2011—2013年西安市各级医疗机构消毒灭菌质量监测

目的了解西安市属各级医疗机构消毒灭菌质量现状，加强医院消毒工作的监督管理，以改进医疗机构消毒灭菌水平与感染控制措施。 方法依据2002年版《消毒技术规范》和GB 15982－1995《医院消毒卫生标准》相关规定，对全市69所医疗机构的消毒灭菌效果进行监测与评价。结果2011-2013年共检测样品2 224份，消毒灭菌质量合格1 766份，总合格率为79.41％。消毒灭菌质量监测中，三级医疗机构合格率（83.67％）高于二级及以下医疗机构（77.50％），差异有统计学意义（P=0.001）；公立医疗机构（79.64％）合格率与民营医疗机构合格率（78.20％）差异无统计学意义（P=0.532）；综合医疗机构合格率（80.18％）高于专科医疗机构（74.92％），差异有统计学意义（P=0.030)。不同监测对象（样品）中，使用中消毒剂和压力蒸汽灭菌效果（测试包和PCD）合格率（分别为98.46%、100.00%、98.06%）较高，医护人员手卫生和戊二醛合格率（分别为58.48%和43.28%）较低。结论西安市各级医疗机构消毒灭菌质量水平参差不齐，不同监测对象消毒灭菌质量差异较大，应重点加强医务人员手卫生和戊二醛浓度的监管工作。

Surveillance on the quality of disinfection and sterilization among medical institutes in Xi’an in 2011-2013

Objective To investigate the status of disinfection and sterilization quality of different levels of medical institu- tes in Xi＇an, and improve the management level of disinfection and sterilization of medical institutes. Methods Disinfection and sterilization efficacy of 69 medical institutes were monitored and evaluated according to Standardization for Disinfec- tion Techniques （2002 edition） and Sanitary Standards for Hospital Disinfection （GB15982 - 1995）. Results From 2011 to 2013, 2 224 specimens were tested, 1 766 （79.41%） were qualified. The qualified rate of tertiary medical institutes was higher than second and below medical institutes （83.67% vs 77.50% ,P = 0. 001）, the qualified rate between public medical institutes and private medical institutes was not statistically different （79.64% vs 78.20%, P = 0. 532）, the qualified rate of comprehensive medical institutes was higher than specialized medical institutes （80.18% vs 74.92% ,P = 0. 030）. of different detected specimens, the qualified rates of disinfectant in use and pressure steam sterilizers （including test pack and process challenge device） were higher （98.46%, 100.00%,and 98.06 % respectively） ,while the hands of health care workers （HCWs） and glutaraldehyde were lower（58.48 % and 43.28% respectively）. Conclusion Disinfection and sterilization quality in different medical institutes in Xi＇an is dif- ferent, and different disinfected and sterilized objects are also varied . It is necessary to intensify the management of hand hygiene of HCWs and concentration of glutaraldehyde.