Miller T E, Findon G
Department of Medicine, University of Auckland, New Zealand.
Perit Dial Int. 1997 Nov-Dec;17(6):560-7.
To determine the level of bacterial contamination associated with touch contact of a connector set during peritoneal dialysis (PD).
The experiment utilized a laboratory-based simulation of a bag exchange procedure. Deliberate touch contamination of the connector set spike was followed by quantitative recovery of micro-organisms from the connector and, in some cases, the dialysis bag.
Patients undergoing PD were used as the "test" group. Departmental secretarial and laboratory staff served as the comparative control group.
The patients were voluntary subjects from a PD outpatients unit and were tested in their own homes.
The numbers of micro-organisms contaminating a connector set and entering the dialysis bag during a touch-contamination event were determined. Additionally we identified hand hygiene and, in particular, the care taken to dry the hands after washing as being highly relevant to microbial touch-contamination levels. Patient hand disinfection, as practised in most PD units, effectively reduced touch contamination to low levels.
Touch contamination of a connector set with unprepared hands led to fewer than 100 micro-organisms translocating from fingers to the spike. If the hands were washed but not dried before touch contact was made, up to 4500 micro-organisms translocated to the connector set spike. Air-towel drying of washed hands before touch contact reduced the translocating numbers by 95%-99%. Hand disinfection, as routinely practiced by PD patients, reduced the bacterial numbers reaching the peritoneal cavity after touch contamination to <5. The range of micro-organisms isolated from the fingers of PD patients using hand disinfectants on a regular basis showed considerably more diversity than the control group.
Hand care prior to bag exchange has a major effect on touch-contamination levels. Accidental touch contact of connecting devices by unprepared hands using a PD-bag exchange procedure leads to the translocation of 500 micro-organisms or fewer to the connector device. If the hands are wet at the time of contact the number translocating can be as high as 4500. Hand drying with an air towel before touch contact reduces the numbers translocating by 95%-99%. Hand disinfection procedures carried out prior to bag exchange minimizes touch-contamination levels.
确定腹膜透析（PD）过程中连接装置的触摸接触所导致的细菌污染水平。
该实验采用基于实验室的袋式交换程序模拟。在故意触摸污染连接装置的穿刺针后，对连接装置以及某些情况下透析袋中的微生物进行定量回收。
接受PD治疗的患者作为“测试”组。部门秘书和实验室工作人员作为比较对照组。
患者为来自PD门诊单元的自愿受试者，在其家中接受测试。
确定了触摸污染事件中污染连接装置并进入透析袋的微生物数量。此外，我们发现手部卫生，特别是洗手后擦干手部的注意事项与微生物触摸污染水平高度相关。大多数PD单元所实施的患者手部消毒可有效将触摸污染降低至低水平。
用未准备的手触摸污染连接装置会导致从手指转移至穿刺针的微生物少于100个。如果在触摸接触前洗手但未擦干，多达4500个微生物会转移至连接装置的穿刺针。触摸接触前用干手机吹干洗手后的手可使转移数量减少95% - 99%。PD患者常规进行的手部消毒可将触摸污染后进入腹膜腔的细菌数量减少至<5个。定期使用手部消毒剂的PD患者手指分离出的微生物种类比对照组多得多。
换袋前的手部护理对触摸污染水平有重大影响。在PD袋式交换程序中，未准备的手意外触摸连接装置会导致500个或更少的微生物转移至连接装置。如果接触时手是湿的，转移的微生物数量可高达4500个。触摸接触前用干手机吹干手可使转移数量减少95% - 99%。换袋前进行手部消毒程序可将触摸污染水平降至最低。
