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基于集束化检测方法的软式内镜清洗消毒质量评估

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目的 调查应用集束化检测方法对软式内镜内腔及各接口的清洗消毒质量,对内镜清洗消毒质量的有效性进行评估.方法 应用集束化检测方法,即目视检查法、三磷酸腺苷(ATP)检测法、微生物培养法及便携式管腔可视系统观察法同时对85条清洗消毒后内镜进行检测.结果 目视检查管腔外部85条内镜外表面3条外表面有轻度磨损;ATP检测内镜内腔不合格率由高到低依次为支气管镜、胃镜、肠镜;细菌学检测内镜内腔、活检口、注水注气口和负压吸引口部位标本327件其中46件呈阳性,内镜内腔检出阳性率最高34.12%,各部位细菌检测阳性率差异有统计学意义(P<0.05);便携式管腔可视系统观察后发现内腔存在划痕内镜78条,其中胃镜划痕最高94.29%;划痕与ATP检测、细菌学检测呈正相关.结论 应用集束化检测方法可弥补单一检测方法对内镜检测的局限性,对内镜清洗消毒的有效性进行评估,为内镜相关医院感染防控工作提供指导.
Assessment of effectiveness of a cluster-testing method for cleaning and disinfection of flexible endoscopes
OBJECTIVE To investigate the quality of cleaning and disinfection of the internal channel and each inter-face of flexible endoscopes by applying cluster-testing methods,and to evaluate the effectiveness of endoscopic cleaning and disinfection quality.METHODS Eighty-five cleaned and disinfected endoscopes were examined simul-taneously using a cluster testing method,visual inspection of the exterior of the lumen,adenosine triphosphate(ATP)testing,microbial culture,and portable lumen instrument visualization system observation.RESULTS Vis-ual inspection of the 85 endoscopic external surface found that the external surface of 3 endoscopes had mild abra-sion.The endoscopic lumen failure rates detected by ATP test from high to low order were bronchoscopy,gastros-copy,and enteroscopy.327 specimens collected from endoscopic lumen,biopsy channel,air/water channel,and suction channel were tested by bacteriological detection,of which 46 were positive,with the highest positive rate of 34.12%being detected in endoscopic lumen,and the difference between the positive rate of bacterial detection of various parts was statistically significant(P<0.05).Portable tube lumen instrument visualization system showed that 78 endoscopes had scratched lumen,with the top scratches rate of 94.29%in gastroscopes.Scratches were positively correlated with ATP detection and bacteriological detection.CONCLUSION The application of the cluster-based detection method could compensate for the limitations of single detection methods for endoscopy de-tection,evaluate the effectiveness of endoscopy cleaning and disinfection,and provide guidance for endoscopy-re-lated hospital infection prevention and control.

Cluster testingSoft endoscopy cleaning and disinfectionQuality evaluation

赵会杰、王力红、赵霞、杨洋、马文晖、王允琮、韩叙、赵中晶、王薇

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首都医科大学宣武医院医院感染管理处,北京 100053

集束化检测 软式内镜清洗消毒 质量评估

北京市卫生健康委高层次公共卫生技术人才建设项目培养计划

学科骨干-01-007

2024

中华医院感染学杂志
中华预防医学会 中国人民解放军总医院

中华医院感染学杂志

CSTPCD北大核心
影响因子:1.885
ISSN:1005-4529
年,卷(期):2024.34(12)