Department of Medical Microbiology, Radboud Centre for Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands.
Antimicrob Resist Infect Control. 2021 May 10;10(1):77. doi: 10.1186/s13756-021-00935-6.
Healthcare-associated infections (HAIs) are a significant cause of morbidity and mortality in hospitalized patients. Water in the environment can be a source of infection linked to outbreaks and environmental transmission in hospitals. Water safety in hospitals remains a challenge. This article has summarized available scientific literature to obtain an overview of outbreaks linked to water-containing hospital equipment and strategies to prevent such outbreaks.
We made a list of water-containing hospital equipment and devices in which water is being used in a semi-closed circuit. A literature search was performed in PubMed with a search strategy containing the names of these medical devices and one or more of the following words: outbreak, environmental contamination, transmission, infection. For each medical device, we summarized the following information: the function of the medical device, causes of contamination, the described outbreaks and possible prevention strategies.
The following water-containing medical equipment or devices were identified: heater-cooler units, hemodialysis equipment, neonatal incubators, dental unit waterlines, fluid warmers, nebulizers, water traps, water baths, blanketrol, scalp cooling, and thermic stimulators. Of the latter three, no literature could be found. Of all other devices, one or more outbreaks associated with these devices were reported in the literature.
The water reservoirs in water-containing medical devices can be a source of microbial growth and transmissions to patients, despite the semi-closed water circuit. Proper handling and proper cleaning and disinfection can help to reduce the microbial burden and, consequently, transmission to patients. However, these devices are often difficult to clean and disinfect because they cannot be adequately opened or disassembled, and the manufacturer's cleaning guidelines are often not feasible to execute. The development of equipment without water or fluid containers should be stimulated. Precise cleaning and disinfection guidelines and instructions are essential for instructing healthcare workers and hospital cleaning staff to prevent potential transmission to patients.
医疗保健相关感染（HAIs）是住院患者发病率和死亡率的重要原因。环境中的水可能是与医院暴发和环境传播相关的感染源。医院的水安全仍然是一个挑战。本文总结了现有的科学文献，以了解与含有水的医院设备相关的暴发情况，并获得预防这些暴发的策略概述。
我们列出了在半封闭回路中使用水的含有水的医院设备和装置。在 PubMed 中进行了文献检索，检索策略包含这些医疗器械的名称和以下一个或多个词：暴发、环境污染、传播、感染。对于每种医疗器械，我们总结了以下信息：医疗器械的功能、污染的原因、描述的暴发以及可能的预防策略。
确定了以下含有水的医疗设备或装置：热交换器、血液透析设备、新生儿孵化器、牙科器械供水管路、液体加温器、喷雾器、水阱、水疗池、毯子卷绕器、头皮冷却器和热刺激器。后三种设备中，未找到相关文献。在所有其他设备中，文献中报道了一种或多种与这些设备相关的暴发。
尽管水回路为半封闭，但含有水的医疗器械中的水储器可能成为微生物生长和向患者传播的源头。正确处理以及适当的清洁和消毒有助于减少微生物负担，从而减少向患者传播的风险。然而，这些设备通常难以清洁和消毒，因为它们无法充分打开或拆卸，而且制造商的清洁指南通常难以执行。应刺激开发无水箱或液体容器的设备。为了指导医护人员和医院清洁人员预防潜在的向患者传播的风险，制定精确的清洁和消毒指南和说明至关重要。
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