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耐甲氧西林金黄色葡萄球菌(MRSA)对放射科CT机污染影响分析及干预措施

作者:张 莹1,2 查云飞1

所属单位:1.武汉大学人民医院放射科(湖北 武汉 430060) 2.湖北省鄂州市中心医院介入放射科(湖北 鄂州 430060)

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摘要

目的通过对放射科CT室耐甲氧 西林金黄色葡萄球菌 (MRSA)污染进行分 析,制定相应的实用于放射科的综合干预 措施。方法 采集2015年1月份到3月份CT 机相关设备表面、CT室内MRSA易感区域 标本,行细菌污染情况检测,共12周, 分两个阶段,前6周为对照组,应用常规 消毒后2小时采集;后6周为实验组,采 用三氯异氰尿酸消毒液(含氯500 mg/L) 和相关特殊干预措施,消毒处理后2 h内 对相同检测区,相同方法进行采样。对 采集的标本进行MRSA菌株确认。结果 两 组CT机相关设备标本MRSA阳性结果相比 较,P<0.05,差异有统计学意义。两组 CT室MRSA易感区域标本MRSA阳性结果相比 较,P>0.05,差异无统计学意义。对照 组标本MRSA阳性率为16.67%,实验组标本 MRSA阳性率为3.03%,两组相比较差异(P <0.05),差异有统计学意义。结论 CT 室在与患者直接接触的区域比较容易被 MRSA污染,通过本研究组制定的综合干预 措施后,CT机污染情况获得了良好的改 善,说明该综合干预措施可有效降低影像 科MRSA感染发生率。

Objective Analyze the CT machine contaminated of methicillin-resistant staphylococcus aureus (MRSA) in radiological department to draw up the comprehensive and practical interventions. Methods The samples of the CT machine and Susceptible area of MRSA were collected from January to March 2015, afterwards, the bacterial contamination was detected. The12 weeks was separated into two stages that the former 6 weeks (the control groups) and the latter 6 weeks (the experimental groups).The samples of the control groups were collected after 2 hours of conventional sterilization. The samples of the experimental groups were collected after 2 hours sterilization with TCCA disinfectant ( chlorine 500 mg / L) and the related special interventions. Applying the same approach to sampling and the samples were collected to confirm MRSA strains. Results The difference of positive results of MRSA samples of two groups CT-related equipment has statistical significance (P<0.05). The difference of two groups positive results of CT laboratory MRSA susceptible area samples has no statistical significance (P>0.05). The positive rate of MRSA of the control groups was 16.67% ,and the the experimental groups was 3.03%. The difference of two groups has statistical significance (P<0.05). Conclusions The most easily contaminated area by MRSA of CT laboratory is the direct contact area with patients. Using the comprehensive interventions enacted by ours research obtains a promising effect.It is illustrated that the comprehensive interventions can effectively reduce the infection rate .

【关键词】耐甲氧西林金黄色葡萄球菌; 放射科;消毒液

【中图分类号】R197.323.4

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2015.07.036

前言

耐甲氧西林金黄色葡萄球菌 ( m e t h i c i l— l i n r e s i s t a n t Staphylococcus aureus,MRSA)是引起全球性医院感染的重要致病菌 之一,也是目前最常见的耐药菌株[1]。放射科病人流动量大,病种复 杂,急诊患者多,感染患者和非感染患者在同样的设备上做相关检 查,导致放射科被致病菌污染的机会较高[2]。CT机作为放射科常用设 备之一,分析和控制CT机被耐甲氧西林金黄色葡萄球菌污染情况十分 重要[3-4]。本研究选择2015年1月份到3月份采集的本院CT机相关设备表 面及CT室MRSA易感区域的标本,进行细菌污染情况检测,根据培养结 果,制定相应的实用于放射科的综合干预措施进行评价。