Troiano G, Lo Nostro A, Calonico C, Nante N, Magistri L, Pulci M B, Niccolini F
Department of Molecular and Developmental Medicine, Area of Public Health, University of Siena, Italy.
Health Science Department, University of Florence, Italy.
Ann Ig. 2019 Jan-Feb;31(1):13-20. doi: 10.7416/ai.2019.2254.
Flexible bronchoscopes are heat labile, complex and difficult to clean, and some nosocomial outbreaks related to bronchoscopy have been reported in literature. The aim of our study was to determine, through a systematic monitoring, whether bronchoscopes' cleaning and disinfection procedures have been correctly adopted by health operators.
We conducted a 19 months-long prospective study in the Unit of Pulmonology at Careggi Teaching Hospital (Florence, Italy), analyzing endoscopes that were reprocessed through a high-level disinfection procedure. Samples collection was performed weekly by two trained operators. Results were organized in a database and then exported for descriptive and inferential statistical analysis.
From February 2016 to September 2017 we collected 218 samples from bronchoscopes' valves (N=109) and from their inner channels (N=109). Staphylococci were found in 34 samples (15.69% of all samples). Pseudomonas was found in 11 samples (5.04% of all samples). Pseudomonas aeruginosa wasn't found in any sample.
Our results came out to be better than similar studies in literature and demonstrated that a correct endoscopes' hygiene should be part of a more complex strategy of surveillance and control of healthcare-associated infections. However, a continuous monitoring of endoscopes could provide a wider view about this problem, and more reliable results.
可弯曲支气管镜不耐热、结构复杂且难以清洁,文献中已报道了一些与支气管镜检查相关的医院感染暴发事件。我们研究的目的是通过系统监测,确定卫生工作人员是否正确采用了支气管镜的清洁和消毒程序。
我们在卡雷吉教学医院(意大利佛罗伦萨)的肺病科进行了一项为期19个月的前瞻性研究,分析通过高水平消毒程序重新处理的内镜。每周由两名经过培训的操作人员进行样本采集。结果整理到数据库中,然后导出进行描述性和推断性统计分析。
从2016年2月到2017年9月,我们从支气管镜的阀门(N = 109)及其内部通道(N = 109)采集了218个样本。在34个样本中发现了葡萄球菌(占所有样本的15.69%)。在11个样本中发现了假单胞菌(占所有样本的5.04%)。在任何样本中均未发现铜绿假单胞菌。
我们的结果优于文献中的类似研究,表明正确的内镜卫生应成为医疗保健相关感染监测和控制更复杂策略的一部分。然而,对内镜进行持续监测可以更全面地了解这个问题,并提供更可靠 的结果。