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抗菌湿巾与含氯消毒剂溶液对医疗机构环境表面污染的影响:一项双交叉研究。

Impact of antimicrobial wipes compared with hypochlorite solution on environmental surface contamination in a health care setting: A double-crossover study.

机构信息

School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK.

School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK.

出版信息

Am J Infect Control. 2018 Oct;46(10):1180-1187. doi: 10.1016/j.ajic.2018.03.020. Epub 2018 May 11.

DOI:10.1016/j.ajic.2018.03.020
PMID:29759641
Abstract

OBJECTIVE

Antimicrobial wipes are increasingly used in health care settings. This study evaluates, in a clinical setting, the efficacy of sporicidal wipes versus a cloth soaked in a 1,000 ppm chlorine solution.

INTERVENTION

A double-crossover study was performed on 2 different surgical and cardiovascular wards in a 1,000-bed teaching hospital over 29 weeks. The intervention period that consisted of surface decontamination with the preimpregnated wipe or cloth soaked in chlorine followed a 5-week baseline assessment of microbial bioburden on surfaces. Environmental samples from 11 surfaces were analyzed weekly for their microbial content.

RESULTS

A total of 1,566 environmental samples and 1,591 ATP swabs were analyzed during the trial. Overall, there were significant differences in the recovery of total aerobic bacteria (P < .001), total anaerobic bacteria (P < .001), and ATP measurement (P < .001) between wards and between the different parts of the crossover study. Generally, the use of wipes produced the largest reduction in the total aerobic and anaerobic counts when compared with the baseline data or the use of 1,000 ppm chlorine. Collectively, the introduction of training plus daily wipe disinfection significantly reduced multidrug-resistant organisms recovered from surfaces. Reversion to using 1,000 ppm chlorine resulted in the number of sites positive for multidrug-resistant organisms rising again.

CONCLUSIONS

This double-crossover study is the first controlled field trial comparison of using preimpregnated wipes versus cotton cloth dipped into a bucket of hypochlorite to decrease surface microbial bioburden. The results demonstrate the superiority of the preimpregnated wipes in significantly decreasing microbial bioburden from high-touch surfaces.

摘要

目的

抗菌湿巾在医疗保健环境中的使用日益增多。本研究在临床环境中评估了杀菌湿巾与浸泡在 1000ppm 氯溶液中的布的杀菌效果。

干预

在一家拥有 1000 张床位的教学医院的 2 个外科和心血管病房进行了一项双交叉研究,为期 29 周。干预期包括用预浸渍湿巾或氯浸泡的布进行表面去污,随后进行 5 周的基线评估,以确定表面微生物生物负荷。每周对 11 个表面的环境样本进行微生物含量分析。

结果

试验期间共分析了 1566 个环境样本和 1591 个 ATP 拭子。总体而言,不同病房和交叉研究的不同部分之间,总需氧菌(P <.001)、总厌氧菌(P <.001)和 ATP 测量(P <.001)的恢复存在显著差异。通常,与基线数据或使用 1000ppm 氯相比,使用湿巾可使总需氧菌和厌氧菌计数的减少幅度最大。总的来说,引入培训和日常擦拭消毒可显著减少从表面回收的多药耐药菌。重新使用 1000ppm 氯会导致对多药耐药菌呈阳性的部位数量再次增加。

结论

这是首次使用预浸渍湿巾与浸泡在漂白水桶中的棉布相比,以减少表面微生物生物负荷的双交叉现场试验比较。结果表明,预浸渍湿巾在显著降低高接触表面微生物生物负荷方面具有优越性。

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