医学临床实验室环境细菌污染调查分析

目的调查本院临床实验室工作环境的卫生状况，使实验室工作人员应用《消毒技术规范》对环境清洁与消毒。方法采用回顾性分析的方法，对2007年本院临床实验室不同区域的空气、物体表面、消毒液、工作人员手等标本按《医院消毒卫生标准》要求监测的结果进行分析。结果984例监测标本545例超过标准，占55．39％；超标率最高为离心机，占88．89％、电话机占83．33％、其次为工作人员手占73．96％；临床体液实验室超标率最高，占65．15％、微生物实验室最低，占32．58％；菌株检出类别依次为革兰阳性球菌占45．19％，革兰阴性杆菌占29．79％（其中肠杆菌科占21．99％），革兰阳性杆菌占14．49％，酵母样真菌占10．53％；从物体表面、工作人员手中分离出金黄色葡萄球菌67株、铜绿假单胞菌246株。结论本院临床实验室环境中的离心机和电话机的表面污染率最高，工作人员手污染严重。金黄色葡萄球菌、铜绿假单胞菌存在于实验室中。实验室工作人员坚持日常清洁与消毒工作是环境保洁的重要环节，坚持手卫生是“标准预防”的重要措施。

The investigation and analysis of bacterial contamination in medical clinical laboratory environment

Objective To investigate the hygienic condition of the medical clinical laboratory environment in our hospital, require the laboratory staff clean and disinfect the environment according to ＂the disinfection technological specification＂. Methods Retrospective analysis was performed on the monitoring results of the clinical laboratory air, the surface of objects and the hands of laboratory staff in the medical clinical laboratory surroundings in our hospital according to ＂the hospital disinfection hygienic standard＂. Results A total of 545 samples （55.39%） exceeded the standard out of 984 samples. The standard exceeding rate of the centrifuges was the highest （88. 89 % ）, followed by telesets （83.33%） and the hands of laboratory staff （73.96%）. The standard exceeding rate of the clinical body fluid laboratory was the highest （65.15 %）, and lowest in the microbiological laboratory （32.58%）. The detection rate of gram positive coccus was the highest （45.19%）, followed by gram negative bacilli （29.79%） （among the total, Enterobacteriaceae accounted for 21.99%）, gram positive bacilli （14.49%） and yeast-like fungi （10.53%）. 67 strains of Staphylococcus aureus and 246 strain of Pseudomonas aeruginosa were isolated from the surface of objects and the hands of laboratory staff in the medical clinical laboratory surroundings. Conclusion The contamination rate of the surface of the centrifuges and telesets was the highest, followed by the hands of laboratory staff in the medical clinical laboratory surroundings. Staphylococcus aureus and Pseudomonas aeruginosa reside in the laboratory. The laboratory staff should adhere to daily cleaning and disinfecting to keep the environment depuratory. Keeping the hand hygiene is an important measure of standard precautions.