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[手术室中的微生物空气监测:主动和被动采样]

[Microbial air monitoring in operating theatre: active and passive samplings].

作者信息

Pasquarella C, Masia M D, Nnanga Nga, Sansebastiano G E, Savino A, Signorelli C, Veronesi L

机构信息

Dipartimento di Sanità Pubblica, Università degli Studi di Parma.

出版信息

Ann Ig. 2004 Jan-Apr;16(1-2):375-86.

Abstract

Microbial air contamination was evaluated in 11 operating theatres using active and passive samplings. SAS (Surface Air System) air sampling was used to evaluate cfu/m3 and settle plates were used to measure the index of microbial air contamination (IMA). Samplings were performed at the same time on three different days, at three different times (before, during and after the surgical activity). Two points were monitored (patient area and perimeter of the operating theatre). Moreover, the cfu/m3 were evaluated at the air inlet of the conditioner system. 74.7% of samplings performed at the air inlet and 66.7% of the samplings performed at the patient area before the beginning of the surgical activity (at rest) exceeded the 35 cfu/m3 used as threshold value. 100% of IMA values exceeded the threshold value of 5. Using both active and passive sampling, the microbial contamination was shown to increase significantly during activity. The cfu values were higher at the patient area than at the perimeter of the operating theatre. Mean values of the cfu/m3 during activity at the patient area ranged from a minimum of 61+/-41 cfu/m3 to a maximum of 242+/-136 cfu/m3; IMA values ranged from a minimum of 19+/-10 to a maximum of 129+/-60. 15.2% of samplings performed at the patient area using SAS and 75.8% of samplings performed using settle plates exceeded the threshold values of 180 cfu/m3 and 25 respectively, with a significant difference of the percentages. The highest values were found in the operating theatre with inadequate structural and managerial conditions. These findings confirm that the microbiological quality of air may be considered a mirror of the hygienic conditions of the operating theatre. Settle plates proved to be more sensitive in detecting the increase of microbial air contamination related to conditions that could compromise the quality of the air in operating theatres.

摘要

采用主动和被动采样方法,对11个手术室的微生物空气污染情况进行了评估。使用表面空气系统(SAS)空气采样来评估每立方米菌落形成单位(cfu/m³),并使用沉降平板来测量微生物空气污染指数(IMA)。在三天的不同时间,于手术活动的三个不同阶段(手术前、手术中、手术后)同时进行采样。监测了两个点(患者区域和手术室周边)。此外,还对空调系统的进气口处的cfu/m³进行了评估。在手术活动开始前(静止状态),进气口处74.7%的采样以及患者区域66.7%的采样超过了用作阈值的35 cfu/m³。100%的IMA值超过了阈值5。通过主动和被动采样均表明,活动期间微生物污染显著增加。患者区域的cfu值高于手术室周边。患者区域活动期间cfu/m³的平均值范围为最低61±41 cfu/m³至最高242±136 cfu/m³;IMA值范围为最低19±10至最高129±60。使用SAS在患者区域进行的采样中,15.2%以及使用沉降平板进行的采样中75.8%分别超过了180 cfu/m³和25的阈值,且百分比存在显著差异。在结构和管理条件欠佳的手术室中发现了最高值。这些发现证实,空气的微生物质量可被视为手术室卫生状况的一个反映。沉降平板在检测与可能损害手术室空气质量的状况相关的微生物空气污染增加方面被证明更为灵敏。

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