Zhang Shuxiao, Ge Jingwu, Zhou Xuelong, Ji Yanhong, Hong Junjie, Xu Wensu, Li Tonglai
Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, No.300 of Guangzhou Road, Gulou District, Nanjing, Jiangsu, 210029, China.
BMC Anesthesiol. 2025 Jan 9;25(1):17. doi: 10.1186/s12871-024-02886-y.
The objective of this study is to investigate bacterial proliferation within the internal circuits of anesthesia machines in post-anesthesia care units (PACUs) following the implementation of the new protocol, where 'a single dedicated external circuit is used for each individual patient.' This measure was introduced during the COVID-19 pandemic, in alignment with a novel prevention and control strategy.
Using the observational technique, we analyzed anesthesia machines in PACUs between July and September 2022. The internal circuits of the anesthesia machines were disinfected every two weeks. Samples were obtained from the internal circuits on the 3rd, 5th, 7th, 10th, 12th, and 14th day following disinfection for bacterial culture. Changes in the positivity rate of bacteria in the internal circuits over time were analyzed using the generalized estimating equation. The anesthesia machines were divided into the positive group (n = 9) and the negative group (n = 41) based on the sampling results on the 14th day after disinfection. Risk factors for positive bacterial culture results in anesthesia machines in PACUs were analyzed using single-factor modified Poisson analysis and multi-factor modified Poisson regression analysis.
The positivity rates of the internal circuits of anesthesia machines in PACUs on the 3rd, 5th, 7th, 10th, 12th, and 14th day following disinfection were 10%, 14%, 12%, 20%, 16%, and 18% respectively. There were no statistically significant differences when the positive rates of the next five time points and the third day were compared (P > 0.05). Risk factors for the contamination in the internal circuits of anesthesia machines was the number of elderly patients and the overall surgical use duration, with the difference was statistically significant (P < 0.025).
Amid the COVID-19 pandemic, characterized by the adoption of new prevention and control protocols, the disinfection interval for internal circuits of anesthesia machines in PACUs may potentially be extended. However, the emphasis of disinfection should still be placed on those anesthesia machines that have been used for a longer cumulative surgical duration and by a higher number of elderly patients over 60 years old. This approach ensures that resources are allocated effectively.
本研究的目的是调查在实施新协议后，麻醉后护理单元（PACU）中麻醉机内部回路中的细菌增殖情况。新协议为“每位患者使用单一专用外部回路”。这一措施是在新冠疫情期间引入的，符合一项新的防控策略。
采用观察技术，我们分析了2022年7月至9月期间PACU中的麻醉机。麻醉机的内部回路每两周消毒一次。在消毒后的第3、5、7、10、12和14天从内部回路获取样本进行细菌培养。使用广义估计方程分析内部回路中细菌阳性率随时间的变化。根据消毒后第14天的采样结果，将麻醉机分为阳性组（n = 9）和阴性组（n = 41）。使用单因素修正泊松分析和多因素修正泊松回归分析来分析PACU中麻醉机细菌培养结果呈阳性的危险因素。
消毒后第3、5、7、10、12和14天，PACU中麻醉机内部回路的阳性率分别为10%、14%、12%、20%、16%和18%。将后五个时间点的阳性率与第三天的阳性率进行比较时，没有统计学上的显著差异（P > 0.05）。麻醉机内部回路污染的危险因素是老年患者数量和总体手术使用时长，差异具有统计学意义（P < 0.025）。
在以采用新防控协议为特征的新冠疫情期间，PACU中麻醉机内部回路的消毒间隔可能可以延长。然而，消毒的重点仍应放在那些累计手术使用时长较长且使用的老年患者（60岁以上）较多的麻醉机上。这种方法可确保有效分配资源。
