次氯酸消毒剂应用于全自动软式内镜清洗消毒机的消毒效果

目的研究次氯酸消毒剂应用于全自动软式内镜清洗消毒机消毒纤维支气管镜的消毒效果。方法监测某院2018年6—7月(共计48 d)使用的7条纤维支气管镜。采用次氯酸消毒剂对临床使用后的纤维支气管镜进行机洗消毒5 min,分别采用ATP荧光检测法和滤膜法、倾注法对纤维支气管镜外表面及内腔面的消毒效果进行监测和评价。结果 7条纤维支气管镜共送至消毒供应中心清洗消毒159次。分不同日期随机抽样30次,采用ATP荧光法检测表面洁净度,RLU范围10～64,中位数为22,合格率100%。共检测内腔面159次,滤膜法与倾注法检出菌落计数均为0～6 CFU/件,合格率均为100%。稳定性试验7个周期的结果显示,次氯酸消毒剂应用于全自动内镜清洗消毒机,有效氯的初始浓度为210 mg/L,经一周消毒后,处理内镜20～32条不等,有效氯浓度为74～106 mg/L。结论次氯酸消毒剂应用于全自动软式内镜清洗消毒机消毒纤维支气管镜可达到规定的消毒要求,次氯酸消毒剂机洗使用7 d时仍能保持有效浓度。

Application of hypochlorite disinfection in automatic soft endoscope cleaning-disinfection machine

Objective To study the disinfection efficacy of hypochlorite disinfectant on fiberoptic bronchoscope by automatic soft endoscope cleaning-disinfection machine. Methods Seven fiberoptic bronchoscopes used in a hospital in June-July 2018 (total 48 days) were monitored. Fiberoptic bronchoscopes were cleaned and disinfected with hypochlorite disinfectant by machine for 5 minutes, ATP fluorescence detection method, filter membrane method and pouring method were used to monitor and evaluate the disinfection efficacy on the outer surface and inner surface of fiberoptic bronchoscopes. Results Seven fiberoptic bronchoscopes were sent to central sterile supply room for 159 times of cleaning and disinfection. Specimens were taken 30 times in different dates, surface cleanliness was detected by ATP fluorescence method with RLU range of 10-64 (median was 22), and qualified rate was 100%. A total of 159 times of detection were performed on the inner surface, colony counts were both 0-6 CFU/piece detected by filter membrane method and pouring method, and qualified rates were both 100%. The results of seven cycles of stability test showed that the initial concentration of available chlorine was 210 mg/L when hypochlorite disinfectant was used in automatic endoscope cleaning-disinfection machine, after one-week disinfection, endoscopes were treated 20-32 times, and concentration of available chlorine was 74-106 mg/L. Conclusion Hypochlorite disinfectant can meet the prescribed disinfection requirements when it is used for disinfection of fiberoptic bronchoscope by automatic soft endoscopy cleaning-disinfection machine, the effective concentration of hypochlorite disinfectant can still be maintained when it is used in machine for 7 days.