医疗废物锐器盒病原微生物污染状况与使用时限研究

目的了解医疗废物锐器盒不同使用时间病原微生物污染状况,探讨锐器盒使用的合理期限,为医疗废物的管理提供参考。方法随机抽取某传染病三级甲等专科医院病区治疗车上使用后的2 L锐器盒12个,检测锐器盒内部以及外表面不同时间节点乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、人类免疫缺陷病毒(HIV)病毒载量和细菌菌落数,同期取3个未使用的锐器盒作为空白对照。结果采集实验组和对照组四个节点(48 h、72 h、5 d、7 d)锐器盒外表面、内容物的洗脱液标本各60份,均未检测到HIV、HCV,锐器盒的外表面标本均未检测到HBV,仅有一个锐器盒使用后72 h内容物洗脱液检测到HBV,含量为2.20E+01 IU/mL。使用后锐器盒内部洗脱液的染菌量变化:使用后5 d锐器盒内容物洗脱液100%有细菌生长,使用后7 d 12个锐器盒内容物洗脱液均细菌载量不可计数。锐器盒外表面细菌载量为1～9 CFU/cm~2。感官指标中所有锐器盒内、外表面均未发生明显改变,未产生不适气味。结论随着锐器盒贮存时间延长至7 d,锐器盒外表面细菌菌落数无明显增长,也未检测到HIV、HBV、HCV,建议不强制要求产生量小(即使用后48 h锐器盒达不到3/4贮存量)的科室锐器盒使用时限设为48 h。

Pathogenic microorganism contamination and duration of service time of medical waste sharps containers

Objective To understand pathogenic microorganism contamination status of medical waste sharps containers with different use time, explore the reasonable duration of service time of sharps containers, provide reference for the management of medical waste. Methods Twelve 2L sharps containers on treatment trolleys in a tertiary first-class infectious disease specialty hospital were randomly selected, viral loads of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) as well as bacterial colonies on inner and outer surfaces of sharps containers at different time points were detected, three unused sharps containers were taken as control at the same time. Results Sixty eluent specimens of outer surface and contents of sharps containers in trial group and control group were collected respectively at four time points (48 h, 72 h, 5 d, 7 d), no HIV and HCV were detected, and no HBV was detected in specimens of outer surface of sharps containers, HBV was detected in the eluent of contents in one sharps container 72 hours after the use, concentration of HBV was 2.20E+01 IU/mL. Changes in bacteria in the eluent of used sharps containers:100% of the eluent of contents in sharps containers grew bacteria on the 5th day after use, bacterial load of the eluent of contents in sharps containers on the 7th day after use was incalculable. Bacterial load on the outer surface of sharps containers ranged from 1 to 9 CFU/cm². No significant changes were observed in the inner and outer surfaces of all sharps containers, and no discomfort odor emerged. Conclusion With the storage time prolonged to 7 days, bacterial colonies on the outer surface of sharps containers didn't increase significantly, HIV, HBV and HCV were not detected. It is suggested that service time of sharps containers with small production of contents should not be set compulsorily at 48 hours (even if the contents in sharps container is less than 3/4 of storage capacity after 48 hours of use).