Buckley T, Dudley S M, Donowitz L G
University of Virginia Health Sciences Center, Charlottesville 22908.
Am J Crit Care. 1994 Nov;3(6):448-51.
Recommendations in the literature conflict on the necessity of disinfecting single-use vials prior to aspiration of fluid. Interventions to disinfect the stopper surface on multiple-dose vials vary considerably.
To determine the necessity of alcohol disinfection of the stopper on single-dose vials and to compare povidone-iodine and alcohol versus alcohol-only disinfection of the stopper prior to each needle penetration on multiple-dose vials.
The rubber stopper surfaces of 100 single-dose vials were cultured for the presence of bacteria. To determine the efficacy of two procedures for disinfection of multiple-dose vials, 87 stopper surfaces routinely disinfected with both povidone-iodine and alcohol were cultured for bacteria. After a change in practice, 100 multiple-dose vials routinely disinfected with alcohol only were cultured for the presence of bacteria.
Of the cultures done on single-dose vial stoppers, 99% were sterile. A comparison of the two disinfection techniques for multiple-dose vials revealed that 83 (95%) of the 87 vials prepped with both povidone-iodine and alcohol were sterile, compared with all stoppers disinfected with alcohol only.
This study shows the lack of necessity of any disinfection procedure on the rubber stopper of single-dose vials and the efficacy of alcohol only for disinfecting the stopper of multiple-dose vials.
文献中的建议对于在抽取液体前对一次性使用小瓶进行消毒的必要性存在冲突。对多剂量小瓶瓶塞表面进行消毒的干预措施差异很大。
确定对单剂量小瓶瓶塞进行酒精消毒的必要性，并比较在多剂量小瓶每次穿刺前使用聚维酮碘和酒精联合消毒与仅使用酒精消毒瓶塞的效果。
对100个单剂量小瓶的橡胶瓶塞表面进行细菌培养。为了确定两种多剂量小瓶消毒程序的效果，对87个常规用聚维酮碘和酒精消毒的瓶塞表面进行细菌培养。在操作改变后，对100个仅常规用酒精消毒的多剂量小瓶进行细菌培养。
在对单剂量小瓶瓶塞进行的培养中，99%是无菌的。对多剂量小瓶的两种消毒技术进行比较发现，87个用聚维酮碘和酒精联合准备的小瓶中有83个（95%）是无菌的，而所有仅用酒精消毒的瓶塞也是无菌的。
本研究表明对单剂量小瓶的橡胶瓶塞进行任何消毒程序都没有必要，并且仅酒精对多剂量小瓶的瓶塞消毒有效。
