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特立尼达岛四家主要医院中消毒剂和防腐剂的微生物污染情况。

Microbial contamination of disinfectants and antiseptics in four major hospitals in Trinidad.

作者信息

Gajadhar Tswana, Lara Alicia, Sealy Patricia, Adesiyun Abiodun A

机构信息

The University of the West Indies, Faculty of Medical Sciences, Pharmacy Programme, St. Augustine, Trinidad and Tobago.

出版信息

Rev Panam Salud Publica. 2003 Sep;14(3):193-200. doi: 10.1590/s1020-49892003000800006.

Abstract

OBJECTIVE

To assess the microbial contamination of disinfectants and antiseptics in major hospitals on the Caribbean island of Trinidad.

METHODS

For this cross-sectional study, disinfectants and antiseptics were sampled from the pharmacy departments, the pediatric/neonatal wards, and the surgical wards of four hospitals. The samples were cultured for aerobic bacteria on nutrient agar using the surface plating method. The antibiotic sensitivity of bacterial isolates was determined by the disk diffusion method, using 14 antimicrobial agents. We studied a total of 180 disinfectant/antiseptic samples: 60 of chlorhexidine gluconate (Hibitane), 60 of chlorhexidine gluconate and cetrimonium bromide (Savlon), and 60 of methylated spirit.

RESULTS

Of the 180 samples studied, 11 of them (6.1%) were contaminated by aerobic bacteria. All bacteria isolated were Pseudomonas spp. Of the 11 contaminated samples, 6 of them (54.5%) occurred at the pharmacy level while 5 (45.5%) were from diluted pre-use or in-use samples in the pediatric/neonatal wards or the surgical wards. Chlorhexidine gluconate and cetrimonium bromide accounted for 9 of the 11 contaminated disinfectants/antiseptics (81.8%), and chlorhexidine gluconate accounted for the remaining 2 (18.2%). Only two of the four hospitals had contaminated disinfectant/antiseptic samples. All 24 isolates of Pseudomonas spp. tested were resistant to one or more of the 14 antimicrobial agents tested, with the prevalence of resistance to ciprofloxacin, norfloxacin, tobramycin, and gentamicin being 58.3%, 50.0%, 45.8%, and 41.7%, respectively.

CONCLUSIONS

Our results show that contaminated disinfectants/antiseptics pose a health risk to patients, particularly in the pediatric and surgical wards. The high prevalence of resistance to antimicrobial agents exhibited by the Pseudomonas spp. that were isolated is of special therapeutic concern.

摘要

目的

评估加勒比海岛国特立尼达主要医院中消毒剂和防腐剂的微生物污染情况。

方法

在这项横断面研究中,从四家医院的药房、儿科/新生儿病房和外科病房采集消毒剂和防腐剂样本。采用表面接种法,将样本接种于营养琼脂上进行需氧菌培养。使用14种抗菌剂,通过纸片扩散法测定细菌分离株的抗生素敏感性。我们共研究了180份消毒剂/防腐剂样本:60份葡萄糖酸氯己定(洗必泰)、60份葡萄糖酸氯己定和溴化十六烷基三甲铵(Savlon)以及60份甲基化酒精。

结果

在研究的180份样本中,有11份(6.1%)被需氧菌污染。所有分离出的细菌均为假单胞菌属。在11份受污染样本中,6份(54.5%)出现在药房层面,5份(45.5%)来自儿科/新生儿病房或外科病房稀释后的使用前或使用中样本。11份受污染的消毒剂/防腐剂中有9份(81.8%)为葡萄糖酸氯己定和溴化十六烷基三甲铵,其余2份(18.2%)为葡萄糖酸氯己定。四家医院中只有两家医院的消毒剂/防腐剂样本受到污染。所有测试的24株假单胞菌属菌株均对所测试的14种抗菌剂中的一种或多种耐药,对环丙沙星、诺氟沙星、妥布霉素和庆大霉素的耐药率分别为58.3%、50.0%、45.8%和41.7%。

结论

我们的结果表明,受污染的消毒剂/防腐剂对患者构成健康风险,尤其是在儿科和外科病房。分离出的假单胞菌属对抗菌剂的高耐药率尤其值得治疗关注。

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