Kardas P, Bielec F, Brauncajs M, Lewek P, Timler D, Łojewska E, Chiurazzi M, Dei N N, Ciuti G, Ros R J, Estevan V S, Maccaro A, Pecchia L, Merino B, Medrano A, Penzel T, Fico G
Department of Family Medicine, Medical University of Lodz, Lodz, Poland.
Department of Microbiology and Laboratory Medical Immunology, Medical University of Lodz, Lodz, Poland.
J Hosp Infect. 2025 Aug;162:17-25. doi: 10.1016/j.jhin.2025.05.006. Epub 2025 May 21.
Autonomous mobile robots (AMRs) have been increasingly used in hospital logistics, particularly in high-risk areas, such as emergency departments (EDs), to streamline operations, reduce staff fatigue, and minimize infection risks. However, their effective disinfection remains a critical concern, especially when it comes to solutions aimed at preventing spread of multi-drug-resistant organisms.
This study evaluated the microbiological cleanliness and effectiveness of various disinfection methods for AMRs in real-life hospital logistics settings, with a particular focus on their application in EDs.
The HOSBOT, an AMR designed for hospital logistics, was deployed in a tertiary hospital for two weeks and validated for transport of biological samples. Microbiological contamination was assessed at multiple robot sites before and after disinfection, using two methods, i.e., manual wiping with a standard disinfectant and non-contact fumigation with low-temperature vaporized hydrogen peroxide. Contamination levels were evaluated using quantitative and qualitative microbiological techniques, and a threshold of <2.5 colony-forming units/cm for critical environments, recommended by the Centers for Disease Control and Prevention (CDC), was considered as proof of success.
Bacterial contamination exceeded thresholds at all sites. Both disinfection methods significantly decreased contamination. Manual wiping reduced bacterial counts below thresholds and eradicated fungal growth, while fumigation was effective for bacterial but not fungal contamination. Fumigation also failed to meet CDC cleanliness standards in hard-to-reach areas.
Both manual wiping and fumigation effectively reduced bacterial contamination, however, wiping showed better results in fungal eradication. Improvements to fumigation methods are necessary, such as application of higher disinfectant concentrations or alternative chemicals. The aforementioned findings not only support the use of AMRs in clinical settings but also emphasize the importance of effective disinfection for safety and efficacy.
自主移动机器人（AMR）已越来越多地应用于医院物流，尤其是在急诊科等高风险区域，以优化运营、减轻员工疲劳并将感染风险降至最低。然而，其有效消毒仍是一个关键问题，特别是对于旨在防止多重耐药菌传播的解决方案而言。
本研究评估了现实医院物流环境中AMR的各种消毒方法的微生物清洁度和有效性，特别关注其在急诊科的应用。
将专为医院物流设计的AMR——HOSBOT部署在一家三级医院两周，并对其运输生物样本的功能进行验证。在消毒前后，使用两种方法对机器人的多个部位进行微生物污染评估，即使用标准消毒剂进行手动擦拭和使用低温汽化过氧化氢进行非接触熏蒸。使用定量和定性微生物技术评估污染水平，疾病控制与预防中心（CDC）推荐的关键环境<2.5菌落形成单位/平方厘米的阈值被视为成功的证明。
所有部位的细菌污染均超过阈值。两种消毒方法均显著降低了污染。手动擦拭将细菌数量降至阈值以下并消除了真菌生长，而熏蒸对细菌污染有效，但对真菌污染无效。熏蒸在难以触及的区域也未达到CDC的清洁标准。
手动擦拭和熏蒸均有效降低了细菌污染，然而，擦拭在根除真菌方面效果更好。有必要改进熏蒸方法，例如应用更高浓度的消毒剂或替代化学品。上述发现不仅支持在临床环境中使用AMR，还强调了有效消毒对于安全性和有效性的重要性。
