手术室空气动态消毒效果监测及相关因素的研究

目的探讨医院手术室有人状态下使用医用消毒净化机的消毒效果及其影响因素。方法采用手术前1 h开机,多次间断的消毒方法;用平板自然尘降法,选择消毒前(7 am)和消毒后15 min、2 h(9 am)、3 h(10 am)、4 h(11am)连续3 d采样观察,根据平板上细菌菌落数计算空气中细菌总数。结果使用医用空气消毒净化机可将室内空气中细菌菌落数降至<58.3 CFU/m3;手术开始的1 h内人员活动频繁,空气中细菌菌落数<83.9 CFU/m3;随着动态消毒时间的延长,空气中细菌菌落数控制在<150.7 CFU/m3;自然菌平均消亡率86.16%。结论医用空气消毒净化机可以在有人的情况下连续使用,持续除菌,可使空气中细菌菌落数明显下降,并解决了传统静态消毒方式中人员不能在场的矛盾;限制室内人员数量和走动可以降低空气污染的程度;手术间内适宜的微小气候可以提高动态消毒效果。     

Role of the Coronavirus Disease 2019 (COVID-19) pandemic in the upgrading of personal hygiene. A cross-sectional study in Saudi Arabia

Objectives:To assess the role of the Coronavirus Disease 2019 (COVID-19) pandemic in improving personal hygiene in Saudi Arabia.Methods:We administered a questionnaire distributed online between 19 and 28 May 2020 to determine alterations in personal hygiene practices during this pandemic compared to the pre-pandemic phase.Results:We included 211 respondents from the Kingdom of Saudi Arabia (KSA) in this study. Improvement at different levels was detected in all examined personal hygiene items compared to the pre-pandemic stage. The percentages of respondents who always washed their hands after coming back home (34.1%), used soap to wash their hands (58.8%), used a hand sanitizer outside (5.2%), wore a face masks while outside (1.4%) and washed their hands before preparing and/or eating food (74.9%) was increased before the pandemic to 89.6%, 90%, 63.5%, 59.2% and 89.1% during the pandemic, respectively. The percentage of respondents who never shake hands with people they know increased from 0% before the pandemic to 62.6% during the pandemic. The mean duration of washing hands with soap significantly increased from 13.31 seconds before the pandemic to 28.01 seconds during the pandemic (p<0.0001).Conclusion:The COVID-19 pandemic resulted in a noticeable improvement in the personal hygiene habits in Saudi Arabia mainly those related to COVID-19 prevention.     

Detection and Identification of Six Foodbome Bacteria by Two-tube Multiplex Real Time PCR and Melting Curve Analysis

Objective This study is aimed to develop a two-tube melting curve-based multiplex real time PCR assay （MCMRT-PCR） for the simultaneous detection of six common foodborne pathogenic bacteria （diarrhoeagenic Escherichia coli, Salmonella, and 5higella in tube 1, Staphylococcus aureus, Vibrio parahaemolyticus, and Listeria monocytogenes in tube 2）. Methods A two-tube MCMRT-PCR assay was performed on 7900HT Fast Real-Time PCR System {Applied Biosystems, USA）. Amplification by PCR was optimized to obtain high efficiency. The sensitivity and specificity of assays were investigated. Results The detection limit of optimized MCMRT-PCR assay was 3.9x102 CFU/mLfor S. aureus, 4.4x102 CFU/mL for L. monocytogenes, 3.0x102 CFU/mL for Salmonella, 2.5x102 CFU/mL for Shigella, 2.1x102 CFU/mL for V. parahaemolyticus, and 1.2x102 CFU/mL for E. coll. The feasibility of MCMRT-PCR was further evaluated using artificially contaminated milk, the sensitivity was at the level of 10s CFU/mL. Conclusion A two-tube MCMRT-PCR assay using six primer sets was developed for detection of multiple pathogens. Our findings demonstrates that the proposed two-tube assay is reliable, useful and rapid for simultaneous detection of six foodborne pathogenic bacteria with an intended application in provincial Centers for Diseases Control and Prevention （CDC）.     

吸唾管道两种清洁消毒方法对口腔诊室空气质量的影响

目的 口腔诊疗中含有大量细菌及病毒的气溶胶易造成周围环境及患者创口的感染,及时有效的吸唾是控制口腔诊室气溶胶污染的有效方法。本研究旨在探讨口腔门诊综合治疗台吸唾管道2种清洁消毒方法对空气质量的影响。 方法 2016年7月-2017年6月合肥市口腔医院采用2种方法清洁吸唾管道,2016年7-12月为对照组使用常规方法,2017年1-6月为实验组在对照组的基础上,第2步冲洗时增加1:200多酶清洗剂3 000 ml进行管道清洁。每月对诊室空气及吸唾器接口处进行采样,并观察吸唾管道的清洁度及异味情况。 结果 清洁消毒后,2组空气菌落数培养分别为(2.667±0.970) CFU/(皿·5 min)、(5.222±2.579) CFU/(皿·5 min),实验组低于对照组,差异有统计学意义(t=-3.934,P<0.05);吸唾器接口菌落数培养分别为(1.889±1.745) CFU/cm2、(4.667±3.125) CFU/cm2,实验组低于对照组,差异有统计学意义(t=-3.293,P<0.05);吸唾软管清洁度、异味程度结果比较,实验组优于对照组,差异有统计学意义(χ2=10.395,P<0.05)。 结论 改进后清洁消毒方法能有效降低诊室空气及吸唾器接口菌落数,同时有效增加吸唾管道清洁度并降低管道异味。改进后的清洁消毒方法简单易行,取材方便且效果可靠,值得在口腔门诊推广应用。      

新型冠状病毒肺炎疫情期间加强医院感染控制措施对院内环境致病菌落分布的影响

目的 探讨新型冠状病毒肺炎（COVID-19）疫情期间加强医院感染控制措施对减少院内环境致病菌落的作用,为防疫安全工作提供保障。方法 随机选取我院加强医院感染控制措施前（2019年12月21日至2020年1月21日）进行过生物采样的160个标点（45个采用平板沉降法采样,115个采用擦拭法采样）作为对照组,加强医院感染控制措施后（2020年1月24日至2020年2月24日）进行过生物采样的160个标点（64个采用平板沉降法采样,96个采用擦拭法采样）作为观察组,比较加强医院感染控制措施前后院内环境中细菌致病菌落分布的变化。结果 加强医院感染控制措施前,160个采样标点中有39个（24.4%）细菌致病菌落检出阳性,其中45个平板沉降法采样的标点中有7个（15.6%）细菌致病菌落检出阳性,115个擦拭法采样的标点中有32个（27.8%）细菌致病菌落检出阳性。加强医院感染控制措施后,160个采样标点中有18个（11.2%）细菌致病菌落检出阳性,其中64个平板沉降法采样的标点中有4个（6.2%）细菌致病菌落检出阳性,96个擦拭法采样的标点中有14个（14.6%）细菌致病菌落检出阳性。统计学分析表明,加强医院感染控制措施后平板沉降法采样的标点细菌致病菌落检出阳性率与加强医院感染控制措施前相比差异无统计学意义（P>0.05）,但擦拭法采样的标点和总体细菌致病菌落检出阳性率均低于加强医院感染控制措施前（P=0.020、0.002）。加强医院感染控制措施后平板沉降法采样的标点细菌致病菌落数量为（0.69±0.09）CFU/cm²,与加强医院感染控制措施前[（0.85±0.15）CFU/cm²]相比差异无统计学意义（P>0.05）;加强医院感染控制措施后擦拭法采样的标点细菌致病菌落数量为每皿（0.19±0.06）CFU,低于加强医院感染控制措施前[每皿（0.32±0.08）CFU],差异有统计学意义（P=0.001）。结论 在COVID-19疫情期间,通过加强消毒、提高消毒质量等医院感染控制措施可有效减少医院环境中的致病菌落,有助于降低医护人员感染暴露的风险。     

耐甲氧西林金黄色葡萄球菌系统性感染小鼠模型的制备

目的 采用临床分离的耐甲氧西林金黄色葡萄球菌（MRSA）感染ICR小鼠,建立MRSA系统性感染小鼠模型。方法 采用连续3 d腹腔注射环磷酰胺（100 mg/kg）进行免疫抑制后,将浓度为1×10⁷ cfu/mL的MRSA菌液经尾静脉接种ICR小鼠,通过生存分析、外周血白细胞计数、组织载菌量和病理学检查对模型进行评价。结果 MRSA接种后第2天小鼠开始死亡,14 d内累积死亡率达60%;外周血白细胞总数显著升高,细菌在多个器官定植,载菌量由高到低依次是肾、关节、肺、肝和脑,肾载菌量高达10⁹ CFU/g,关节、肺、肝和脑的载菌量范围在10⁴~10⁹ CFU/g。病理观察显示肾、心脏、肺、肝、脑和关节多器官感染的组织病理学改变。结论 采用环磷酰胺免疫抑制后静脉接种MRSA的方法首次成功建立MRSA系统性感染小鼠模型,该模型可应用于MRSA发病机理及药物筛选等研究领域。     

Microbiological assessment of indoor air of a teaching hospital in Nigeria

Objective

To investigate the quality of indoor air of different wards and units of Olabisi Onabanjo University Teaching Hospital, Sagamu, to ascertain their contribution to infection rate in the hospital.

Methods

The microbial quality of indoor air of nine wards/units of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria was conducted. Sedimentation technique using open Petri-dishes containing different culture media was employed and samplings were done twice daily, one in the morning shortly after cleaning and before influx of people/patients into the wards/units and the other in the evening when a lot of activities would have taken place in these wards. Isolates were identified according to standard methods.

Results

Results showed that there was a statistically significant difference (χ² = 6.016 7) in the bacteria population of the different sampling time whereas it was not so for fungi population (χ² = 0.285 7). Male medical ward (MMW) and male surgical general (MSG) recorded the highest bacterial and fungal growth while the operating theatre (OT) was almost free of microbial burden. The bacteria isolates were Staphylococcus aureus, Klebsiella sp., Bacillus cereus, Bacillus subtilis, Streptococcus pyogenes and Serratia marscences while the fungi isolates included Aspergillus flavus, Penicillium sp., Fusarium sp., Candida albicans and Alternaria sp. Staphylococcus aureus was the predominantly isolated bacterium while Penicillium sp. was the most isolated fungus.

Conclusions

Though most of the microbial isolates were potential and or opportunistic pathogens, there was no correlation between the isolates in this study and the surveillance report of nosocomial infection during the period of study, hence the contribution of the indoor air cannot be established. From the reduction noticed in the morning samples, stringent measures such as proper disinfection and regular cleaning, restriction of patient relatives'' movement in and out of the wards/units need to be enforced so as to improve the quality of indoor air of our hospital wards/units.     

手术室连台消毒灭菌监测结果分析

[目的]探讨我院普通手术室术前与接台时术间消毒效果的差异,完善接台手术消毒处理环节.[方法]我院普通手术室,共3个术间,分别在手术室术前和接台手术间隔期间进行消毒处理,然后做空气,物体表面,医护人员手3方面的消毒效果监测.[结果]术前与接台时消毒效果监测合格率分别为96.5％和85.2％,差异具有统计学意义(P＜0.05).[结论]接台手术前应加强消毒处理,最大程度减少术中医源性感染的几率.     

美容美发业公共用品微生物污染状况的分析与研究

目的研究南宁市美容美发业公共用品的卫生质量,为加强消毒管理工作提供理论依据。方法对南宁市625家美容美发店(美发店414家、美容店211家)进行卫生消毒设施配备、公共用品清洗消毒情况的卫生学调查及其公共用品抽样检测。结果采取正确消毒措施的美发店为32.66%、美容店为62.31%;抽检毛巾类3898份,细菌总数合格率为82.14%,有39份毛巾检出大肠菌群;抽检美发、美容工具类3292份,有l8份样品检出大肠菌群,l0份样品检出金黄色葡萄球菌。结论南宁市理发、美容业公共用品清洗消毒不规范现象严重,今后需规范落实消毒措施。     

Visual Detection of Vibrio parahaemolyticus using Combined CRISPR/Cas12a and Recombinase Polymerase Amplification

ObjectiveTo establish an ultra-sensitive, ultra-fast, visible detection method for Vibrio parahaemolyticus (VP).MethodsWe established a new method for detecting the tdh and trh genes of VP using clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 12a (CRISPR/Cas12a) combined with recombinase polymerase amplification and visual detection (CRISPR/Cas12a-VD).ResultsCRISPR/Cas12a-VD accurately detected target DNA at concentrations as low as 10^-18 M (single molecule detection) within 30 min without cross-reactivity against other bacteria. When detecting pure cultures of VP, the consistency of results reached 100% compared with real-time PCR. The method accurately analysed pure cultures and spiked shrimp samples at concentrations as low as 10² CFU/g.ConclusionThe novel CRISPR/Cas12a-VD method for detecting VP performed better than traditional detection methods, such as real-time PCR, and has great potential for preventing the spread of pathogens.     

玉溪市中心城区民营医院消毒灭菌质量监测分析

目的了解玉溪市中心城区民营医院消毒灭菌质量状况。方法采用现场采样和实验室检测方法监测玉溪市中心城区20家民营医院消毒灭菌质量。结果经连续3年监测消毒与灭菌总合格率为93.29%;2007～2009年的合格率依次为81.27%、95.72%和98.87%。使用中消毒液、物体表面、压力蒸汽灭菌器和灭菌物品合格率为100%,手术室空气合格率为93.47%,紫外线灯管辐照度合格率为87.95%,医护人员手合格率为79.35%。结论建议改善手术室空气消毒设备,完善洗手设施,加强培训,规范洗手,加强自主监测,提高医院消毒灭菌质量,保障医疗安全。     

The insecticidal effect of diatomaceous earth against adults and nymphs of Blattella germanica

ObjectiveTo evaluate the insecticidal effect of diatomaceous earth (DE) against adults and nymphs of Blattella germanica.MethodsThis cross sectional study has been done on the laboratory strain of German cockroaches. Two stages, nymph and adult, were exposed to six dose rates of the DE, 2.5, 5, 10, 15, 20 and 25 g/m², at 24, 48 and 72 h exposure period. Mortality (number of dead cockroaches) was assessed after 24 h. Other exposed specimens were transferred to the beakers contained food and water for counting the retard mortality rate after 1 week.ResultsIncreasing in dose rates of DE increased mortality rate, so that the lowest and highest mortality rates were observed in 2.5 and 25 g/m², respectively. The results of the statistical analysis showed no significant difference in the lethality of 50% of DE plus water on the German cockroach nymphs.ConclusionsDue to the resistance of German cockroach against organochloride, organophosphorus, carbamate and pyrethriodes insecticides, it is suggested to use DE for insect's control.     

Production of microbial medium from defatted brebra (Milletia ferruginea) seed flour to substitute commercial peptone agar

Objective

To investigate and optimize microbial media that substitute peptone agar using brebra seed defatted flour.

Methods

''Defatted process, inoculums preparation, evaluation of bacterial growth, preparation of cooked and hydrolyzed media and growth turbidity of tested bacteria were determined.

Results

Two percent defatted flour was found to be suitable concentration for the growth of pathogenic bacteria: Escherichia coli (ATCC 25922) (E. coli), Pseudomonas aeruginosa (ATCC 27853), Salmonella (NCTC 8385) and Shigella flexneri (ATCC 12022) (S. flexneri), while 3% defatted flour was suitable for Staphylococcus aureus (ATCC 25923) (S. aureus). E. coli (93±1) and S. flexneri (524±1) colony count were significantly (P≤0.05) greater in defatted flour without supplement than in supplemented medium. E. coli [(3.72×10⁹±2) CFU/mL], S. aureus [(7.4×10⁹±2) CFU/mL], S. flexneri [(4.03×10⁹±2) CFU/mL] and Salmonella [(2.37×10⁹±1) CFU/mL] in non-hydrolyzed sample were statistically (P≤0.05) greater than hydrolyzed one and commercial peptone agar. Colony count of Salmonella [(4.55×10⁹±3) CFU/mL], S. flexneri [(5.40×10⁹±3) CFU/mL] and Lyesria moncytogenes (ATCC 19116) [(5.4×10⁹±3) CFU/mL] on raw defatted flour agar was significantly (P≤0.05) greater than cooked defatted flour and commercial peptone agar. Biomass of E. coli, S. aureus, Salmonella and Enterococcus faecalis in non-hydrolyzed defatted flour is highly increased over hydrolyzed defatted flour and commercial peptone broth.

Conclusions

The defatted flour agar was found to be better microbial media or comparable with peptone agar. The substances in it can serve as sources of carbon, nitrogen, vitamins and minerals that are essential to support the growth of microorganisms without any supplements. Currently, all supplements of peptone agar are very expensive in the market.     

Inhibitory Effect of Short-Term Palpebral Margin Cleaning with Antibiotic Eye Drops on Ocular Surface Flora before Cataract Extraction: A New Preoperative Antibacterial Method

ObjectiveTo explore the clinical significance of the combined application of palpebral margin cleaning and antibiotic eye drops in inhibiting bacterial growth in the palpebral margin and conjunctival sacs before cataract extraction.MethodsIn this study, 61 patients (97 eyes) with age-related cataract who underwent phacoemulsification and intraocular lens implantation were selected, and randomly grouped. In the experimental group, the combined application of palpebral margin cleaning with cotton pads and levofloxacin eye drops was given for three days before the surgery. In the control group, levofloxacin eye drops alone were applied for three consecutive days. Bacteria samples from the conjunctival sac and eyelid margins were cultivated and identified before and three days after taking antimicrobial measures, respectively.ResultsIn the experimental group, the positive rates of the two bacteria samples were 100% (50/50) and 40% (20/50) before and 10% (5/50) and 0% (0/50) after the treatment. In the control group, the positive rates of the two bacteria samples were 97.9% (46/47) and 29.8% (14/47) before and 40.4% (19/47) and 10.6% (5/47) after the treatment. The positive rates between the two groups were not significantly different before taking antimicrobial measures (P = 0.485 and 0.395), while they were significantly different after taking antimicrobial measures (P = 0.001 and 0.024).ConclusionCombined application of eyelid and palpebral margin cleaning with cotton pads and antibiotic eye drops before cataract extraction imparted excellent antibacterial effects.     

Risk Factors for Anesthesia-Related Airway Patient Safety Incidents: A Single-Center Retrospective Case-Control Analysis from 2009 to 2022

ObjectiveAirway-related patient safety incident (PSI) has always been the top concern of anesthesiologists because this type of incidents could severely threaten patient safety if not treated immediately and properly. This study intends to reveal the composition, prognosis, and to identify risk factors for airway related incidents reported by anesthesiologists.MethodsAll airway related PSIs reported by anesthesiologists in a Chinese academic hospital between September 2009 and May 2022 were collected from the PSI reporting system. Patients with airway incidents reported were matched 1:1 with controls based on sex and type of surgery. Univariable and multivariable analysis were performed to find risk factors associated with airway incident occurrence, and to evaluate influence of airway PSIs on patient prognosis.ResultsAmong 1,038 PSIs voluntarily reported by anesthesiologists during the study period, 281 cases (27.1 %) were airway-related incidents, with an overall reporting incidence of 4.74 per 10,000 among 592,884 anesthesia care episodes. Only ASA physical status was found to be significant independent predictor of these airway PSIs (P = 0.020). Patients with airway PSIs reported had longer extubation time (0.72 ± 1.56 d vs. 0.16 ± 0.77 d, 95%CI: 0.29 to 0.82, P < 0.001), longer ICU length of stay (LOS) (1.63 ± 5.71 d vs. 0.19 ± 0.84 d, 95%CI: 0.57 to 2.32, P = 0.001), longer post operative LOS (10.56 ± 13.09 d vs. 7.59 ± 10.76 d, 95%CI: 0.41 to 5.53, P = 0.023), and longer total in-hospital LOS (14.99 ± 15.18 dra. 11.62 ± 11.88 d, 95%CI: 0.46 to 6.27, P = 0.024).ConclusionsThis single-center retrospective case-control study describes the composition of airway-related PSIs reported by anesthesiologists within thirteen years. Airway incidents might influence patient prognosis by elongating extubation time and LOS. Airway PSI data were worth analyzing to improve patient safety.     

漯河市洁净手术室建设及管理现状调查报告

目的了解漯河市洁净手术室建设及管理现状。方法依据《医院洁净手术部建筑技术规范》(GB50333-2002)进行现场查看及询问填写调查表,再现场检测部分洁净手术室。结果漯河市医疗机构洁净手术室在设计等级、建筑布局、设备安装、综合管理及自身检测等方面都存在不同程度的问题,不同指标不同等级洁净手术室共检测198间,合格162间,合格率为81.81%。结论漯河市医疗机构洁净手术室建设及管理现状不容乐观,急需科学指导和规范管理。     

On-Site Assessment of a Cryogenic Disinfectant for the Alpine Environment and Outer Packaging of Frozen Items

Objective To study the effectiveness and feasibility of cryogenic disinfectants in different cold scenarios and analyze the key points of on-site cryogenic disinfection.Methods Qingdao and Suifenhe were selected as application sites for the manual or mechanical spraying of cryogenic disinfectants. The same amount of disinfectant(3,000 mg/L) was applied on cold chain food packaging, cold chain containers, transport vehicles, alpine environments, and article surfaces. The killing log value of the ...     

可见光连续环境消毒系统对手术室消毒前后菌群生物气溶胶浓度的影响

目的探讨可见光连续环境消毒系统(CED)对手术室真菌和细菌气溶胶浓度的影响以及与环境因素的相关性。方法以焦作市第二人民医院5间手术室作为研究对象,分别对CED应用前后手术室内生物气溶胶浓度进行检测,并进行真菌和细菌培养,将检测结果进行比较,并与同期检测的消毒前后的室内温度和湿度相关性进行分析。结果消毒前和消毒后强化消毒模式下手术室内细菌、真菌浓度均较常规消毒模式降低,其次术后消毒完成后强化消毒模式下室内相对湿度相比常规消毒降低,差异均有统计学意义(P<0.05)。消毒过程中手术室的相对湿度标准值为(41.12±4.06)%,温度为(23.41±2.07)℃。经Spearman相关分析显示,消毒后真菌和细菌浓度与相对湿度标准值呈正相关(r=0.109,0.107;P=0.034,0.037),与温度无相关性(P>0.05)。结论常规消毒措施上加用可见光连续环境消毒系统能大大降低手术室的菌群生物气溶胶浓度,同时维持室内相对湿度减少细菌和真菌的繁殖。     

In vitro Staphylococcus aureus–induced oxidative stress in mice murine peritoneal macrophages: a duration–dependent approach

ObjectiveTo evaluate the free radical generation and status of the antioxidant enzymes in murine peritoneal macrophage during in vitro vancomycin sensitive Staphylococcus aureus (VSSA) treatment with different time interval.MethodsPeritoneal macrophages were treated with 5×10⁶ CFU/mL VSSA cell suspension in vitro for different time interval (1, 2, 3, 6, 12, and 24 h) and superoxide anion generation, NADPH oxidase activity, myeloperoxidase activity, nitric oxide generation, antioxidant enzyme status and components of glutathione cycle were analyzed.ResultsSuperoxide anion generation, NADPH oxidase activity, myeloperoxidase activity and nitric oxide generation got peak at 3 h, indicating maximum free radical generation through activation of NADPH oxidase in murine peritoneal macrophages during VSSA infection. Reduced glutathione level, glutathione peroxidase, glutathione reductase, and glutathione-s-transferase activity were decreased significantly (P<0.05) with increasing time of VSSA infection. But the oxidized glutathione level was time dependently increased significantly (P<0.05) in murine peritoneal macrophages. All the changes in peritoneal macrophages after 3 h in vitro VSSA treatment had no significant difference.ConclusionsFrom this study, it may be summarized that in vitro VSSA infection not only generates excess free radical but also affects the antioxidant status and glutathione cycle in murine peritoneal macrophages.     

医护人员手卫生现状及对策

目的探讨手污染状况与医院感染的关系,提出保持手卫生的措施。方法了解手污染、洗手的现状、洗手与医院感染的相关性和提高手卫生的措施。结果手污染是导致医院感染的主要途径,洗手是保持手卫生的主要方法,能有效减少医院感染,但临床执行严格的手消毒现状并不满意。通过提高洗手的意识,提供洗手的条件,掌握正确洗手的时间和方法,选择适当的手消毒剂,能提高洗手的依从性,提高手消毒的效果。结论手污染同医院感染密切相关,须有效改善手卫生状况,洗手能减少医院感染。