山东省淄博市4家医院洁净手术室空气微生物监测情况及影响因素分析

Analysis on air microbial monitoring and influencing factors in clean operating rooms of 4 hospitals in Zibo city,Shandong province from 2016 to 2020

目的 了解山东省淄博市医院洁净手术室空气微生物负荷状况及其影响因素,为改善洁净手术室空气质量提供依据。方法 2016-2020年选取山东省淄博市医疗机构感染消毒监测的4家监测点医院的层流洁净手术室202间次,包括静态条件下94间次、动态条件下108间次。在静态和动态条件下,对淄博市4家医疗机构百级、千级和万级层流洁净手术室用自然沉降法和仪器采样法两种采样方法进行连续5年的平行监测,检测空气中细菌菌落总数,并分析洁净手术室空气质量不合格的影响因素。结果 2016-2020年医疗机构洁净手术室的空气质量合格率分别为97.50%、92.50%、89.29%、92.50%、100.00%。静态和动态条件下,医疗机构百级、千级、万级洁净手术室分别采用自然沉降法和仪器采样法检测的细菌菌落总数除百级手术区外,差异均有统计学意义(Z=-1.821,P=0.069);两种采样方法结果具有相关性,但相关性较弱(r=0.436,P<0.05)。医疗机构百级、千级、万级洁净手术室空气的总合格率分别是85.00%(51/60)、95.00%(57/60)、98.21%(55/56)。多元线性逐步回归分析结果显示,万级手术室的细菌菌落总数是百级的10.65倍(OR=10.649,P=0.009),仪器采样法细菌菌落总数是自然沉降法的31.61倍(OR=31.609,P=0.000)。结论 2016-2020年淄博市医疗机构不同年份、洁净级别手术室的空气合格率有一定差异,手术室洁净级别、采样方法是洁净手术室空气质量合格率的影响因素。

Objective To understand the status of air microbial load and its influencing factors in clean operating room of Zibo hospital,so as to provide a basis for improving the air quality of clean operating room in the next step.Methods In 2016 to 2020,202 laminar flow clean operating rooms in 4 monitoring point hospitals were selected for infection disinfection monitoring in healthcare institutions in Zibo city,Shandong province,including 94 times under static conditions and 108 times under dynamic conditions.The sedimentation method and the plankton method were used to monitor the laminar flow clean operating room in 4 medical institutions in Zibo city under static and dynamic conditions for 5 consecutive years to detect the total number of bacterial colonies in the air,and analyze the influencing factors of unqualified air quality in clean operating rooms.Results The air quality compliance rates for clean operating rooms in healthcare facilities from 2016 to 2020 were 97.50%,92.50%,89.29%,92.50%,and 100.00%,respectively.Except for 100-grade operating rooms,statistically significant differences were observed in the total number of bacterial colonies detected by the sedimentation method and the planktonic method in 100,1000,and 10000-grade clean operating rooms under both static and dynamic conditions(Z=-1.821,P=0.069).The results of the 2 sampling methods were correlated,but the correlation was weak(r=0.436,P<0.05).The average qualified rate of air in 1001000 and 10000 clean operating rooms in medical institutionswas 85.00%(51/60),95.00%(57/60)and 98.21%(55/56),respectively.The results of multiple linear stepwise regression analysis showed that the total number of bacterial colonies in 10000 grade operating room was 10.65 times that of 100 grade operating room(OR=10.649,P=0.009),and the total number of bacterial colonies in plankton-method was 31.61 times that of sedimentation method(OR=31.609,P=0.000).Conclusion The air quality qualification rates of operating rooms in medical institutions in Zibo city varied across years and cleanliness levels from 2016 to 2020.The cleanliness level of operating rooms and the sampling method used are significant influencing factors for the air quality qualification rates of these facilities.