115条外来内镜消毒前后微生物污染调查及建议

Investigation and recommendations on microbiological contamination of 115 endoscopes received before and after disinfection

摘要:

研究接收时和清洗消毒后外来内镜钳子管道的微生物污染状况，初步了解其真实消毒质量，分析存在的问题并提出建议。选取2022年6月至2023年12月期间武汉大学人民医院的115条外来内镜作为研究对象，在接收时和清洗消毒后，分别对外来内镜的钳子管道进行微生物采样及菌种鉴定，比较两者的消毒合格率和微生物检出率。外来内镜清洗消毒后的总体消毒合格率（91.3%，105/115）高于接收时（57.4%，66/115，χ2=37.026，P<0.001），清洗消毒后总体微生物检出率（13.0%，15/115）低于接收时（48.7%，56/115，χ2=41.000，P<0.001），高致病微生物检出率（7.0%，8/115）低于接收时（29.6%，34/115，χ2=24.039，P<0.001），低致病微生物检出率（6.1%，7/115）低于接收时（19.1%，22/115，χ2=13.067，P<0.001）。外来内镜在接收时消毒合格率低，微生物检出率高，存在较大交叉感染风险；清洗消毒后，消毒合格率提高，微生物检出率降低，大大降低了患者感染风险。因此，建议重视外来内镜投入临床使用前的消毒质量监测。

Abstract:

To study the microbiological contamination of endoscopic forceps channel at the time of reception and after disinfection, and gain a preliminary understanding of their real disinfection quality, then analyse the problems and make recommendations. A total of 115 endoscopes received at Renmin Hospital of Wuhan University from June 2022 to December 2023 were chosen. Microbiological sampling and strain identification of the endoscopic forceps channel were carried out at the time of reception of the endoscopes and after cleaning and disinfection, respectively, then the qualified disinfection rate and microbial detection rate were compared. The overall qualified disinfection rate after cleaning and disinfection of endoscopes received (91.3%, 105/115) was higher than that at reception (57.4%, 66/115, χ2=37.026, P<0.001). The overall microbiological detection after cleaning and disinfection of endoscopes received (13.0%, 15/115) was lower than that at reception (48.7%, 56/115, χ2=41.000, P<0.001), the detection rate of high pathogenic organisms after cleaning and disinfection (7.0%, 8/115) was lower than that at reception (29.6%, 34/115, χ2=24.039, P<0.001), low pathogenic organisms after cleaning and disinfection (6.1%, 7/115) was lower than that at reception (19.1%, 22/115, χ2=13.067, P<0.001). At the time of reception, the qualified disinfection rate was low and the microbiological detection rate was high, and there may become a greater risk of cross-infection; after cleaning and disinfection, the qualified disinfection rate was increased and the microbiological detection rate was decreased, which may greatly reduce the risk of patient infection. Therefore, it is recommended that attention should be paid to the disinfection quality monitoring of endoscopes received before putting into clinical use.