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| 可抛弃便携式支气管镜消毒方法及消毒效果评价 |
| 孙成龙1,张潇2,王琴1,李奕3,张艳君3,张伟1,夏阳1* |
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(1. 海军军医大学(第二军医大学)第一附属医院呼吸与危重症医学科, 上海 200433;
2. 海军军医大学(第二军医大学)第一附属医院全科医学科, 上海 200433;
3. 海军军医大学(第二军医大学)第一附属医院感染控制科, 上海 200433
*通信作者) |
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| 摘要: |
| 目的 选择适合可抛弃便携式支气管镜的高水平消毒方法，探索三磷酸腺苷（ATP）生物荧光检测技术在消毒效果评价中的应用价值。方法 将10根全新的可抛弃便携式支气管镜随机分为对照组（n＝1）及次氯酸组（n＝3）、过氧乙酸组（n＝3）、低温等离子组（n＝3）3个实验组。对照组不做任何处理；将各实验组支气管镜模拟临床吸痰操作后进行预处理并采用非完全浸泡方式洗消，次氯酸组、过氧乙酸组及低温等离子组分别采用次氯酸浸泡法、过氧乙酸浸泡法及低温等离子灭菌法进行消毒，消毒时间分别为3、5、45 min。应用ATP生物荧光检测技术和细菌培养法评价消毒效果。结果 ATP生物荧光检测显示，次氯酸组、过氧乙酸组5轮次消毒后支气管镜管腔采样液的相对发光单位（RLU）值为16～179，均＜200，两组的消毒合格率均为100%；低温等离子组2轮次消毒后支气管镜管腔采样液的RLU值为675～4 532，均＞200，消毒合格率为0。细菌培养法检测结果显示，次氯酸组、过氧乙酸组支气管镜5轮次消毒后管腔采样液的菌落计数为0～6 cfu/件，消毒合格率为100%；低温等离子组支气管镜2轮次消毒后管腔采样液的菌落计数均＞20 cfu/件，消毒合格率为0。与对照组相比，所有实验组每轮次消毒后支气管镜的图像质量、插入部远端弯曲度、负压吸引力均未见明显差异。结论 将可抛弃便携式支气管镜预处理后，使用次氯酸浸泡消毒法及过氧乙酸浸泡消毒法均能达到高水平消毒的目的，且不影响支气管镜的使用性能。ATP生物荧光检测技术与细菌培养法检测结果一致性高，可快速评判可抛弃便携式支气管镜的消毒效果。 |
| 关键词: 可抛弃便携式支气管镜 消毒 次氯酸 过氧乙酸 低温等离子 ATP生物荧光检测 |
| DOI：10.16781/j.CN31-2187/R.20220892 |
| 投稿时间：2022-11-22修订日期：2023-03-07 |
| 基金项目:海军军医大学（第二军医大学）第一附属医院“深蓝123”军事医学专项（2020SLZ025）. |
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| Disinfection method and effect evaluation of disposable portable bronchoscope |
| SUN Chenglong1,ZHANG Xiao2,WANG Qin1,LI Yi3,ZHANG Yanjun3,ZHANG Wei1,XIA Yang1* |
(1. Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. Department of General Practice, The First Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200433, China;
3. Department of Infection Control, The First Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To select a high-level disinfection method suitable for disposable portable bronchoscope, and to explore the application value of adenosine triphosphate (ATP) bioluminescence detection in the evaluation of disinfection effect. Methods Ten new disposable portable bronchoscopes were randomly divided into control group (n＝1) and 3 experimental groups (hypochlorous acid group ［n＝3］, peracetic acid group ［n＝3］, and low-temperature plasma group ［n＝3］). The control group did not receive any treatment. The hypochlorous acid group, peracetic acid group and low-temperature plasma group were disinfected respectively by hypochlorous acid immersion, peracetic acid immersion and low-temperature plasma sterilization after simulated clinical aspiration. The bronchoscopes in each experimental group were pretreated and decontaminated by incomplete immersion. The time of hypochlorous acid immersion, peracetic acid immersion, and low-temperature plasma sterilization was 3, 5, and 45 min, respectively. The disinfection effect was evaluated by ATP bioluminescence detection and bacterial culture. Results The results of ATP bioluminescence detection showed that the relative luminous unit (RLU) values of bronchoscopic lumen sampling solution in the hypochlorous acid group and peracetic acid group after 5 rounds of disinfection were between 16 and 179 (all values＜200), and the qualified rates of disinfection were 100% in both groups. After 2 rounds of disinfection in the low-temperature plasma group, the RLU values of bronchoscopic lumen sampling solution were between 675 and 4 532 (all values＞200), and the qualified rates of disinfection were 0. After 5 rounds of disinfection, the results of bacterial culture in the hypochlorous acid group and peracetic acid group showed that colony-forming units were between 0 and 6, and the qualified rates were 100%. After 2 rounds of disinfection, the results of bacterial culture in the low-temperature plasma group showed that colony-forming units were greater than 20, and the qualified rates were 0. There were no significant differences in the image quality, distal curvature or negative pressure attraction of the bronchoscopes between the experimental groups and the control group after each round of disinfection. Conclusion Both hypochlorous acid immersion disinfection and peracetic acid immersion disinfection can achieve a high level of disinfection without affecting the performance of bronchoscope after the pretreatment of disposable portable bronchoscope. The results of ATP bioluminescence detection are consistent with those of bacterial culture, and it can quickly evaluate the disinfection effect of disposable portable bronchoscope. |
| Key words: disposable portable bronchoscope disinfection hypochlorous acid peracetic acid low-temperature plasma ATP bioluminescence detection |
