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耳鼻喉科(ENT)科室的微生物污染

Microbiological contamination of ear, nose and throat (ENT) units.

作者信息

Krull Marco, Steinmann Joerg, Heintschel von Heinegg Evelyn, Buer Jan, Sucharski Anke, Mattheis Stefan, Lang Stephan, Ross Birgit

机构信息

Universitätsmedizin Essen, Krankenhaushygiene, Essen, Germany.

Universitätsmedizin Essen, Institut für Medizinische Mikrobiologie, Essen, Germany.

出版信息

GMS Hyg Infect Control. 2019 Feb 1;14:Doc03. doi: 10.3205/dgkh000319. eCollection 2019.

Abstract

In ENT (Ear, Nose and Throat) treatment units, medical devices for examination are commonly stored on open trays. The aim of this study is to investigate whether open storage is a relevant cause for microbiological contamination of ENT instruments during a working day. Qualitative and quantitative tests, such as imprints and swabs, were performed on the instruments and the surfaces of the treatment units in an ENT outpatient clinic at the beginning and at the end of consultation hours. The microbiological analysis of the samples focused on potential pathogens, e.g., or , bacteria of skin and oral microbiota, as well as the number of colony forming units (CFU). The samples were collected at three distinct ENT treatment units over five working days. The samples taken at the beginning of consultation hours showed a low number of CFU and no pathogens. Overall, 5% of the instruments were contaminated with bacteria of skin microbiota. At the end of a working day, this rate increased significantly to 17.5% (p<0.01). At the beginning of the working day, the mean number on the instrument trays was 4 CFU/25 cm², which increased to 34 CFU/25 cm² at the end of the working day. In some cases of the imprints taken at the end of the working day showed that a bacterial lawn had formed. In two cases, the pathogens and were detected; in another case . was identified. The contamination of ENT instruments and the ENT treatment unit increased significantly (p<0.01) over the duration of consultation hours. The results show that the current hygiene requirements for storage und reprocessing are not sufficient to conform to the mandatory guidelines of the German Commission on Hospital Hygiene and Infection Prevention. Although we could not find a pressing risk for the patients, we also cannot exclude it in the long term. Thus, new concepts are needed.

摘要

在耳鼻喉科(耳、鼻、喉)治疗单元中,检查用医疗设备通常存放在开放式托盘上。本研究的目的是调查开放式存放是否是工作日期间耳鼻喉科器械微生物污染的一个相关原因。在耳鼻喉科门诊的咨询时段开始时和结束时,对器械以及治疗单元的表面进行了定性和定量测试,如印记和拭子检测。样本的微生物分析聚焦于潜在病原体,例如[此处原文缺失具体病原体名称]、皮肤和口腔微生物群的细菌以及菌落形成单位(CFU)的数量。在五个工作日内,在三个不同的耳鼻喉科治疗单元采集了样本。咨询时段开始时采集的样本显示CFU数量较少且无病原体。总体而言,5%的器械被皮肤微生物群的细菌污染。在工作日结束时,这一比例显著上升至17.5%(p<0.01)。工作日开始时,器械托盘上的平均数量为4 CFU/25平方厘米,工作日结束时增至34 CFU/25平方厘米。在工作日结束时采集的一些印记样本显示形成了菌苔。在两个案例中检测到了病原体[此处原文缺失具体病原体名称];在另一个案例中鉴定出了[此处原文缺失具体病原体名称]。在咨询时段内,耳鼻喉科器械和治疗单元的污染显著增加(p<0.01)。结果表明,目前关于储存和再处理的卫生要求不足以符合德国医院卫生与感染预防委员会的强制性指南。虽然我们没有发现对患者有紧迫风险,但从长远来看也不能排除。因此,需要新的概念。

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