镇江市医院内镜消毒现状调查

目的了解镇江市医院内镜清洗消毒状况,以提高内镜消毒质量。方法采用问卷调查和现场抽样检测方法,对镇江市部分医院内镜消毒情况进行了调查。结果共抽样检测内镜及其相关用品297份,总合格率为47.81%,各级医疗机构消毒效果合格率均较低,但上级医院好于下级医院。检测胃镜、肠镜和纤维支气管镜共37份内腔面,合格率为54.1%,其中胃镜细菌总数最高达6000 cfu件/,肠镜细菌总数最高达6300 cfu件/,并检出铜绿假单胞菌。检测内镜清洗消毒槽内壁、进水管口、出水管口内表面122份,合格率仅为36.1%,其中胃镜冲洗槽内壁最高污染菌数为2100 cfu/cm2,进水管口内表面为3000 cfu/cm2;肠镜冲洗槽内壁为1800 cfu/cm2,有9份样检出铜绿假单胞菌。结论镇江市医疗机构内镜消毒与灭菌质量合格率比较低,市级医院好于县级以下医院;存在制度不健全,清洗消毒操作不规范问题,需要加强管理和改进内镜消毒质量。

SURVEY OF PRESENT SITUATION OF DISINFECTION OF ENDOSCOPES IN HOSPITALS OF ZHENJIANG CITY

Objective To know the condition of washing and disinfection of endoscopes in hospitals of Zhenjiang City in order to improve the disinfection quality of endoscopes.Methods Questionnaire investigation and on-the-spot sampling examination method were used to carry out a survey of condition of disinfection of endoscopes in some hospitals of Zhenjiang City.Results 297 sets of endoscopes and their related articles were sampled and examined and the overall eligible rate was 47.81%.The elgible rates of disinfection efficacy in medical institutions at various levels were relatively low,but the hospitals of higher level were better than those of the lower level.The inner surfaces of 37 gastroscopes,enteroscopes and bronchial fiberscopes were examined and the eligible rate was 54.1%.The highest total bacterial count in gastroscopes attained 6000 cfu/piece,that in enteroscopes attained 6300 cfu/piece and Pseudomonas aeruginosa was detected. The inner surfaces of 122 inner walls of endoscope washing-disinfection tanks,water inlets and water outlets were examined and the eligible rate was only 36.1%.The highest contaminating bacterial count on the inner walls of gastroscope irrigation tanks was 2100 cfu/cm2,that on the inner surfaces of water inlet was 3000 cfu/cm2 and that on the inner walls of enteroscope irrigation tank was 1800 cfu/cm2 and P.aeruginosa was detected in 9 samples. Conclusions The eligible rate of disinfection and sterilization quality of endoscopes in medical institutions of Zhenjiang City was relatively low and the hospitals of municipal level were better than the hospitals lower than county level.There were problems of imperfection of rules and regulations and non-standardization of washing-disinfection operation,so it is necessary to strengthen administration and improve endoscope disinfection quality.