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喉镜手柄:存在感染风险。

Laryngoscope handles: a potential for infection.

作者信息

Simmons S A

出版信息

AANA J. 2000 Jun;68(3):233-6.

Abstract

Laryngoscope handles do not usually come in direct contact with the patient's mucous membranes. Consequently, routine disinfection of laryngoscope handles is not currently standard practice unless gross contamination is clearly evident. Recent reports indicate that apparently clean handles may be contaminated with blood or body fluids. No report examined microbes on handles. The present article describes the incidence and types of microbes on laryngoscope handles after their use in the operating rooms of a 502-bed medical center in northwestern Pennsylvania. Twenty laryngoscope handles were cultured on Mueller Hinton 5% sheep blood agar plates. The plates were incubated at 37 degrees C for 48 hours and examined for growth. The identification, incidence, and susceptibility patterns of organisms were determined. Microorganisms were present on all 20 laryngoscope handles. Nine different types were isolated; some strains were resistant to multiple antibiotics. Organisms were categorized as contaminants or opportunistic pathogens. The presence of opportunistic pathogens places anesthesia providers and patients at risk of nosocomial infections. Based on the recommendations of the 1997 American Association of Nurse Anesthetists' Infection Control Guide and the results of the present study, institutional guidelines should be established for the use of disposable laryngoscope covers, high-level (destroying all microorganisms with the exception of high numbers of bacterial spores) disinfection, or sterilization of laryngoscope equipment between each patient use.

摘要

喉镜手柄通常不会直接接触患者的黏膜。因此,除非明显可见严重污染,目前喉镜手柄的常规消毒并非标准做法。最近的报告表明,看似干净的手柄可能被血液或体液污染。尚无报告对手柄上的微生物进行检测。本文描述了宾夕法尼亚州西北部一家拥有502张床位的医疗中心手术室使用后的喉镜手柄上微生物的发生率和种类。在穆勒-欣顿5%羊血琼脂平板上培养了20个喉镜手柄。将平板在37摄氏度下孵育48小时并检查生长情况。确定了微生物的鉴定、发生率和药敏模式。所有20个喉镜手柄上均存在微生物。分离出9种不同类型;一些菌株对多种抗生素耐药。微生物被归类为污染物或机会致病菌。机会致病菌的存在使麻醉人员和患者面临医院感染的风险。根据1997年美国护士麻醉师协会感染控制指南的建议以及本研究的结果,应制定机构指南,规定在每位患者使用后对一次性喉镜套的使用、高水平(除大量细菌芽孢外杀灭所有微生物)消毒或喉镜设备的灭菌。

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