Department of Clinical Microbiology and Infectious Diseases, University of the Witwatersrand, South Africa.
S Afr Med J. 2013 Feb 19;103(6):386-9. doi: 10.7196/samj.6385.
Hospital-acquired infections (HAIs) are largely preventable through risk analysis and modification of practice. Anaesthetic practice plays a limited role in the prevention of HAIs, although laryngoscope use and decontamination is an area of concern. We aimed to assess the level of microbial contamination of re-usable laryngoscope blades at a public hospital in South Africa.
The theatre complex of a secondary-level public hospital in Johannesburg.
Blades from two different theatres were sampled twice daily, using a standardised technique, over a 2-week period. Samples were quantitatively assessed for microbial contamination, and stratified by area on blade, theatre and time using Fisher's exact test.
A contamination rate of 57.3% (63/110) was found, with high-level contamination accounting for 22.2% of these. Common commensals were the most frequently isolated micro-organisms (79.1%), but important hospital pathogens such as Enterobacter species and Acinetobacter baumannii were isolated from blades with high-level contamination. No significant difference in the level of microbial contamination by area on blade, theatre or time was found (p<0.05).
A combination of sub-optimal decontamination and improper handling of laryngoscopes after decontamination results in significant microbial contamination of re-usable laryngoscope blades. There is an urgent need to review protocols and policies surrounding the use of these blades.
医院获得性感染（HAI）可以通过风险分析和实践操作的改变来有效预防。尽管喉镜的使用和消毒是值得关注的领域，但麻醉科在预防 HAI 中所起的作用有限。我们旨在评估南非一家公立医院可重复使用喉镜叶片的微生物污染程度。
约翰内斯堡一家二级公立医院的手术室。
在两周的时间内，每天两次使用标准化技术对来自两个不同手术室的叶片进行采样。使用 Fisher 确切检验按叶片、手术室和时间分层，对微生物污染进行定量评估。
发现污染率为 57.3%（63/110），其中高水平污染占 22.2%。常见共生菌是最常分离出的微生物（79.1%），但重要的医院病原体，如肠杆菌科和鲍曼不动杆菌，也从高水平污染的叶片中分离出来。叶片、手术室或时间不同区域的微生物污染程度无显著差异（p<0.05）。
消毒不彻底以及消毒后喉镜处理不当，导致可重复使用喉镜叶片的严重微生物污染。迫切需要审查这些叶片使用相关的规程和政策。
