引流袋出口逆行污染模拟实验研究

目的研究引流袋出口逆行污染的情况,为制定相关医院感染规范提供依据。方法2016年10月14日将尿液、5%葡萄糖溶液、葡萄糖盐水、无菌水、0.9%生理盐水按无菌操作分别注入抗返流引流袋(抗逆组)与普通引流袋(普通组),入口端封闭,用出口离地面10 cm(悬挂组)和触地(触地组)两种方式悬挂,每间隔3 d从出口端取标本送细菌培养共10次,动态观察引流袋出口逆行污染情况。结果引流袋出口逆行污染发生率抗逆组(7.7%)低于普通组(46.0%),差异有统计学意义(P=0.000);悬挂组(17.9%)低于拖地组(35.8%),差异有统计学意义(P=0.000)。不同液体性质的引流袋出口逆行污染发生率分别为尿液(54.3%)5%葡萄糖溶液(34.5%)葡萄糖盐水(24.3%)0.9%生理盐水(10.8%)或无菌水(10.5%),两两比较差异有统计学意义(P=0.000)。首次出现引流袋出口逆行污染的时间抗逆组发生在第13天,普通组发生在第7天,两者在第7天差异有统计学意义(P=0.041)。发生出口逆行污染的引流袋种类与液体性质差异呈中等强度关联(Pearson C=0.5)。结论不同类型引流袋、留置时间和液体性质均不同程度影响引流袋出口逆行污染,临床应重视在使用引流袋过程中定期送尿培养,以便合理使用抗菌药物以及指导更换引流袋的时间。

Simulation experiment of retrograde contamination of drainage bag outlets

ObjectiveTo explore the retrograde contamination of drainage bag outlets, and provide basis for the formulation of related guideline for healthcare associated infection(HAI) management. MethodsOn October 14, 2016, with sterile manipulation, urine, 5% glucose solution, glucose normal saline, sterile water, and 0.9% normal saline were injected into anti reflux drainage bags (anti reflux group) and common drainage bags (common group) respectively, entrances of bags were sealed and bags were hung in two ways: outlets were 10 cm away from the ground (suspended group) and touched the ground (ground touching group) respectively, specimens were collected from bag outlets to perform bacterial culture every 3 days, a total of 10 times of cultures were performed, re trograde contamination of drainage bag outlets was observed dynamically. ResultsRetrograde contamination rate of drainage bag outlets of anti reflux group was significantly lower than common group (7.7% vs 46.0%, P=0.000); suspended group was significantly lower than ground touching group (17.9% vs 35.8%, P=0.000). Retrograde contamination rates of outlets of drainage bags filled with different properties of liquid were as follows: urine (54.3%)＞5% glucose solution (34.5%)＞glucose normal saline (24.3%)＞0.9% normal saline (10.8%)＞ste rile water (10.5%), pairwise comparison showed a significant difference(P=0.000). The initial occurrence time of contamination in anti reflux group and common group was on the 13th day and 7th day respectively, two group was significantly different on the 7th day(P=0.041). There was a medium intensity correlation between the types of drainage bags and liquid properties（Pearson C=0.5）. ConclusionDifferent types of drainage bags, retention time, and liquid property can impact retrograde contamination of drainage bag outlets, regular urine culture during the use of drainage bags should be paid attention in clinical practice, so as to use antimicrobial agents rationally and guide replacement time of drainage bags.