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脉冲氙紫外线房间消毒设备对耐甲氧西林金黄色葡萄球菌和需氧菌菌落计数的影响。

Effect of pulsed xenon ultraviolet room disinfection devices on microbial counts for methicillin-resistant Staphylococcus aureus and aerobic bacterial colonies.

机构信息

Central Texas Veterans Health Care System, Temple, TX; Center for Applied Health Research, Baylor Scott & White Healthcare, Temple, TX.

Portland VA Medical Center, Portland, OR.

出版信息

Am J Infect Control. 2018 Jun;46(6):668-673. doi: 10.1016/j.ajic.2018.02.001. Epub 2018 Apr 11.

Abstract

BACKGROUND

Inadequate environmental disinfection represents a serious risk for health care-associated infections. Technologic advancements in disinfection practices, including no-touch devices, offer significant promise to improve infection control. We evaluated one such device, portable pulsed xenon ultraviolet (PX-UV) units, on microbial burden during an implementation trial across 4 Veterans Affairs hospitals.

METHODS

Environmental samples were collected before and after terminal room cleaning: 2 facilities incorporated PX-UV disinfection into their cleaning protocols and 2 practiced manual disinfection only. Specimens from 5 high-touch surfaces were collected from rooms harboring methicillin-resistant Staphylococcus aureus (MRSA) or aerobic bacteria colonies (ABC). Unadjusted pre-post count reductions and negative binomial regression modeled PX-UV versus manual cleaning alone.

RESULTS

Seventy samples were collected. Overall, PX-UV reduced MRSA and ABC counts by 75.3% and 84.1%, respectively, versus only 25%-30% at control sites. Adjusting for baseline counts, manually cleaned rooms had significantly higher residual levels than PX-UV sites. Combined analyses revealed an incident rate ratio of 5.32 (P = .0024), with bedrails, tray tables, and toilet handrails also showing statistically superior PX-UV disinfection.

CONCLUSIONS

This multicenter study demonstrates significantly reduced disinfection across several common pathogens in facilities using PX-UV devices. Clinical impact of laboratory reductions on infection rates was not assessed, representing a critical future research question. However, such approaches to routine cleaning suggest a practical strategy when integrated into daily hospital operations.

摘要

背景

环境消毒不充分对医源性感染是一个严重的威胁。消毒实践中的技术进步,包括无接触设备,为改善感染控制提供了巨大的希望。我们评估了一种这样的设备,即便携式脉冲氙紫外线(PX-UV)装置,在 4 家退伍军人事务部医院进行的实施试验中对微生物负担的影响。

方法

在终末房间清洁前后采集环境样本:2 个设施将 PX-UV 消毒纳入其清洁方案,2 个设施仅进行手动消毒。从携带耐甲氧西林金黄色葡萄球菌(MRSA)或需氧菌菌落(ABC)的房间采集 5 个高接触表面的标本。未调整的前后计数减少和负二项式回归模型分别对 PX-UV 与单独手动清洁进行了比较。

结果

共采集了 70 个样本。总体而言,与对照组相比,PX-UV 分别使 MRSA 和 ABC 的计数减少了 75.3%和 84.1%,而对照组仅减少了 25%-30%。调整基线计数后,手动清洁的房间比 PX-UV 房间的残留水平明显更高。综合分析显示,发病率比为 5.32(P = .0024),床栏、托盘桌和厕所扶手的 PX-UV 消毒效果也明显更好。

结论

这项多中心研究表明,在使用 PX-UV 设备的设施中,几种常见病原体的消毒效果显著降低。未评估实验室减少对感染率的临床影响,这是一个关键的未来研究问题。然而,当将这些方法整合到日常医院操作中时,它们代表了一种实用的策略。

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