新型消毒剂对内镜消毒效果的研究

目的 了解目前新型高水平消毒剂对内镜中病原菌的现场杀灭程度,验证消毒效果.方法 分别选取酸性氧化电位水与2％的碱性戊二醛消毒剂对15份污染培养龟分枝杆菌脓肿亚种的内镜进行现场模拟消毒效果比对,邻苯二甲醛、过氧乙酸与2％碱性戊二醛对10份枯草芽胞杆菌黑色变种芽胞污染的内镜进行现场模拟消毒效果比；检测方法采用无菌毛刷头振荡后,再经过采用0.45 μm孔径负压膜过滤法直接用滤膜培养.结果 经过中和剂鉴定,龟分枝杆菌脓肿亚种和枯草芽胞杆菌黑色变种芽胞满足现场消毒试验要求,酸性氧化电位水和2％戊二醛浸泡消毒后,对龟分枝杆菌的除菌率均≥99.99％,但酸性氧化电位水消毒后龟分枝杆菌脓肿亚种菌数明显少于戊二醛组(P=0.019)；过氧乙酸、2％戊二醛和邻笨二甲醛泡消毒后,对枯草芽胞杆菌黑色变种芽胞除菌率均≥99.99％,但经氧乙酸消毒后枯草芽胞杆菌黑色变种芽胞菌数结果明显少于其他两组(F=15838.512,P=0.000).结论 目前新型内镜专用消毒剂能满足目前内镜高水平消毒需要,采样方法及龟分枝杆菌培养技术在试验中得到了应用.

Effect of new type of disinfectant on disinfection of endoscope

OBJECTIVE To learn the effect of a new type of disinfectants on the disinfection of the endoscope in a simulated contaminated environment,further verify the disinfection effect.METHODS The effects of the electrolyzed acid water and 2% alkaline glutaraldehyde were compared on the disinfection of the endoscope which were contaminated by cultured Mycobacterium chelonae,O-phthalaldehyde,peracetic acid and 2% alkaline glutaraldehyde were compared on the effects of disinfection of the endoscopes contaminated by Bacillus subtilis.The filter membrane was cultured to verify the disinfection effect after filtration of membrane with 0.45 μm pore size under the negative pressure.RESULTS Both M.chelonae and B.subtilis met the need of creating a simulated contaminated environment in endoscope.Acid oxidation potential water and 2% glutaraldehyde immersion disinfection,sterilization rate of M.chelonae can be more than 99.99%,but by calculating the residual bacterial count results of glutaraldehyde,electrolyzed acid water did a better job on the disinfection of M.chelonae than glutaraldehyde(P=0.019),peracetic acid,2% glutaraldehyde and adjacent benzene two formaldehyde bubble after disinfection,B.subtilis sterilization rate was over than 99.99%,but by calculating the residual bacterial count results,peracetic acid was better than O-phthalaldehyde and glutaraldehyde on the disinfection of B.subtilis(F=15838.512,P=0.000).CONCLUSION The new type of disinfectant can meet the need of efficient disinfection of the endoscope.The sampling method and the culture technology of M.chelonae have been applied appropriately in this study.