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[吸入室中的感染风险]

[The danger of infection in inhalation rooms].

作者信息

Breer M, Christiansen B, Gundermann K O

机构信息

Institut für Hygiene und Umweltmedizin im Klinikum, Christian-Albrechts-Universität zu Kiel.

出版信息

Zentralbl Hyg Umweltmed. 1992 Dec;193(4):364-78.

PMID:1290566
Abstract

There are alarming reports about high counts of Legionella and Pseudomonas in the aerosol of inhalation-rooms. We therefore investigated 14 institutions (6 kurhauses, 5 hospitals and 3 sanatoria for children) in Schleswig-Holstein, each of them at least five-fold. For that purpose the inhalant (seawater as a rule) was investigated for the total bacterial number and the number of Legionella. Cfu/m3 air were determined at the aerosol outlet and a qualitative search for Legionella was done in the piping. In addition bacterial numbers in the air at the breathing-levels of patients were measured in order to be able to assess health hazards by germs of other patients. Detected bacterial numbers (10(1) - > 10(4)) were basically subject to the handling of the equipment and the type of apparatus used. Predominantly Staphylococci and Bacilli were found and above all when the first row of investigations was carried out large numbers of Pseudomonas, Aeromonas and others occurred. Legionella could not be detected. As a whole the investigations showed that properly maintained room-inhalators pose no higher risk of infection. These facilities, however, might be contaminated at any time and there is a certain--even though comparatively low--risk of infection due to germs exhaled by other patients. Patients, which are predisposed to infections of the respiratory tract--f.i. patients suffering from mucoviscidosis or patients with lowered resistance--should therefore generally use single inhalators.

摘要

有令人担忧的报告称,吸入室气溶胶中嗜肺军团菌和铜绿假单胞菌数量很高。因此,我们对石勒苏益格-荷尔斯泰因州的14家机构(6家温泉疗养院、5家医院和3家儿童疗养院)进行了调查,每家机构至少调查了5次。为此,对吸入剂(通常为海水)的细菌总数和嗜肺军团菌数量进行了调查。在气溶胶出口处测定每立方米空气中的菌落形成单位(cfu),并对管道进行嗜肺军团菌定性检测。此外,还测量了患者呼吸水平处空气中的细菌数量,以便能够评估其他患者的病菌对健康的危害。检测到的细菌数量(10(1) -> 10(4))基本上取决于设备的操作和所用仪器的类型。主要发现的是葡萄球菌和芽孢杆菌,尤其是在进行第一轮调查时,出现了大量的铜绿假单胞菌、气单胞菌等。未检测到嗜肺军团菌。总体而言,调查表明,维护良好的室内吸入器不会带来更高的感染风险。然而,这些设施可能随时受到污染,并且存在一定的——尽管相对较低——因其他患者呼出的病菌而导致感染的风险。因此,易患呼吸道感染的患者——例如患有囊性纤维化的患者或抵抗力较低的患者——通常应使用单人吸入器。

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