强化清洁对医院环境表面细菌污染的影响：埃及医院重症监护病房的临床试验。
The impact of enhanced cleaning on bacterial contamination of the hospital environmental surfaces: a clinical trial in critical care unit in an Egyptian hospital.
机构信息
Alexandria University Hospitals, Alexandria University, Alexandria, Egypt.
Neurosurgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
出版信息
Antimicrob Resist Infect Control. 2024 Nov 19;13(1):138. doi: 10.1186/s13756-024-01489-z.
BACKGROUND
Contaminated environmental surfaces play an important role in the transmission of pathogens that cause healthcare acquired infection (HAI). The present study aimed to assess the effect of enhanced cleaning techniques on bacterial contamination in high-touch areas compared to routine cleaning at the intensive care units (ICU) of the neurosurgery department of Alexandria Main University Hospital, Egypt.
METHODS
The assessment of the knowledge and practices of healthcare cleaning workers and nurses was conducted through a questionnaire and an observational checklist. An educational program about enhanced cleaning was carried out for healthcare cleaning workers and nurses in one room of the ICU unit. Environmental surface swabs were taken from the two rooms of the ICU before and after cleaning (room A and room B). Room A was selected to apply the enhanced cleaning, and room B was selected for routine cleaning.
RESULTS
A significant decrease in bacterial counts in the high-touch areas around the patients after the application of enhanced cleaning compared to routine cleaning (p < 0.001) was observed. Gram-negative bacteria isolated from high-touch areas accounted for 45.6% of the samples collected before enhanced cleaning, and they became 16.3% after enhanced cleaning (p < 0.001), while they accounted for 40% after routine cleaning. The enhanced cleaning intervention in Room A resulted in a significant reduction in total infections, decreasing from 18 cases in the six months prior to the intervention to 11 cases in the six months following its implementation. (p < 0.05).
CONCLUSION
The effect of enhanced cleaning was evident in decreasing bacterial counts in the high-touch areas around the patient and consequently in the records of the HAI rate inside the ICU.
CLINICAL TRIAL REGISTRATION NUMBER
PACTR202402531001186, date: 15 February 2024, 'retrospectively registered'.
背景
受污染的环境表面在传播导致医院获得性感染（HAI）的病原体方面起着重要作用。本研究旨在评估与常规清洁相比，强化清洁技术对埃及亚历山大大学医院神经外科重症监护病房（ICU）高接触区域细菌污染的影响。
方法
通过问卷和观察检查表评估医护清洁人员和护士的知识和实践情况。在 ICU 病房的一个房间中，为医护清洁人员和护士开展了强化清洁教育计划。在清洁前后（房间 A 和房间 B）从 ICU 的两个房间采集环境表面拭子。选择房间 A 应用强化清洁，选择房间 B 进行常规清洁。
结果
与常规清洁相比，强化清洁后患者周围高接触区域的细菌计数显著下降（p<0.001）。强化清洁前从高接触区域分离出的革兰氏阴性菌占采集样本的 45.6%，强化清洁后降至 16.3%（p<0.001），而常规清洁后占 40%。在房间 A 实施强化清洁干预后，总感染率显著下降，从干预前六个月的 18 例降至干预后六个月的 11 例（p<0.05）。
结论
强化清洁可明显降低患者周围高接触区域的细菌计数，进而降低 ICU 内 HAI 发生率的记录。
临床试验注册号
PACTR202402531001186，日期：2024 年 2 月 15 日，'回顾性注册'。
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