Department of Anaesthetics, ABMU NHS Trust, Swansea, UK.
J Hosp Infect. 2010 Feb;74(2):123-8. doi: 10.1016/j.jhin.2009.09.015. Epub 2010 Jan 22.
Despite use of sterile or disposable laryngoscope blades for each patient, disinfection of laryngoscope handles does not routinely occur, and these devices present a potential route of transmission of pathogens between patients and staff. A total of 192 specimens from 64 laryngoscope handles deemed 'ready for patient use' in the anaesthetic rooms of 32 operating theatres were semiquantitatively assessed for bacterial contamination. A further 116 specimens from 58 of the handles were tested for occult blood contamination. One or more species of bacteria were isolated from 55 (86%) of the handles, and included organisms such as enterococci, meticillin-susceptible Staphylococcus aureus, Klebsiella and acinetobacter. Cultures did not yield any anaerobes, fungi, meticillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci or multiply-resistant Gram-negative bacilli. No occult blood contamination was demonstrated. Although the majority of organisms isolated were not pathogenic, their presence indicates the potential for transmission of pathogens from laryngoscope handles. Strategies to address contamination of handles include revision of procedures for disinfection and storage prior to use, introduction of disposable handles or sheaths, and re-design of handles to eliminate knurled surfaces and contact points.
尽管为每位患者使用了无菌或一次性喉镜刀片,但喉镜手柄的消毒并未常规进行,这些设备是患者和医务人员之间病原体传播的潜在途径。在 32 个手术室的麻醉室中,共有 64 个被认为“可用于患者”的喉镜手柄的 192 个样本进行了半定量评估,以检测细菌污染。进一步对 58 个手柄中的 116 个样本进行了隐匿性血液污染检测。55 个(86%)手柄中分离出一种或多种细菌,包括肠球菌、耐甲氧西林金黄色葡萄球菌、克雷伯菌和不动杆菌等。培养物未产生任何厌氧菌、真菌、耐甲氧西林金黄色葡萄球菌、万古霉素耐药肠球菌或多重耐药革兰氏阴性杆菌。未发现隐匿性血液污染。尽管分离出的大多数细菌都不是病原体,但它们的存在表明了从喉镜手柄传播病原体的可能性。解决手柄污染的策略包括在使用前修订消毒和储存程序、引入一次性手柄或护套,以及重新设计手柄以消除滚花表面和接触点。