Wilkins M C
St Vincent Hospital and Medical Center, Portland, OR 97225.
Respir Care. 1993 Nov;38(11):1155-60.
An early study demonstrated that standard cleaning techniques did not adequately disinfect reusable pulse oximetry sensors that had been intentionally contaminated with high titers of pathogenic microorganisms. This current study evaluated patient-ready sensors being used in hospitals, by testing them for bacterial contamination.
Reusable pulse oximetry sensors from 15 hospitals throughout the United States were tested. Each sensor was deemed by the hospital to be ready for patient use, and it had been prepared for use according to hospital procedures. Patient-contact areas of each sensor were swabbed, and the swabs were analyzed for bacterial contamination using standard testing procedures. This study had two stages, and different sensors were tested in each stage. In the "bacterial-growth stage," swabs were evaluated for bacterial contamination but organisms were not identified; in the "identification stage," bacterial species were identified.
Forty-four sensors were evaluated, 16 in the bacterial-growth stage and 28 in the identification stage. Bacteria were cultured from 29 of the 44 sensors (66%), including 20 that had been cleaned with alcohol or an antibacterial/antiviral agent. Among the isolated organisms were Staphylococcus aureus, Staphylococcus haemolyticus, Enterococcus faecalis, and Klebsiella oxytoca. Bacterial contamination was found on sensors from 12 of the 15 participating hospitals.
These data demonstrate the need to define effective cleaning methods for reusable sensors, and we are currently conducting such studies. The data also suggest that disposable patient-dedicated sensors may be the most appropriate choice when infection control is of particular concern.
一项早期研究表明,标准清洁技术无法充分消毒故意被高滴度致病微生物污染的可重复使用脉搏血氧饱和度传感器。本研究通过检测医院中准备用于患者的传感器的细菌污染情况来对其进行评估。
对来自美国各地15家医院的可重复使用脉搏血氧饱和度传感器进行了测试。每家医院都认为每个传感器已准备好供患者使用,并且它已按照医院程序准备就绪。对每个传感器的患者接触区域进行擦拭,并使用标准测试程序对拭子进行细菌污染分析。本研究分为两个阶段,每个阶段测试不同的传感器。在“细菌生长阶段”,对拭子进行细菌污染评估,但不识别微生物;在“鉴定阶段”,鉴定细菌种类。
共评估了44个传感器,其中16个在细菌生长阶段,28个在鉴定阶段。44个传感器中有29个(66%)培养出细菌,其中20个曾用酒精或抗菌/抗病毒剂进行过清洁。分离出的微生物包括金黄色葡萄球菌、溶血葡萄球菌、粪肠球菌和产酸克雷伯菌。在15家参与研究的医院中的12家医院的传感器上发现了细菌污染。
这些数据表明需要为可重复使用的传感器定义有效的清洁方法,我们目前正在进行此类研究。数据还表明,当特别关注感染控制时,一次性专用患者传感器可能是最合适的选择。