层流GICU物体表面消毒方法的比较及菌群检测

目的比较两种消毒剂对层流综合重症监护病房（GICU）高频接触物体表面的抑菌效果，为层流GICU选择合理的物体表面消毒方法提供临床依据；了解物体表面细菌的污染情况，为预防控制感染提供理论依据。方法对层流GICU住院患者床档、床头桌的物体表面（常规消毒前），采集样本做细菌培养、鉴定，以了解层流GICU物体表面菌群分布。分别采用含有效氯500 mg/L消毒剂（常规组）、伽玛TM消毒湿巾（对照组）对层流GICU床单位周围物体表面进行消毒，比较两种消毒方法在消毒后的抑菌率和物体表面细菌总数合格率。结果常规消毒前共采集200份物体表面样本，分离细菌87株，细菌污染率43.50%。检出革兰阳性菌68株（78.16%），以棒状杆菌（18株，26.47%）、金黄色葡萄球菌（16株，23.53%）、表皮葡萄球菌（16株，23.53%）为主；革兰阴性杆菌19株（21.84%），以鲍曼不动杆菌为主（12株，63.16%）。进行物体表面消毒后10 min的抑菌率，常规组为（94.89±7.72）%，对照组为（96.33±12.88）%，两组差异无统计学意义（P>0.05）；两组物体表面细菌总数合格率均为100%。结论定期对层流GICU住院患者床单位周围物体表面进行检测、消毒，并规范医护人员的操作及手卫生执行力，是切断细菌传播，预防医院感染简单、有效的方法。

Comparison in disinfection methods and flora detection for object surfaces in laminar flow general intensive care unit

Objective To compare the bacteriostasis effect of two disinfectants on frequently touched object surfaces in laminar flow general intensive care unit（GICU）,and investigate bacterial contamination on the object surfaces,so as to provide reference for proper disinfection method and control of infection.Methods Specimens from surfaces of bed rails and bedside tables were taken for bacterial culture before being disinfected.Then object surfaces around bed units were disinfected with disinfectant containing 500 mg/L of available chloride（routing group）and GammaTMdisinfecting wet wipes（control group）respectively,bacteriostasis rate and qualified rate of bacterial count on object surfaces between two kinds of disinfection methods were compared.Results Before routine disinfection,a total of 87 pathogens were isolated from200 specimens of object surfaces,bacterial contamination rate was 43.50%.Detection rate of gram-positive bacteria was 78.16%%（n=68）,the major were Corynebacterium（26.47%,n=18）,Staphylococcus aureus（23.53%,n=16）and Staphylococcus epidermidis（23.53%,n=16）;detection rate of gram-negative bacteria was 21.84%（n=19）,the major was Acinetobacter baumannii（63.16%,n=12）.After a 10-minute disinfection on surfaces,bacteriostasis rate of routine group and control group was（94.89±7.72）% and（96.33±12.88）%respectively,there was no significant difference between two groups（P〉0.05）;qualified rates of bacterial count of object surfaces of two groups were both100%.Conclusion Regular disinfection of object surfaces around bed units,standardization of the manipulation and hand hygiene compliance of medical personnels are simple and effective method of cutting off bacteria dissemination and preventing healthcare-associated infection.