Panta Gopal, Richardson Ann K, Shaw Ian C
School of Health Sciences, University of Canterbury, Christchurch, New Zealand.
School of Physical and Chemical Sciences, University of Canterbury, Christchurch, New Zealand.
J Infect Dev Ctries. 2019 Oct 31;13(10):858-864. doi: 10.3855/jidc.11433.
Medical devices are sterilized before being used for invasive clinical procedures such as surgery, to prevent pathogen transfer. Failure to sterilize medical devices properly presents a risk of healthcare-associated infections. Studies and reports have indicated that inadequately sterilized medical devices are one of the causes of a higher rate of healthcare-associated infections in developing countries. Steam sterilization (autoclaving) is the most widely used method for sterilization and is considered the most robust and cost-effective method for sterilization of medical devices. The effectiveness of steam sterilization can be measured using biological indicators. A literature search was undertaken to understand the effectiveness of autoclaving in sterilizing reusable medical devices in healthcare facilities across the globe. Studies using biological indicators for measuring the effectiveness of autoclaving were obtained. Failures of steam sterilization practices were identified and discussed as a means of identifying factors that might be associated with the ineffectiveness of steam sterilization practices between different countries. The number of studies measuring the effectiveness of steam sterilization is small, and few evaluate the effectiveness of steam sterilization specifically in developing countries. There are fewer studies on higher level healthcare facilities than dental facilities. More evidence about the effectiveness of autoclaving in healthcare facilities is needed to draw firm conclusions, but the data suggest that there are inadequacies in autoclave procedures and operator education.
医疗设备在用于手术等侵入性临床程序之前需进行消毒，以防止病原体传播。医疗设备消毒不当会带来医疗相关感染的风险。研究和报告表明，医疗设备消毒不充分是发展中国家医疗相关感染率较高的原因之一。蒸汽消毒（高压灭菌）是最广泛使用的消毒方法，被认为是医疗设备消毒最可靠且最具成本效益的方法。蒸汽消毒的有效性可用生物指示剂来衡量。进行了文献检索，以了解全球医疗机构中高压灭菌对可重复使用医疗设备的消毒效果。获取了使用生物指示剂测量高压灭菌效果的研究。确定并讨论了蒸汽消毒操作的失败情况，以此作为识别不同国家间可能与蒸汽消毒操作无效相关的因素的一种方式。测量蒸汽消毒效果的研究数量较少，很少有研究专门评估发展中国家蒸汽消毒的效果。针对高级别医疗机构的研究比牙科机构的研究更少。需要更多关于医疗机构中高压灭菌效果的证据才能得出确凿结论，但数据表明高压灭菌程序和操作人员培训存在不足。
