医疗机构使用的采样液主要为中和剂(60.74%),采样方法主要为普通冲洗采样法(83.47%),泵辅助采样法和刷辅助采样法仅占5.99%和6.61%,大部分机构(96.90%)均对活检腔道采样。60.33%医疗机构以活检腔道微生物学监测的结果作为判定指标,且45.04%机构在培养结果未出来前直接使用内镜。结论各医疗机构在执行内镜微生物学监测仍旧存在一定的偏差,对内镜微生物学监测标准还有待进一步细化和规范,应针对不同的内镜类型及风险等级建立微生物学监测标准,推进内镜质量监测的有效实施与执行。

OBJECTIVE To investigate the current status of microbiological monitoring of gastroenteroscopes in China.METHODS By means of convenience sampling method,aquestionnaire survey was conducted for the microbiological monitoring of gastroenteroscopes in 492medical institutions from Nov 27,2022to Nov 30,2022,including the status of execution,frequency of monitoring,sampling methods and result determination.RESULTS The 492medical institutions covered 27provincial-level administrative regions,79.07%of which were tertiary medical institutions,and 20.93%were secondary medical institutions.98.37%of the medical institutions have carried out the microbiological monitoring for the endoscopes,2.89%of which carried out once a year,54.13%carried out once per quarter,40.50%carried out once per month,and 1.86%carried out once per week.Neutralizer was the most commonly used sampling solution by the medical institutions,accounting for 60.74%;the common rinse sampling was the major sampling method,accounting for 83.47%,while,the pump assisted sampling and brush assisted sampling only accounted for 5.99%and 6.61%,respectively.Most of the medical institutions(96.90%)sampled from biopsy cavities.60.33%of the medical institutions took the result of microbiological monitoring for the biopsy cavities as the determination indexes,and 45.04%of the medical institutions used endoscopes without the culture result came out.CONCLUSIONThere are still some deviations in implementing the microbiological monitoring of endoscopes.It is necessary to further refine and standardize the microbiological monitoring and establish the standards for the microbiological monitoring based on the type of endoscope and grade of risk so as to push forward the effective implementation of quality monitoring of endoscopes.