器械消毒液污染与手术感染关系的研究

广州一医院10天内连续发生3例心脏手术感染。经检查乃由于器械消毒液受到绿脓杆菌严重污染所致。药敏试验显示分离的菌株具有抗洁而灭特性,对某些抗生素的抗性亦有所增高,而对酚、洗必泰、碘伏、戊二醛仍保留其原敏感性。

STUDY ON THE RELATIONSHIP BETWEEN CONTAMINATION OF IN STRUMENT DISINFECTANT AND SURGICAL WOUND INFECTION

Three cases of wound infection after heart operation occurred successively in a hospital of Guangzhou City. Bacteriological examination of the on-the-spot samples isolated Pseudomonas aeruginosa at concentrations of 6 600～1 070 000 cfu/ml from 6 of the 8 disin- fectant solution (containing 0.1％ benzalkonium and 0.5％ sodium benzoate) samples for immersing disinfection of surgical instruments. Cross reactions between the six bacterial stains isolated from the disinfectant samples and the sera of the patients were positive. Test of the bacterial strains isolated from the disinfectant solution and those (2 strains) from the blood of patients for sensitivity to disinfectants (benzalkonium, chlorhexidine acetate, iodophor, glutaraldehyde and phenol) and antibiotics (amikacin, polymycin B, gentamycin, tobramycin, tetracycline, chloromycetin and kanamycin) gave same results. As compared with the control strains, these eight strains exhibited certain resistance to benzalkonium as well as to gentamycin and tobramycin to which the P. aeruginosa was originally sensitive, but they did not show resistance to other 4 disinfectants tested. The results indicated that the P. aeruginosa causing infection of the patients came from contaminated instrument disinfectant and had developed resistance to chlorhexidine after prolonged living in the disinfectant solution.