正压中央空调换气系统保持空气洁净度效果研究

目的了解正压中央空调换气方法保持治疗室空气洁净度效果。方法在5个月内每月连续2d对某院7个治疗室空气进行微生物学监测,第1天为实验组:治疗室采用正压中央空调换气,第2天为对照组:在实验组工作基础上,加用紫外线照射空气消毒1h,比较两组的空气微生物学监测结果。结果共采集210个平板,取均值后计为70份(治疗室)样本,实验组与对照组各有1份样本菌落计数>500CFU/m3,合格率为97.14%。实验组经正压中央空调换气后各采样点平均空气细菌数为(1.71±0.97)CFU/m3,对照组为(1.67±0.96)CFU/m3,两组比较,差异无显著性(P>0.05)。结论正压中央空调换气系统在正常运行时能有效维持治疗室空气洁净度,且无需对室内进行常规空气消毒。     

富血小板血浆对糖尿病大鼠难愈感染创面的作用机制

目的 观察富血小板血浆(PRP)对糖尿病大鼠难愈感染创面的影响并分析作用机制。方法 将24只SD雄性大鼠给予高脂高糖饲养+腹腔注射链脲佐菌素(STZ)制备糖尿病模型，其中成功20只，随机分为模型组和治疗组各10只，另取大鼠设对照组和取血组各10只，取腹主动脉血制备富血小板血浆，其余三组建立皮肤缺损创伤模型，干预14 d后，观察大鼠一般情况，比较随机血糖、创面愈合率，痂下组织菌落数，以及创面组织中肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、IL-6和羟脯氨酸(HYP)水平，血管内皮生长因子(VEGF)、转化生长因子-β1(TGF-β1)、Smad同源物3(Smad3)相对表达量。结果 与同时间对照组比较，模型组、治疗组血糖均上升(P<0.05),治疗组治疗第14天血糖低于治疗前(P<0.05);治疗第7、14天，与对照组比较，模型组大鼠创面愈合率降低(P<0.05),与模型组比较，治疗组大鼠创面愈合率显著升高(P<0.05);模型组第3、7、14天创面菌落数均高于对照组(P<0.05),治疗组各时间创面菌落数均低于模型组(P<0.05)...     

循环风持续消毒对烧伤病房空气质量的影响

目的探讨换药时循环风消毒对烧伤病房空气质量的影响。方法设计试验组和对照组,试验组烧伤病房换药同时用循环风消毒机对空气进行现场试验,对换药前、后的病房空气进行细菌采样;对照组换药时,不进行循环风消毒,空气采样同试验组,分析两组菌落数变化。结果两组换药前菌落数比较,差异无统计学意义,换药后试验组菌落数为(111.0±42.9)CFU/m3,明显少于对照组的(997.4±220.0)CFU/m3,差异有统计学意义(P<0.05);试验组消毒后菌落数少于消毒前,差异有统计学意义(P<0.05),对照组换药后菌落数高于换药前,差异有统计学意义(P<0.05)。结论烧伤病房换药时循环风持续消毒有利于改善空气质量。     

床单位细菌污染的调查及臭氧消毒机消毒效果研究

目的探讨普通病房、床单位细菌污染状况及臭氧消毒机对床单位消毒的效果。方法对2个病区普通病房15个床单位的被、褥和床垫于臭氧消毒前后分别采样进行细菌定量培养和菌种鉴定。结果床单位污染严重,污染率为100.0%,并检测条件致病菌和致病菌;采用臭氧消毒后床单位菌量明显下降,菌种明显减少。结论被、褥污染严重,床垫次之,建议对被、褥、床垫定期清洗或更换,患者出院后,将床单位送到消毒间进行消毒后再使用。     

门诊和病房电脑鼠标细菌污染情况调查

目的调查门诊和普通病房电脑鼠标不同时段的细菌污染情况。方法随机抽取某院门诊及普通病房的各16个电脑鼠标，分别于8∶00、10∶30、13∶00、15∶30进行采样，样本接种培养后对菌落计数并筛查多重耐药菌。结果32个鼠标共计采样128次，最高菌落数达121 CFU/cm2，平均菌落数为23.9 CFU/cm2。随着时间的推移，同一鼠标的细菌计数逐渐增多。不同时段门诊和病房的电脑鼠标菌落数比较，在10∶30、13∶00、15∶30三个时间点，病房鼠标的菌落数均高于门诊（均P≤0.05）。64个病房电脑鼠标标本中检出耐甲氧西林金黄色葡萄球菌（MRSA）和耐碳青霉烯类鲍曼不动杆菌（CRAB）各1株。结论加强鼠标日常清洁消毒及监测工作非常重要，应增加清洁消毒频率或更换长效消毒剂，加强病房环境的清洁消毒。     

季铵盐联合含氯消毒液在ICU终末消毒中的应用与效果分析

目的了解季铵盐联合含氯消毒液的消毒方法在ICU病房终末消毒中的效果。方法将ICU病房的20个床单位,采用随机数字表法分为观察组和对照组各10个。观察组使用季铵盐联合含氯消毒液,对照组按常规使用季铵盐实施物体表面消毒,终末消毒前后对两组物体表面采样并进行细菌培养与鉴定。结果终末消毒前,两组物体表面菌落数合格率、平均带菌量、微生物检出率比较差异均无统计学意义(p>0.05)。终末消毒后,两组物体表面菌落数合格率均有明显提升,物体表面平均带菌量、微生物检出率均有不同程度下降,且观察组物体表面菌落数合格率高于对照组,物体表面平均带菌量、微生物检出率低于对照组,差异有统计学意义(p<0.05),观察组终末消毒效果优于对照组。结论两组终末消毒方法均可以有效降低物体表面暂居菌数量,但季铵盐联合含氯消毒液的效果更优。     

不同清洁方法对儿童雾化器的清洁效果

目的评价不同清洁方法对儿童雾化器的清洁效果。方法随机抽取某院门诊雾化中心进行雾化吸入治疗的患儿27例,以及同期入住该院呼吸内科且每日至少接受2次雾化吸入治疗的患儿30例(分为对照组:雾化器由家属自行清洗和保存;干预A组:雾化器由指定医务人员统一清洗;干预B组:统一回收后浸泡于含少量清洗剂的温水中5 min,其余步骤同干预A组),比较不同部位、不同使用时间、不同分组雾化器的细菌菌落数。结果雾化吸入治疗的第1天、第2天,以及≥3 d门诊患儿雾化器不同部位均报告有大量的细菌菌落数,其中以雾化器面罩内壁污染最重(中位数:1 250~1 775.00CFU)。对照组住院患儿不同时间(雾化第1、3、5、7天)雾化器面罩内壁和储药杯内壁平均细菌菌落数(中位数分别为:100.00~625.00、50.00~625.00CFU)均高于干预A、B组(中位数:0.00~12.50 CFU);对照组、干预A组、干预B组患儿空气导管接口的平均细菌菌落数(中位数:0.00~25.00CFU)比较,干预A组和B组间平均细菌菌落数比较,差异均无统计学意义(均P0.05)。结论规范的清洁保存可降低雾化器细菌污染程度,使用清水冲洗,不加用清洗剂,也可保证雾化器的清洁效果。     

循环风消毒与紫外线照射对烧伤病房空气消毒效果的比较

目的 探讨循环风消毒与紫外线照射对烧伤病房空气消毒的效果,为寻找安全、高效、方便的空气消毒方法、减少空气污染提供依据.方法 循环风消毒机和紫外线灯两种空气消毒方法对烧伤病房空气进行现场试验,对消毒即时,进人后30、60 min病房空气细菌进行采样,分析两组灭菌率.结果 消毒前菌落数循环风(856±99)CFU/m3和紫外线(860±100)CFU/m3比较,差异无统计学意义；消毒后菌落数循环风(102±35) CFU/m3明显少于紫外线(134±42)CFU/m3,差异有统计学意义(P＜0.05)；两组消毒前后空气菌落数比较,差异有统计学意义(P＜0.05).结论 两种消毒方法均有消毒效果,而循环风消毒效果持久,更适用于烧伤病房空气的消毒.     

5种岗位护士工作前和工作中手细菌培养结果比较

目的了解不同工作岗位护士在正常工作中手的污染情况，为提高其手卫生的依从性提供有力依据。方法分别从某院5种岗位(手术室、病房治疗、病房配药、病房护理以及门诊注射室工作)护士中随机抽取20名，同一天分别做洗手前、六步洗手法洗手（或手消毒）后以及工作2 h后手部采样细菌培养，并对结果进行统计分析。结果经统计学分析，不同工作岗位间护士洗手（或手消毒）前手采样培养菌落数均严重超标，差异无统计学意义（P＞0.05）；同一岗位护士洗手（或手消毒）后手采样培养菌落数显著低于洗手（或手消毒）前（P＜0.05）；洗手（或手消毒）后，各工作岗位间护士手采样培养菌落数差异无统计学意义（P＞0.05）。工作2 h后，从事手术室和病房配药工作的护士与其洗手（或手消毒）后手采样培养菌落数比较，差异无统计学意义（P＞0.05）；而从事治疗、护理和门诊注射工作的护士上述比较，差异有统计学意义（P＜0.05），即菌落数显著增加。结论无论采用何种手卫生方法，只要严格按照规范要求进行，基本都能达到各自岗位规范的要求，能很好地预防因手传播而造成的医院感染。     

清菌片电热熏蒸法对幼儿园室内空气消毒的效果

目的探讨清菌片电热熏蒸法对幼儿园室内空气的消毒效果。方法选择幼儿园活动室（约30 m2）,每间活动室有幼儿33～42名（大、中、小班）,均在幼儿学习和活动时采样。试验组采用生命岛清菌片电热熏蒸法,对照组采样时未采用任何空气消毒方法,监测活动室内空气细菌菌落总数。结果共采样8间幼儿园活动室,其中试验组6间,对照组2间。活动室内平均空气细菌菌落数：试验组消毒前为（1 772.87±510.91）CFU/m3,对照组第1次采样为（2 004.30±833.68）CFU/m3,两组比较差异无统计学意义（t=-0.370,P=1.262）。不同采样时间空气细菌菌落数比较差异无统计学意义（F=3.909,P=0.078）;不同消毒方法之间空气细菌菌落数存在差异（F=14.982,P=0.008）;两组活动室内均未检出溶血性链球菌和金黄色葡萄球菌;试验组消毒1 h时空气细菌平均清除率为46.55%。结论生命岛清菌片能有效降低幼儿园活动室内有人活动状态下的空气细菌菌落数。     

综合医院普通病房床垫细菌污染调查

目的了解综合医院普通病房床垫细菌污染状况,降低床垫传播医院感染的机会。方法对5个病区普通病房的床垫分别在患者使用前、使用中1~6 d7、~13 d1、4~20 d、>21 d进行细菌监测。结果随着患者住院时间的延长,床垫细菌污染程度加重,其感染量超过卫生部所规定的普通物体表面带菌标准。结论长时间连续使用是造成普通病房床垫污染的主要因素,必须定期清洁消毒。     

一种被褥洗涤工艺对棉胎与床垫等携带细菌的清除效果

目的 探讨一种被褥洗涤工艺对棉胎、床垫等的消毒效果。方法 2018年11月—2019年1月随机选取某院住院部神经外科、普通外科、神经内科3个病区普通病房的部分棉胎、床垫、枕芯作为研究对象，采用一种被褥洗涤工艺对其进行消毒、检测，比较使用10、30 d以及清洗消毒前后其细菌数的差异。结果 三个科室共抽取72个床单位的棉胎、床垫、枕芯。采用该被褥洗涤工艺清洗消毒后，棉胎、床垫、枕芯上均未检出大肠菌群、金黄色葡萄球菌，普通外科棉胎、床垫细菌污染率均为4.2%，其余科室棉胎、床垫、枕芯细菌数均合格。细菌数神经外科和神经内科棉胎、床垫、枕芯患者使用10、30 d细菌数与清洗消毒后细菌数比较，差异均有统计学意义（均P<0.01）；普通外科棉胎患者使用10、30 d细菌数与清洗消毒后细菌数比较，差异均无统计学意义（均P>0.05），但床垫、枕芯患者使用10、30 d细菌数与清洗消毒后细菌数比较，差异均有统计学意义（均P<0.01）。结论 该被褥洗涤工艺对棉胎、床垫等消毒效果可靠，可以预防因棉胎、床垫、枕芯污染致医院感染的发生。     

一种被褥洗涤工艺对棉胎与床垫等携带细菌的清除效果

目的探讨一种被褥洗涤工艺对棉胎、床垫等的消毒效果。方法 2018年11月—2019年1月随机选取某院住院部神经外科、普通外科、神经内科3个病区普通病房的部分棉胎、床垫、枕芯作为研究对象,采用一种被褥洗涤工艺对其进行消毒、检测,比较使用10、30 d以及清洗消毒前后其细菌数的差异。结果三个科室共抽取72个床单位的棉胎、床垫、枕芯。采用该被褥洗涤工艺清洗消毒后,棉胎、床垫、枕芯上均未检出大肠菌群、金黄色葡萄球菌,普通外科棉胎、床垫细菌污染率均为4.2%,其余科室棉胎、床垫、枕芯细菌数均合格。细菌数神经外科和神经内科棉胎、床垫、枕芯患者使用10、30 d细菌数与清洗消毒后细菌数比较,差异均有统计学意义(均P0.01);普通外科棉胎患者使用10、30 d细菌数与清洗消毒后细菌数比较,差异均无统计学意义(均P0.05),但床垫、枕芯患者使用10、30 d细菌数与清洗消毒后细菌数比较,差异均有统计学意义(均P0.01)。结论该被褥洗涤工艺对棉胎、床垫等消毒效果可靠,可以预防因棉胎、床垫、枕芯污染致医院感染的发生。     

急救车内急救物品集中与分散处理效果比较

目的 为急救车内急救物品寻找一种经济、有效、可操作的清洗、消毒、包装、灭菌方法,以提高消毒、灭菌质量.方法 将使用后急救物品(开口器、舌钳、压舌板)分为两组,试验组:2011年5-7月全院使用后急救物品由消毒供应中心集中处理,共处理115件;对照组:2011年2-4月全院急救物品由各病房分散处理,共处理112件;比较两种处理模式的清洗质量,目测、隐血试验、菌落数合格率、消毒液的消耗量、耗费的时间.结果 试验组、对照组清洗质量目测合格率分别为98.3％、75.9％,隐血试验合格率分别为98.0％、86.0％,菌落数合格率分别100.0％、60.0％,差异均有统计学意义(P＜0.05);试验组节约施康480片,节约时间13.4h.结论 急救物品由供应中心集中处理,既能保证清洗质量,还能减少消毒液的用量,节省了时间、成本,减少了环境污染和对人体的伤害.     

造血干细胞移植病房终末空气消毒方法的研究

目的寻求一种简便易行且对医务人员伤害小的造血干细胞移植层流病房终末空气消毒方法。方法将经过氧乙酸熏蒸终末消毒处理的病房列为对照组,擦拭、空气层流消毒处理的病房列为试验组,分别比较空气沉降菌落培养计数及同期入住该病房患者的发热时间。结果试验组与对照组中心区及周边区空气培养菌落比较差异无统计学意义,同期入住病房行ATG治疗的患者在发热时间上差异无统计学意义。结论擦拭与空气层流即可以完成病房的终末处理达到净化标准,其方法简便易行,值得临床推广。     

Microbiological conditions of hospital beds before and after terminal cleaning

INTRODUCTION: The hospital's environment keeps a close relationship with hospital infection, which may promote focus of contact and transmission. The terminal cleaning of patient unit represents one way to control microbiological environmental contamination. The study has as its main objective to evaluate the microbiological conditions of hospital mattresses before and after cleaning. METHODS: Rodac plates were utilized for specimen collection with culture medium - blood agar plate. The patients beds were chosen by criteria established before hand and the places for specimen collection in the mattress were chosen by aleatory drawing. To the study of numerical alteration related to the positivity of plates before and after cleaning, Goodman' statistics tests were used. RESULTS: From 52 mattress investigated, 520 culture plates were done from which 514 (98,8%) had a positive culture, 259 before cleaning and 255 after cleaning showing a reduction of positive cultures in only 4 plates after cleaning. CONCLUSIONS: The number of plates with countable and countless colonies suggests that the cleaning, as it is done, instead of reducing the microorganism is dislocating it to other areas of the mattress keeping the microbiological condition as it was before the cleaning process.     

A bacteriological study of hospital beds before and after disinfection with phenolic disinfectant.

In hospitals, one of the ways to control microbial contamination is by disinfecting the furniture used by patients. This study's main objective was to evaluate the microbiological condition of hospital mattresses before and after such disinfection, in order to identify bacteria that are epidemiologically important in nosocomial infection, such as Staphylococcus aureus and Pseudomonas aeruginosa. RODAC plates with two different culture media were used to collect specimens. Patient beds were selected according to previously established criteria, and surface areas on the mattresses were chosen at random. From the total of 1,040 plate cultures from 52 mattresses, positive results were obtained from 500 of them (48.1%), 263 before disinfection and 237 after disinfection. Considering the selectivity of the culture media, the positivity rate was high. There were high prevalences of S. aureus both before and after mattress disinfection. The study results suggest that the usual disinfection procedures, instead of diminishing the number of microbes, merely displace them from one part of the mattress to another, and the number of microorganisms remains the same.     

Mite and pet allergen levels in homes of children born to allergic and nonallergic parents: the PIAMA study

The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study is a birth cohort study that investigates the influence of allergen exposure on the development of allergy and asthma in the first several years of life. The objectives of this study were to investigate the relationship between a family history of allergy and/or asthma and exposure of newborn children to mite and pet allergen and to study the influence of different home and occupant characteristics on mite allergen exposure. Dust was sampled from the child's mattress and the parental mattress at 3 months after birth of the index child and analyzed for mite and pet allergens. Subjects were divided in groups according to history of asthma and allergy in their parents, and allergen exposure was studied in the different groups. Cat allergen exposure was significantly lower on parental mattresses in families with allergic mothers, but dog allergen exposure was not different. Mite allergen exposure was lower on parental mattresses in families with allergic mothers. Use of mite allergen-impermeable mattress covers reduced mite allergen exposure. Some other characteristics such as age of home and mattress were also found to influence mite allergen exposure. Parental mattresses in homes of allergic mothers had lower cat and mite (but not dog) allergen loadings than mattresses in homes of nonallergic parents. Paternal (as opposed to maternal) allergy seemed to have little influence.     

Results of a field study on the influence of HygienicWood mattress toppers on the number of mites in bed dust and the state of health of people with house dust mite allergies

Objectives: So far, there has been no practical or toxicologically non-hazardous way to decimate mites – without interrupting use of beds – in their main reservoir on bed mattresses to such an extent that the allergic condtion of people suffering from house dust mite allergies is reduced or even remedied. As so-called HygienicWood was effective against mites under simulated conditions, the influence of a mattress topper filled with HygienicWood chips on the content of mite antigen Der p1 was to be investigated and the influence on the state of health of the persons concerned analysed at the same time.Procedure: 32 test persons suffering from dust mite allergy were randomly selected. During the course of 5 months, the influence of a HygienicWood mattress topper on the content of the mite antigen Der p1 as well as the number of bacteria, dermatophytes and yeasts in the bed dust were determined and compared with the values obtained during the 5 weeks prior to the application of HygienicWood mattress toppers. The samples were taken from between the HygienicWood mattress topper and the sheet below. At the same time, changes in well-being, state of health, typical allergy symptoms and frequency of taking antihistamines and glucocorticoids were recorded as self-assessments in the form of questionnaires.Findings: The most striking finding was the significant decrease (p=0.000) of the house dust mite antigen Der p1 during usage of the HygienicWood mattress toppers. The effect started immediately after applying the toppers and continued with little fluctuation until the end of the observation period without lessening. At the end of the study, 43% of the test persons stated a slight improvement in their well-being. 13% of the test persons felt no change, and 6% of the test persons stated a slight deterioration. The situation was similar with regard to allergy symptoms: 43% reported a significant reduction, 38% a slight reduction, and 19% did not notice any change. The improvement in symptomatology could not be ascribed to an increased intake of antihistamines or glucocorticoids.The dermatophytes, too, showed a slight, albeit statistically not significant decrease after application of HygienicWood mattress toppers. In contrast, the pollution of bed dust with yeasts rose significantly (p=0.002), whereas there was only a tendency towards an increase in the number of bacteria, which, if one considers the slight increase, is without hygienic relevance. Conclusion: HygienicWood mattress toppers are able to reduce the house dust mite allergen load. This leads to a distinct reduction in the allergy symptomatology, and the well-being of the persons concerned increased significantly.