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氯己定浸渍的手术服和全身洗涤液用于减少医护人员的定植。

Chlorhexidine impregnated surgical scrubs and whole-body wash for reducing colonization of health care personnel.

机构信息

Department of Internal Medicine, Hospital Universitario Dr. José Eleuterio González, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.

Department of Hospital Epidemiology and Infectious Disease Service, Hospital Universitario Dr. José Eleuterio González, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.

出版信息

Am J Infect Control. 2020 Oct;48(10):1216-1219. doi: 10.1016/j.ajic.2020.01.004. Epub 2020 Feb 11.

Abstract

BACKGROUND

The use of chlorhexidine as a strategy to reduce nosocomial infections in patients has been proven useful. Bacterial contamination of health care worker's uniforms during routine patient care has been demonstrated to have potential for horizontal transmission of pathogens.

METHODS

We performed a prospective, open comparative trial. We included nurses who were in direct patient care and evaluated clothing microbial growth during 3 interventions: (1) participants were given a sterile surgical scrub (SSS) to put on the beginning of the shift, (2) they were instructed to take a chlorhexidine bath (CHG-B) before putting on the SSS, and (3) participants were given a chlorhexidine impregnated SSS (CI-SSS). Cultures were obtained from 3 areas (chest pocket, chest, and abdominal) at hour 0, 6, and 12 hours after the start of the shift.

RESULTS

A total of 306 cultures processed with 17 bacterial groups. The uniform area with the highest number of CFU was the abdomen (818 CFU), followed by the thorax (654 CFU). Over 50% of the bacterial load occurred at 12 hours (1,092 CFU at 12 hours, 766 CFU at 6 hours, and 184 CFU at 0 hour). There was a significant reduction in CFU when SSS was compared to CHG-B (CFU mean = 12.5 [0-118] vs CFU mean = 3.5 [0-22], P = .003); and SSS versus CI-SSS (CFU mean = 12.5 [0-118] vs CFU mean = 3 [0-39], P = .007). No severe adverse events were reported.

CONCLUSIONS

Bacterial load in uniforms decreased when chlorhexidine was used (bathing of personnel or impregnation) when compared to the use of a sterile uniform.

摘要

背景

已证实,使用洗必泰作为降低医院感染患者的策略是有效的。医护人员在日常护理患者时的制服细菌污染已被证明具有横向传播病原体的潜力。

方法

我们进行了一项前瞻性、开放的对照试验。我们纳入了直接护理患者的护士,并在 3 项干预措施中评估了服装微生物生长情况:(1)在轮班开始时,给参与者提供无菌手术刷手服(SSS);(2)在穿 SSS 之前,指导他们使用洗必泰沐浴(CHG-B);(3)给参与者提供氯己定浸渍的 SSS(CI-SSS)。在轮班开始后 0、6 和 12 小时,从 3 个部位(胸前口袋、胸部和腹部)采集培养物。

结果

共处理了 306 个培养物,涉及 17 个细菌群。CFU 数量最多的制服区域是腹部(818 CFU),其次是胸部(654 CFU)。超过 50%的细菌负荷发生在 12 小时(12 小时时为 1092 CFU,6 小时时为 766 CFU,0 小时时为 184 CFU)。与 CHG-B 相比,SSS 显著降低了 CFU(CFU 均值=12.5[0-118] vs CFU 均值=3.5[0-22],P=0.003);与 CI-SSS 相比,SSS 也显著降低了 CFU(CFU 均值=12.5[0-118] vs CFU 均值=3[0-39],P=0.007)。未报告严重不良事件。

结论

与使用无菌制服相比,当使用洗必泰(人员沐浴或浸渍)时,制服上的细菌负荷会减少。

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