Blume Philipp, Chaberny Iris
Institut für Hygiene, Krankenhaushygiene und Umweltmedizin, Universitätsklinikum Leipzig, Leipzig.
Gesundheitswesen. 2021 Jun;83(6):443-449. doi: 10.1055/a-1152-4800. Epub 2020 Jun 5.
Surface disinfection is one of the elementary measures of infection prevention in healthcare facilities. However, the current widely used tissue dispenser systems can be microbially contaminated as a result of various causes and play a decisive role in the spread of pathogens. For this reason, these systems must be considered both as a source of infection in routine surveillance and as part of nosocomial outbreaks.
Tissue dispenser systems used at the University Hospital Leipzig (UKL) were extensively analyzed between 2016 and 2018 in accordance with the recommendations of the German Association for Applied Hygiene (VAH). Within this period, 1096 disinfectant solutions from dispenser systems were tested. Areas without or with infection risk were represented with equal distribution. To exclude the possibility of contamination by dosing units (DU), the microbial-hygienic tests were extended to the 135 decentralized DU at the UKL.
Overall, a decline in contaminated disinfectant solutions was recorded over the study period (31% in 2016, 18% in 2017 and 8% in 2018). However, in 2017 as well as in 2018, more contaminants were recorded in high-risk areas. Specific follow-up examinations after training in handling and preparation of the systems resulted in a decrease of contaminated disinfection solutions at hospitals. The dominant microbial contamination was with . (81%), followed by . (10%), vancomycin-resistant enterococci (VRE) (4%) and apathogenic environmental microorganisms (5%). The solutions taken from the dosing units (n=135) did not show any growth (91.1%). . were detected in 8.2% and molds in 0.7% of solutions.
Contaminated dosing units as well as drinking water used for this purpose could be excluded as source of the pathogens detected in tissue dispenser systems. It is assumed that a lack of knowledge and a false sense of security led to incorrect handling of tissue dispenser systems when dealing with disinfectants.
表面消毒是医疗机构感染预防的基本措施之一。然而,当前广泛使用的纸巾分发系统可能因各种原因受到微生物污染,并在病原体传播中起决定性作用。因此,在常规监测中,这些系统必须被视为感染源,也是医院感染暴发的一部分。
根据德国应用卫生协会(VAH)的建议,于2016年至2018年对莱比锡大学医院(UKL)使用的纸巾分发系统进行了广泛分析。在此期间,对来自分发系统的1096份消毒溶液进行了检测。无感染风险区域和有感染风险区域的样本分布均衡。为排除加药装置(DU)污染的可能性,微生物卫生检测扩展至UKL的135个分散式DU。
总体而言,在研究期间记录到受污染消毒溶液数量有所下降(2016年为31%,2017年为18%,2018年为8%)。然而,2017年和2018年在高风险区域记录到的污染物更多。在对系统的操作和准备进行培训后的特定后续检查中,医院受污染消毒溶液的数量有所减少。主要的微生物污染是由……(81%)引起的,其次是……(10%)、耐万古霉素肠球菌(VRE)(4%)和无致病性环境微生物(5%)。从加药装置中取出的溶液(n = 135)未显示任何生长(91.1%)。在8.2%的溶液中检测到……,在0.7%的溶液中检测到霉菌。
受污染的加药装置以及用于此目的的饮用水可被排除为纸巾分发系统中检测到的病原体来源。据推测,知识的缺乏和错误的安全感导致在处理消毒剂时对纸巾分发系统的操作不当。