上海市医院内窥镜污染与消毒现状调查

为了解上海市医院内窥镜的使用状况及其污染与消毒现状,对30所医院的5种常用内窥镜进行了调查与采样检测。结果,内窥镜使用场地符合率为85.88％,用于肝炎、结核等特殊传染病人检查的内窥镜专用率为69.41％,使用消毒剂正确率为90.59％,内窥镜消毒、灭菌作用时间符合率为45.88％,仅2.35％活检钳进行灭菌;内窥镜消毒、灭菌合格率为84.42％（168/199）,胃肠镜水瓶水检测合格率为41.27％（26/63）。胃镜污染微生物主要为金黄色葡萄球菌、HBsAg、绿脓杆菌、大肠杆菌及分枝杆菌。胃肠镜水瓶水中尚检出绿脓杆菌。内窥镜消毒不合格主要与作用时间不足、消毒剂含量不够有关;胃镜污染分枝杆菌则与其消毒后用自来水冲洗有关。因此,应严格掌握消毒剂用量、消毒与灭菌作用时间、以及消毒后冲洗用水。

A SURVEY OF PRESENT STATUS OF CONTAMINATION OF ENDOSCOPES AND DISINFECTION IN HOSPITALS OF SHANGHAI

In order to know the use of endoscopes and the present status of their contamination and disinfection in hospitals of Shanghai, a survey and sampling of 5 kinds of common endoscopes were carried out in 30 hospitals. The results showed that the compliance rate of places for endoscopy was 85.88%. The rate of using endoscopes special for examination of the patients with special infectious diseases such as hepatitis and tuberculosis was 69.41%. The rate of correct use of disinfectants was 90.59%. The compliance rate of duration of disinfection and sterilization of endoscopes was 45.88% and only 2.35% of biopsy forceps were sterilized. The eligible rale of disinfection and sterilization of endoscopes was 84.42% (168/199) and that of examination of water in the water bottle of gastroscope and enleroscope was 41.27% (26/63). The microorganisms contaminating the gastroscope were mainly Staphylococcus aureus, HBsAg, Pseudomonas aeruginosa, Escherichia coli, and mycobacteria, Pseudomonas aeruginosa was also detected from the water in water bottle of gastroscope and enleroscope. Ineligibility of endoscope disinfection was related mainly to inadequate exposure lime and insufficienl disinfectanl content. Contamination of gaslroscope by mycobacteria was related to rinse with tap water after disinfeclion. Therefore, the dose of disinfeclant, duration of disinfection and sterilization and the water used for rinse after disinfeclion should be slriclly conlrolled.