一项多中心研究比较了无工作通道的软性内镜在 UV-C 光消毒与标准内镜清洗消毒机消毒之间的细菌减少效果：一项随机对照试验。
A multicenter study comparing the bacterial reduction on flexible endoscopes without a working channel between UV-C light disinfection versus standard endoscope Washer Disinfection: a randomized controlled trial.
机构信息
Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center Nijmegen, P/O Box 9101, Nijmegen, The Netherlands.
Radboud University Medical Center Nijmegen, P/O Box 9101, Nijmegen, The Netherlands.
出版信息
Antimicrob Resist Infect Control. 2024 Oct 26;13(1):128. doi: 10.1186/s13756-024-01486-2.
BACKGROUND
To prevent cross-contamination between patients, adequate reprocessing is necessary when using flexible endoscopes (FEs) without a working channel. The current reprocessing process using an Endoscope Washer Disinfector (EWD) is time-consuming. Ultraviolet light group C (UV-C) exposition is an alternative and fast disinfection method and has previously been shown to adequately reduce Colony Forming Units (CFUs) on FEs without a working channel. The objective of this study was to examine whether UV-C light is as effective in reducing CFUs on contaminated FEs without a working channel compared to the EWD.
METHODS
FEs without a working channel were collected in three different Otorhinolaryngology Departments in the Netherlands. After pharyngolaryngoscopy, a manual pre-cleaning with tap water was performed and a culture was collected by rolling the distal 8-10 cm of the FE over an agar plate. Next, the FE was randomly assigned to be disinfected with UV-C light (D60) or the EWD (gold standard). After disinfection, another culture was taken. The primary outcome was microbiological contamination, defined by Colony Forming Units (CFU).
RESULTS
600 FEs without a working channel were randomized. After clinical use and manual pre-cleaning, 239/300 (79.7%) FEs in the UV-C group and 262/300 (87.3%) FEs in the EWD group were contaminated (i.e., > 0 CFU). FEs without culture confirmed contamination were excluded from further analysis. After UV-C light disinfection, 195/239 (81.6%) FEs showed 0 CFUs, compared to 187/262 (71.4%) FEs disinfected with the EWD (p < 0.01). A multivariate logistics regression analysis showed an increased odds of 0 CFUs when using UV-C light (OR 1.83, 95% CI 1.19-2.79; p < 0.01), conditional on participating hospitals and types of FE.
CONCLUSIONS
UV-C light disinfection of FEs without a working channel appears more effective in reducing CFUs compared to the EWD and might be a good alternative disinfection method.
TRIAL REGISTRATION
Not applicable.
背景
为防止患者间交叉感染，在使用无工作通道的软性内镜时，必须进行充分的再处理。目前使用内镜清洗消毒器（EWD）的再处理过程耗时较长。紫外线 C 组（UV-C）照射是一种替代的快速消毒方法，先前的研究已经表明，该方法可以充分减少无工作通道的软性内镜的集落形成单位（CFU）。本研究旨在检验与 EWD 相比，UV-C 光是否能更有效地减少无工作通道的污染软性内镜上的 CFU。
方法
在荷兰的三个不同的耳鼻喉科收集无工作通道的软性内镜。在咽喉镜检查后，用自来水进行手动预清洁，并通过将软性内镜的远端 8-10 厘米在琼脂板上滚动来收集培养物。然后，将软性内镜随机分配用 UV-C 光（D60）或 EWD（金标准）进行消毒。消毒后，再次进行培养。主要结局是微生物污染，定义为集落形成单位（CFU）。
结果
共随机化了 600 根无工作通道的软性内镜。在临床使用和手动预清洁后，UV-C 组 300 根中有 239 根（79.7%）和 EWD 组 300 根中有 262 根（87.3%）被污染（即>0 CFU）。没有培养物确认污染的软性内镜被排除在进一步分析之外。经过 UV-C 光消毒后，239 根中有 195 根（81.6%）显示 0 CFU，而 262 根中有 187 根（71.4%）用 EWD 消毒（p<0.01）。多变量逻辑回归分析显示，使用 UV-C 光时，0 CFU 的可能性增加（OR 1.83，95%CI 1.19-2.79；p<0.01），条件是参与医院和软性内镜的类型。
结论
与 EWD 相比，无工作通道的软性内镜的 UV-C 光消毒似乎更能有效减少 CFU，可能是一种较好的替代消毒方法。
试验注册
不适用。
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