Frabetti Alessia, Vandini Alberta, Balboni Piergiorgio, Triolo Fabio, Mazzacane Sante
CIAS Laboratory, Center for the Study of Contamination of Highly Sterile Environments, Department of Architecture, University of Ferrara, Ferrara, Italy.
Am J Infect Control. 2009 Oct;37(8):658-64. doi: 10.1016/j.ajic.2009.03.011.
There remains much debate on how to define an adequate sanitation protocol in hospital environments.
The efficacy of a sanitation protocol in the operating room (OR) of a modern hospital was evaluated by measuring bacterial load on different types of finishing materials of all internal surfaces (ie, walls, floors, and furnishings). Samples were obtained before cleaning and over the subsequent 24 hours. A total of 2124 microbiological samples were collected using RODAC plates and sterile swabs.
The data demonstrate a very significant postsanitation reduction of bacterial load on floors and furnishings; however, no significant data on walls were obtained, because of the low levels of initial contamination (1.50 to 5.98 cfu/100 cm2). The increase in postsanitation bacterial load over time was greater on smooth materials than on porous materials, on which a further reduction in contamination was seen. The study outcomes were confirmed by simulation experiments in which different materials were contaminated with a predetermined bacterial load and then subjected to the sanitation protocol. These simulation experiments were carried out both in vitro and in an eddy-flux testing room that simulated a full-scale OR similar (in terms of architectonic systems) to a real setting.
Our data demonstrate that the spatial (vertical/horizontal) disposition of materials affects the initial contamination level, which is always much lower on vertical surfaces than on horizontal ones. Moreover, postsanitation bacterial load recovery is dependent on the physical properties of the surface.
关于如何在医院环境中定义适当的卫生清洁方案仍存在诸多争议。
通过测量现代医院手术室（OR）内所有内表面（即墙壁、地板和家具）不同类型饰面材料上的细菌载量，评估卫生清洁方案的效果。在清洁前及随后的24小时内采集样本。使用RODAC平板和无菌拭子共采集了2124份微生物样本。
数据表明，卫生清洁后地板和家具上的细菌载量显著降低；然而，由于初始污染水平较低（1.50至5.98 cfu/100 cm²），未获得关于墙壁的显著数据。卫生清洁后细菌载量随时间的增加在光滑材料上比在多孔材料上更大，而多孔材料上的污染进一步减少。通过模拟实验证实了研究结果，在模拟实验中，不同材料被预先设定的细菌载量污染，然后进行卫生清洁方案。这些模拟实验在体外以及在一个模拟与真实环境（在建筑系统方面）相似的全尺寸手术室的涡流测试室中进行。
我们的数据表明，材料的空间（垂直/水平）布局会影响初始污染水平，垂直表面的初始污染水平始终远低于水平表面。此外，卫生清洁后细菌载量的恢复取决于表面的物理性质。
