低温蒸汽甲醛灭菌方法及影响因素的研究

目的研究建立低温蒸汽甲醛灭菌器灭菌效果的评价方法及影响因素。方法采用载体定性杀菌试验方法并参照欧洲标准相关规定,对低温蒸汽甲醛灭菌器灭菌效果及其灭菌程序和影响因素等进行了综合评价。结果该低温蒸汽甲醛灭菌器使用60℃、78℃低温蒸汽灭菌温度的半周期程序,注入甲醛复合液汽化(甲醛浓度分布约为307 mg/L),物品装量在满载条件下,对PCD装置内染有嗜热脂肪杆菌芽孢菌片和枯草杆菌黑色变种芽孢的菌片,以及直接染于塑料片、不锈钢和止血钳齿部的枯草杆菌黑色变种芽孢均可达到完全杀灭。布放在灭菌柜室内带锈迹止血钳齿部的枯草杆菌黑色变种芽孢,经半周期灭菌后均有部分样本有菌生长。结论低温蒸汽甲醛灭菌器达到灭菌合格所需条件:灭菌温度为60℃和78℃,半周期灭菌时间为15 min和5 min,满载装量和小装量,所试验的管状PCD及塑料片、不锈钢片和止血钳齿部均可达到灭菌。     

新冠状病毒在不同条件下可存活多久?

答 :中国香港、日本和德国实验室网络研究确定 :新的冠状病毒 (SARS CoV)在干燥塑料表面至少存活 4 8h ;在粪便中至少可存活 2d ,在尿液中至少可存活 2 4h ;而在腹泻病人的粪便中病毒因pH比正常粪便低 ,可存活 4d ;在粪便和尿液的混合物中 (室温 )至少可存活 1～ 2d。在低温环境中可存活更长时间 ,而在 0℃时可无限期存活。SARS CoV在细胞培养上清液中的存活时间分别为 :4℃和 8℃放置 2 1d时 ,病毒浓度仅有很小程度的减少 ;在稳定的室温放置 2d时 ,病毒的浓度只降低 1个对数 (比冠状病毒稳定 ) ;加热达 5 6℃时 ,则以每 15min可杀灭 …     

全棉布及医用皱纹纸类包装物品的灭菌效果及有效期探讨

目的探讨全棉布、医用皱纹纸类包装材料包装的物品经高压蒸汽或环氧乙烷气体灭菌,能否达到完全无菌;研究在不同存放条件下和不同灭菌方法,两种材料包装灭菌物品的存放有效期。方法将医用皱纹纸和全棉布包装医疗器械,分别进行高压蒸汽和环氧乙烷灭菌,存放在无菌、清洁、污染场所共5个,分别于灭菌的当天、7d、14d、1个月、2个月、3个月、4个月、5个月、6个月做细菌培养。结果全棉布和医用皱纹纸用于包装医疗用品能达到灭菌效果,且在半年内能保持无菌状态。结论建议根据本医院的实际情况,将全棉布的制作和清洗费用与医用皱纹纸的成本进行比较,进行选择。     

灭菌包装用无纺布与棉布包装物品的灭菌效果比较

目的 探讨棉布、灭菌包装用无纺布包装的物品经高压蒸气,环氧乙烷灭菌及过氧化氢等离子灭菌,能否达到完全无菌及灭菌物品的存放有效期.方法 将医用灭菌包装用无纺布和棉布包装医疗器械各360份,分别进行高压蒸气和环氧乙烷灭菌及过氧化氢等离子灭菌各120份,另外选取60份存放在无菌、清洁、污染场所各20份,分别于灭菌的当天、灭菌后7,14 d,1,3,6个月做细菌培养,并对检测结果进行比较.结果 灭菌包装用无纺布用于包装医疗用品能达到灭菌效果,且在半年内能保持无菌状态,效果优于棉布包装.结论 建议根据本医院的实际情况,将目前棉布的购买和使用费用与灭菌包装用无纺布的采购成本进行比较,进行最佳选择.     

“非典”定点医院消毒工作管理

传染性非典型肺炎(SARS)具有较强的传染性,世界卫生组织公布的资料提示,SARS病毒在被污染物表面可存活24h,在粪便中可存活4d,在低温环境可能会长期存活,当条件适宜时可能会重新传播感染.     

不同灭菌方式对无菌物品有效期的影响

不同灭菌方法灭菌处理过的无菌物品储存有效期受到包装材料、封口的严密性、灭菌条件、储存环境等诸多因素影响。按照规范规定,对于棉布包装材料和开启式容器,建议在室温25℃以下保存2周,潮湿多雨季节应缩短保存时间。对于其它包装材料如一次性无纺布,一次性纸塑包装材料,如证实该包装材料能阻挡微生物渗入,其有效期可相应延长,至少为半年以上。不同的灭菌方式是否对无菌物品的有效期会有所影响尚不得而知,为此我们采用一次性纸塑包装材料使用不同的灭菌方式在不同的医疗环境中研究对无菌物品有效期的影响。1方法1.1试验组设计我们将4#手术…     

含氯消毒剂使用不当对护士伤害的报道

<正> 在SARS流行期间,含氯消毒剂在控制流行传播方面起到了重要作用,常用其浸泡、擦拭、喷雾消毒被SARS病毒污染的空气、物品、物体表面。但若使用剂量和方法不当,会导致氯气对人体的伤害。     

棉布与无纺布包装无菌物品储存有效期限的比较

目的比较棉布与无纺布包装物品压力蒸汽灭菌后无菌储存有效期限。方法采用无菌检验方法对两种灭菌包装灭菌后储存有效期进行比较观察。结果采用常规的包装方法,经压力蒸汽灭菌干燥之后于无菌室内储存。在夏秋季从4月份开始,棉布包装的物品可连续储存180 d经检测无菌生长,储存190 d开始长菌;无纺布包装的物品连续储存120 d无菌生长,储存130 d开始长菌。在冬春季11月份开始,棉布包装物品可储存270 d无菌生长,无纺布包装物品储存205 d无菌生长。结论在同等条件下,棉布包装的物品无菌储存有效期限比无纺布包装的物品有效期长,一次性无纺布阻挡微生物渗入的效果并不优于棉布。     

新型包装材料行脉动真空压力蒸汽灭菌的生物监测研究

目的 探讨全棉布、无纺布和纸塑包装材料包装的物品行脉动真空压力蒸汽灭菌后,能否达到完全灭菌.方法 将嗜热脂肪杆菌芽孢菌片试管分别置于用全棉布、无纺布和纸塑包装材料三组包装的标准试验包中心部位,每组五个;将三组材料包装的标准试验包分别置于脉动真空压力蒸汽灭菌器的下前、中上、后上、中下、后下位置进行灭菌,灭菌后取出芽孢菌片,送检验科进行生物监测.结果 三组包装材料进行的生物监测结果均为灭菌合格.结论 新型包装材料用于灭菌物品包装安全、经济、可靠,并可预防院内感染.     

疫情期间中心供应室的质量控制管理

综合性医院供应室在遇到大规模的急性突发传染病时，应正确实施消毒灭菌方法，严格执行消毒灭菌的有关规章制度，并制订严格的消毒隔离流程及防护措施。我院在收治SARS患期间，供应室工作坚持2个保证，即保证SARS病房回收物品进入供应室污染区消毒，处理及时、快捷，符合灭菌要求；保证供应室内清洁物品和无菌物品不受污染。以上2个保证对控制传染源，切断传播途经起着重要作用，是控制医院内感染和安全防护的有效手段。     

SARS病毒对温度耐受性的实验研究

为观察SARS病毒在冷藏和自然温度下的稳定性以及灭活SARS病毒的有效温度,将SARS病毒培养的上清液(10~6TCID_(50))分装到10ml离心管中,放置在4℃冰箱、室温(24.5℃)、37℃、56℃和70℃水浴中,间隔一定时间以后取样0.5ml,接种Vero-E6细胞。结果,SARS病毒在冷藏和室温条件下十分稳定,冷藏(4℃)放置10d,滴度只下降大约2个log,室温放置5d,滴度下降大约4个log,仍然保持较高的感染性。加热时SARS病毒的滴度迅速下降,56℃加热30min、70℃加热15min检测不出有活病毒。结论,SARS病毒在冷藏和自然温度下十分稳定,加热是灭活SARS病毒简单有效的方法。     

影响环氧乙烷消毒效果主要因素的观察

<正> 环氧乙烷具有较强的杀菌能力,又适用于对忌热忌湿物品的消毒处理,故近年来应用较为广泛。但其消毒效果常易受温度、湿度与物品表面性质等因素的影响。为正确指导实际应用,特针对上述主要影响因素,进行了有关规律的观察。     

Efficacy of various methods of sterilization of acupuncture needles

The iatrogenic transmission of hepatitis B virus by inadequately sterilized acupuncture needles recently has been reported. Because some licensed chiropractors use acupuncture as a therapeutic modality, we have evaluated sterilization methods for these needles, which would be adaptable for use in a chiropractic office. Dry heat, boiling water, pressurized steam, sodium hypochlorite, and 70% alcohol were compared with a glass bead dry heat sterilizer originally developed for dental instruments. Presterilized acupuncture needles were contaminated with Bacillus stearothermophilus, Escherichia coli or Staphylococcus epidermidis and sterilized for intervals ranging from 5 sec to 30 min. The needles were then cultured to determine the efficacy of the sterilization regimen. Seventy percent alcohol was ineffective as a sterilization method. In terms of both time and convenience, the glass bead apparatus was the most efficient of the remaining methods tested. B. stearothermophilus-contaminated acupuncture needles were sterilized within 10 sec of exposure to preheated glass beads. Less than 10 sec exposure killed E. coli and S. epidermidis. A significant advantage of the glass bead sterilizer over the other methods was the absence of physical damage to the needles.     

微波与洗必泰协同杀菌效果的试验观察

试验表明，６５０Ｗ微波与０．５％洗必泰溶液协同作用５分钟，可使在聚丙烯塑料密封包装内的物品达到灭菌。医院内应用试验，检测３９８份医疗器械，全部达到灭菌。此法累积作用７２小时，对碳钢和铝有轻度腐蚀，对不锈钢与黄铜基本无腐蚀。     

Clinical brief: severe acute respiratory syndrome (SARS).

The World Health Organization (http:/www.who.int/en/) and Centers for Disease Control and Prevention (http://www.cdc.gov) websites are updated daily as new information is learned about the Severe Acute Respiratory Syndrome (SARS) phenomena. The transmission of SARS appears to occur predominantly through direct contact with infectious material. This includes dispersed respiratory droplets, making touching contaminated objects a potential concern. Occupational health nurses must educate themselves and their employees about SARS to allow for accurate and timely sharing of information.     

SARS病房工作的医护人员血清中特异抗体测定分析

目的 检测密切接触SARS患者的医护人员血清中SARS病毒IgM及IgG抗体的水平，对SARS病毒有无隐性感染作初步调查。方法 分别用酶联免疫吸附法和间接免疫荧光法(IIFA)检测200例正常人，200例在SARS病房工作1个月的医护人员血清中SARS病毒IgM及IgG抗体的水平。结果 正常人及医护人员血清中未检测到SARS病毒IgM及IgG抗体。结论 不同于普通的流行性传染性疾病，SARS病毒可能不具有隐性感染性。     

传染性非典型肺炎临床诊断病例血清标本不同非典型肺炎病原体抗体检测

目的研究传染性非典型肺炎(SARS)临床诊断病例血清标本中常见的不同非典型肺炎病原体感染抗体分布情况。方法选取2003年SARS流行期间90份SARS临床确诊病例血清标本和40份健康志愿者血清标本进行血清抗体检测。结果90份临床诊断的传染性非典型肺炎(SARS)病例急性期血清标本中,21.1%(19/90)标本SARS抗体阳性,79.9%(71/90)标本SARS抗体阴性。肺炎支原体、呼吸道合胞病毒、腺病毒、军团菌、肺炎衣原体等抗体检测呈现不同的分布。结论2003年SARS流行期间,SARS抗体阴性的传染性非典型肺炎临床确诊病例可能存在或合并其它病原体感染。     

A PLAQUE ASSAY FOR ENUMERATING ANTIGEN-SENSITIVE CELLS IN DELAYED-TYPE HYPERSENSITIVITY

A general method is described for enumerating antigen-sensitive lymphocytes obtained from individuals having delayed hypersensitivity, in this case from highly tuberculin-sensitive guinea pigs. The method is based on the observation that resting lymphocytes are generally unable to support replication of RNA viruses, whereas antigen-"activated" lymphocytes can. Lymph node lymphocytes from individual animals were cultured in the presence or absence of tuberculin purified protein derivatives (PPD). After various periods of time, the cells were infected either with Newcastle disease virus or vesicular stomatitis virus, and plated in agar over a monolayer of cells susceptible to the virus. Wherever a lymphocyte yielded infectious virus, a discrete plaque in the monolayer could be seen. The increase in plaques of the antigen-stimulated cells over the background of the control sample was taken as the number of antigen-sensitive cells in the population. When lymphocytes from normal guinea pigs or from guinea pigs immunized to produce only circulating antibody to PPD were similarly tested, no increase in plaque-forming units (PFU) was observed. The average increase in PFU due to antigenic stimulation varied from 1 per 1000 lymphocytes at 24 hr to 16 per 1000 lymphocytes at 96 hr. By employing inhibitors of mitosis (colchicine, vinblastine, and thymidine) it was evident that the increase in PFU at least up to 48 hr was primarily due to initial antigen-reactive cells and not their progeny.     

Theoretically estimated risk of severe acute respiratory syndrome transmission through blood transfusion during an epidemic in Shenzhen, Guangdong, China in 2003.

BACKGROUND: Severe acute respiratory syndrome (SARS) is a newly recognized infectious disease that caused an outbreak in south China in 2003. The cause of SARS was identified as a novel coronavirus (CoV). The existence of asymptomatic seroconvertors and the detection of the SARS-CoV RNA in plasma during the course of infection all suggest that SARS could, as least theoretically, be transmitted by transfusion. An estimate of the risk of SARS transmission through blood transfusion will contribute to decisions concerning blood safety monitoring and may be useful in the design of strategies to decrease the risk of transfusion-transmitted infections. STUDY DESIGN AND METHODS: Case onset dates from the 2003 Shenzhen SARS epidemic and investigational results from Taiwan on viremia in humans are used to estimate the number of cases that were viremic throughout the epidemic. Estimates of the asymptomatic-to-clinically confirmed SARS-CoV infection ratio, the proportion of asymptomatic infections reported in a seroprevalence survey in Hongkong, and the population size of Shenzhen are used to infer the SARS-CoV transfusion-transmission risk. Statistical resampling methods are used. RESULTS: Based on data from Shenzhen, Hongkong and Taiwan, the maximum and mean risk (per million) of SARS-CoV transmission from donors in Shenzhen were estimated as 23.57 (95% CI: 6.83-47.69) and 14.11 (95% CI: 11.00-17.22), respectively. The estimated risk peaked on April 02, 2003. CONCLUSIONS: Although there are currently no confirmed reports of the transmission of SARS-CoV from asymptomatic individuals, recent research data indicate that transfusion-transmitted SARS-CoV is at least theoretically possible. Although the risk is low, with its rapid spread of the disease, appearance of alarmingly high infectivity and high fatality rate, public health authorities need to consider strategies for blood donor recruitment and virus inactivation during an epidemic to further ensure blood safety.     

Purification of severe acute respiratory syndrome hyperimmune globulins for intravenous injection from convalescent plasma

BACKGROUND: Severe acute respiratory syndrome (SARS) is a new infectious disease caused by the SARS virus. Current first-line treatments are experimental, and their effectiveness remains open to question. For more effective treatment and prevention of SARS, human SARS hyperimmune globulins for intravenous (IV) injection were purified in this study. STUDY DESIGN AND METHODS: A combination of cold ethanol precipitation and ion-exchange chromatography was used to process pooled SARS convalescent plasma samples. Virus inactivation and removal approaches were taken to ensure safety. RESULTS: The purified hyperimmune globulins were formulated as a 5 percent solution, with an antibody titer specifically against the SARS virus of 1:83, 1:1600, and 1:200, as determined by enzyme-linked immunosorbent assay, immunofluorescence assay, and neutralizing antibody test, respectively. The purity of the SARS hyperimmune globulins was 99.0 percent, and the monomer and dimer content was 100 percent. Other variables analyzed met the Chinese Requirements of Biologics for IV immune globulin. The SARS hyperimmune globulins prepared were subsequently approved for clinical evaluation by the Chinese National Institute for the Control of Pharmaceutical & Biological Products. CONCLUSION: IV-injectable, purified, and concentrated human SARS hyperimmune globulins were prepared from pooled convalescent plasma samples, which are ready to be further evaluated.