Hsu M-S, Wu M-Y, Huang Y-T, Liao C-H
Department of Internal Medicine, Section of Infectious Disease, Far Eastern Memorial Hospital, Taipei, Taiwan.
Infection Control Center, Far Eastern Memorial Hospital, Taipei, Taiwan.
J Hosp Infect. 2016 May;93(1):22-8. doi: 10.1016/j.jhin.2016.01.005. Epub 2016 Jan 25.
Chlorinated tap water in hospitals often contains low levels of non-fermentative Gram-negative bacilli (NFGNB) and non-tuberculous mycobacteria (NTM). Measures are needed to ensure a safe water supply in hospitals to prevent nosocomial infections from these waterborne pathogens.
To evaluate the efficacy of ClO2 treatment of a hospital water system on the levels of NFGNB and NTM in the water.
Our institution is a 1000-bed medical centre with two main buildings (B1 and B2). B1 has three intensive care units (ICUs) and transplant wards and polyethylene water pipes. B2 (control) has no ICUs and galvanized water pipes. A ClO2 generating unit was installed in the water system of B1 in April 2012 and water samples were collected in B1 and B2 before and eight times after installation. All samples were cultured for NFGNB and NTM.
The ClO2 concentration was significantly lower in the hot water than in the cold water (P<0.001). After 40 weeks of ClO2 use, the overall NFGNB colonies decreased significantly (hot water: 160±143 vs 2±4cfu/mL, P<0.001; cold water: 108±138 vs 3±7cfu/mL, P<0.001). Highly prevalent nosocomial NFGNB, such as Pseudomonas spp. and Stenotrophomonas spp., were undetected three months after ClO2 disinfection; Sphingomonas spp. persisted but had lower colony counts. NTM was present in 25% (three out of 12) of sampling locations initially, but was not detected at two weeks after ClO2 disinfection. The ICUs had no overall change in the number of NFGNB nosocomial infections after the intervention.
Addition of a ClO2 disinfection unit to our hospital water system reduced the numbers of NTM and NFGNB in the hot and cold water systems.
医院的氯化自来水通常含有低水平的非发酵革兰氏阴性杆菌（NFGNB）和非结核分枝杆菌（NTM）。需要采取措施确保医院的供水安全，以防止这些水源性病原体引起的医院感染。
评估二氧化氯处理医院供水系统对水中NFGNB和NTM水平的效果。
我们的机构是一家拥有1000张床位的医疗中心，有两栋主要建筑（B1和B2）。B1有三个重症监护病房（ICU）和移植病房以及聚乙烯水管。B2（对照）没有ICU且有镀锌水管。2012年4月在B1的供水系统中安装了一个二氧化氯发生器，并在安装前以及安装后八次在B1和B2采集水样。所有样本均培养NFGNB和NTM。
热水中的二氧化氯浓度显著低于冷水（P<0.001）。使用二氧化氯40周后，总的NFGNB菌落数显著减少（热水：160±143对2±4cfu/mL，P<0.001；冷水：108±138对3±7cfu/mL，P<0.001）。二氧化氯消毒三个月后未检测到医院中高度流行的NFGNB，如假单胞菌属和嗜麦芽窄食单胞菌属；鞘氨醇单胞菌属持续存在但菌落数较低。最初，12个采样点中有25%（3个）存在NTM，但二氧化氯消毒两周后未检测到。干预后，ICU中NFGNB医院感染的数量没有总体变化。
在我们医院的供水系统中添加二氧化氯消毒装置可减少热水和冷水系统中NTM和NFGNB的数量。
