提高口腔医护人员手卫生依从性的实践研究

目的提高口腔医护人员的手卫生依从性,降低医院感染率。方法通过临床调查了解口腔医护人员手卫生执行状况,分析手卫生执行欠佳的原因并针对原因采取解决措施。结果口腔医护人员的手卫生依从性逐年上升,手卫生执行正确率分别从2006年的60.8%、68.9%与70.3%上升到2009年的96.2%、99.1%与95.2%,手消毒液的使用率由51.2%上升至100%。x2=16.7p〈0.01,差别有高度显著意义。结论通过具体分析原因,从主观及客观两方面提高口腔医护人员的手卫生依从性是切实可行的。     

三氯异氰尿酸复方消毒剂杀菌效果的试验观察

由三氯异氰尿酸、酒石酸、苯甲酸钠制成的白色泡腾片,含有效氯39.58％（g/g）,易溶于水。为了解其杀菌效果,进行了载体定量杀菌试验及擦拭消毒物体表面与手的试验。结果,用其含有效氯100mg/L溶液（pH6.0）对布片上大肠杆菌作用1min,以其含有效氯1000mg/L溶液（pH6.5）对布片上枯草杆菌黑色变种芽孢作用15min,平均杀灭率均为99.99％;前者作用3min,后者作用30min,杀灭率均为100％。用其含有效氯100mg/L溶液擦拭桌面、台面、电话机与人员手后作用3min,可使自然菌减少≥90.00％。该复方杀菌效果较好。     

紫外分光光度法快速测定消毒剂中三氯生含量

为建立紫外分光光度法测定消毒剂和抗菌剂中三氯生的方法,采用紫外分光光度计,在280 nm波长下,对用无水乙醇稀释后的三氯生样品直接测定,进行了工作曲线、精密度、回收率等实验。结果,当标准溶液在0.0～50.0 μg/ml浓度范围内,回收率90％～105％,相对标准偏差1.5％,与高效液相色谱法对比,结果无显著性差异,并与配方值相符。经过对54℃ 14 d和37℃ 90 d保存样检测,标准和样品含量均没有降低。结果显示,三氯生具有良好稳定性,紫外分光光度法测定三氯生含量,方法简便、快速、准确、灵敏度高,适宜大批样品测定。     

关于《医院消毒卫生标准》的应用与完善

为了使《医院消毒卫生标准》中有关规定更具有可操作性,结合检验实际,对其中有关消毒液和无菌器械保存液采样量问题进行了改进和完善。结果,按本检验规定采样量1.0 ml进行检验程序操作,检测样187份,合格182份,合格率达到97.3％。经对3份细菌总数超过3 000cfu/ml的样本进行复检,检出绿脓假单胞菌1份。结论,本方法采样量少、培养基用量少、操作方便、结果准确,便于大批量采样和检验。     

高效液相色谱法测定消毒剂中的呋喃西林

用高效液相色谱法,于呋喃西林有特征吸收峰且干扰较小的260nm波长下测定消毒剂中呋喃西林含量。结果,在0～0.80μg/ml含量范围内呈线性关系。检出限0.002μg/ml,回收率范围为86.87％～103.14％,相对标准偏差为0.88％～7.12％。     

肺炎克雷伯菌对消毒剂抗性的研究

当前,细菌对消毒剂的抗性问题越来越受到关注,国内外对消毒剂抗性也作了大量的研究。该文介绍消毒剂抗性的概念以及消毒剂抗性的产生机制,探讨消毒剂抗性的研究方法,重点回顾对肺炎克雷伯菌的消毒剂抗性方面的研究成果,并进行简要分析,指出目前消毒剂研究领域存在的问题,对今后该领域研究发展的方向给出建议。     

Comparative study on toxic effects induced by oral or intravascular administration of commonly used disinfectants and surfactants in rats

Accidental ingestion or injection of household products sometimes occurs due to their accessibility, but the toxic manifestations have not been well characterized when they are internally administered. The aim of this study was to investigate the toxic effects induced by ingestion or injection of different ionic surfactants and disinfectants in rats. The test drugs involved benzalkonium and benzethonium (BZK and BZT, both cationic surfactants used as disinfectants), alkyldiaminoethylglycine (AEG, an amphoteric surfactant used as a disinfectant), linear alkylbenzenesulfonate (LAS, an anionic surfactant), polyoxyethylene cetylether (PEC, a nonionic surfactant), chlorhexidine (CHX, not a surfactant but a disinfectant) and saline (control). Male Sprague–Dawley rats were administered one of the test drugs orally (p.o.), intravenously (i.v.) or intraarterially (i.a.). The fatal effects appeared rapidly (<30 min) in i.v.‐administered rats, while taking hours (>5 h) in i.a./p.o.‐administered rats after a dose of around LD₅₀, although the progress and degree of toxic effects varied among the drugs tested. In intravascular administration, BZK and BZT were fatal at doses of 15–20 mg kg^?1. Higher concentrations in lung and kidney than in blood were determined. CHX showed a high toxic effect compared with cationic surfactants. The rats administered anionic (LAS) or amphoteric (AEG) surfactant died in less than 24 h at doses over 100 mg kg^?1. In p.o. administration, the toxic effects were concentration/dose‐dependent, and all rats administered high doses of surfactants except for PEC died at 5–20 h. The overall toxic ranks could be: cationic surfactant/CHX> anionic/amphoteric surfactant > nonionic surfactant. Copyright © 2011 John Wiley & Sons, Ltd.     

防冻剂对二氧化氯消毒效果的影响观察

目的为了了解防冻剂对二氧化氯杀菌效果的影响。方法采用悬液定量杀菌试验进行了实验室研究。结果乙醇、氯化钠均可作为二氧化氯低温消毒防冻剂。以体积分数为10％的乙醇为防冻剂的二氧化氯消毒液,在-20℃条件下,用含有效氯100mg／L,250mg／L的二氧化氯消毒液作用20min,对枯草杆菌黑色变种芽孢的杀灭率分别为100．00％、99．97％。结论低温条件下,在二氧化氯消毒液中加入乙醇或氯化钠做为防冻剂,具增效、协同作用,能有效杀灭枯草杆菌黑色变种芽孢。     

消毒剂及紫外线照射对细菌L型的灭菌效果观察

目的探讨消毒剂及紫外线对L型菌的诱导及杀灭情况,为指导现场消毒杀菌工作提供实验依据。方法分别采用常用消毒剂与紫外线作用于金黄色葡萄球菌、大肠埃希氏菌或枯草杆菌,观察L型菌的诱导及杀灭情况。结果采用常用消毒剂消毒,发现仅75%乙醇作用1min内可诱导金黄色葡萄球菌形成L型,L型菌仍具有DNA酶活性、溶血作用,凝固酶仍为阳性;在紫外线消毒中,在不干燥的条件下,即使杀灭照射剂量足够,仍不能达到完全杀灭细菌的目的。结论采用乙醇消毒,应严格保证有效作用浓度和足够的消毒时间;采用紫外线消毒,应严格控制空气及物体表面的湿度,从而达到完全杀灭细菌的目的。     

Transmission of Clostridium difficile spores in isolation room environments and through hospital beds

The aim of this study was to determine the dissemination of Clostridium difficile (CD) spores in a hospital setting where the potassium monopersulfate‐based disinfectant Virkon^TM was used for cleaning. In the initial part of the study, we sampled 16 areas of frequent patient contact in 10 patient rooms where a patient with CD infection (CDI) had been accommodated. In the second part of the study, we obtained samples from 10 patient beds after discharge of CDI patients, both before and after the beds were cleaned. In the first part, CDspores were isolated in only 30% of the rooms. In the second part, which focused on transmission to hospital beds, C. difficile was found in four of 10 beds either before or after cleaning. In conclusion, in both parts of the study, we demonstrated a moderate spread of CD spores to the environment despite routine cleaning procedures involving Virkon^TM.