Department of Respiratory Therapy, Mackay Memorial Hospital, Taipei, Taiwan.
Respir Care. 2012 Feb;57(2):250-6. doi: 10.4187/respcare.01180. Epub 2011 Jul 12.
Pathogens in healthcare settings can be transmitted via skin contact and environmental media. This study investigates bacterial contamination rate on surfaces of mechanical ventilator systems and bedside equipment. An experimental study evaluates the effectiveness of 75% alcohol in killing bacteria on surfaces.
Surface swab sampling was conducted on ventilator systems and patient bedside equipment for detection of bacterial contamination. Surfaces of ventilator systems, such as faceplates, Y-pieces, and water traps, were swab sampled at 0.5, 8, and 24 hours after initial disinfection using a solution containing 0.5% sodium hypochlorite and pasteurization. The 75% alcohol aerosol was sprayed on the surfaces of faceplates, Y-pieces, and water traps on ventilator systems at 24 hours after initial disinfection, and then bacterial levels on the surfaces were evaluated.
Detection rates of Staphylococcus aureus were measured on the handrails of mechanical ventilators (64.7%), Y-pieces of breathing circuits (86.7%), and resuscitators (60.0%). Pseudomonas aeruginosa was identified on the surfaces of Y-pieces (6.7%) and water traps (13.3%) of breathing circuits, and also on suction systems (6.7%) and resuscitators (13.3%). The positive rate for total bacterial count was clearly increased on the surfaces of faceplates, Y-pieces, and water traps at 8 hour following disinfection by 0.5% sodium hypochlorite solution and pasteurization. Concentrations of S. aureus on surfaces decreased following treatment with 75% alcohol. However, considerable P. aeruginosa growth on water trap surfaces was observed after treatment with 75% alcohol.
The surfaces of ventilator systems, including faceplates, Y-pieces, and water traps, must be disinfected frequently (at least every 8 h) to control bacterial growth. Disinfection using 75% alcohol spray with air drying effectively decreased S. aureus on ventilator system surfaces.
医疗机构中的病原体可通过皮肤接触和环境媒介传播。本研究调查了机械通气系统和床边设备表面的细菌污染率。一项实验研究评估了 75%酒精在杀死表面细菌方面的效果。
对通气系统和患者床边设备进行表面拭子采样，以检测细菌污染。在初始消毒后 0.5、8 和 24 小时，使用含有 0.5%次氯酸钠和巴氏消毒的溶液对通气系统的面罩、Y 型件和水阱等表面进行拭子采样。在初始消毒后 24 小时，将 75%酒精气溶胶喷在通气系统的面罩、Y 型件和水阱表面，然后评估表面的细菌水平。
在机械通气机的扶手（64.7%）、呼吸回路的 Y 型件（86.7%）和复苏器（60.0%）上检测到金黄色葡萄球菌的检出率。在呼吸回路的 Y 型件（6.7%）和水阱（13.3%）以及抽吸系统（6.7%）和复苏器（13.3%）表面鉴定出铜绿假单胞菌。经 0.5%次氯酸钠溶液和巴氏消毒消毒后 8 小时，面罩、Y 型件和水阱表面的总细菌计数阳性率明显增加。用 75%酒精处理后，表面的金黄色葡萄球菌浓度下降。然而，在用 75%酒精处理后，水阱表面的铜绿假单胞菌大量生长。
必须经常（至少每 8 小时）对包括面罩、Y 型件和水阱在内的通气系统表面进行消毒，以控制细菌生长。使用 75%酒精喷雾干燥进行消毒可有效降低通气系统表面的金黄色葡萄球菌。
