摘要
目的探讨麻醉机内部呼吸回路污染特点及对医院感染的影响。方法 2015年3月-2016年12月随机选择医院手术室正常使用的150台麻醉机。均于手术结束并正确拆卸麻醉机后,对其内部呼吸回路的7个部位分别进行采样,送医院检验科进行细菌培养、鉴定。统计麻醉机内部呼吸回路各采样部位的细菌污染情况,对可能引起麻醉机内部呼吸回路感染的因素进行单因素及多因素Logistic分析,分析麻醉机污染对患者术后住院期间下呼吸道感染率的影响。结果 150台麻醉机共采集标本1 050份,其中污染麻醉机56台,污染率37.33%(56/150),共188份标本细菌培养为阳性,污染部位以呼气口端单向阀为主,55份占29.26%;188份细菌培养阳性的标本共检出病原菌213株,其中革兰阴性菌113株占53.05%、革兰阳性菌68株占31.92%、真菌32株占15.02%;Logistic多因素分析结果显示,手术时间>3h、年龄>60岁、腔镜手术为麻醉机内部呼吸回路污染的影响因素(P<0.05)。结论手术时间、患者年龄、腔镜手术为麻醉机内部呼吸回路污染的影响因素,这类患者术后住院期间较易发生下呼吸道感染。
OBJECTIVE To explore the pollution characteristics of breathing-circuit-systems in anesthesia machines and its influence on nosocomial infection.METHODS From Mar.2015 to Dec.2016,150 anesthesia machines were randomly selected from the operating room of our hospital.After the operation was completed and the anesthesia machine was removed,7 parts of breathing-circuit-systems were sampled(1,050 specimens),and the bacteria culture and identification were conducted in the laboratory.Bacterial contamination status of the sampling sites in the breathing-circuit-systems of anesthesia machines was recorded.Univariate and multivariate logistic analysis were performed on the factors that might cause the infection of breathing circuits in anesthesia machines.The influence of anesthetic machine pollution on the incidence of lower respiratory tract infection during postoperative hospitalization was analyzed.RESULTS Of the 150 anesthesia machines,56 were contaminated,with a contamination rate of 37.33%,and among the 1,050 specimens collected,188 specimens were positive in bacterial culture.Among all sampling sites,the positive rate of bacterial culture was the highest in the check valve of the exhalation port,accounting for 29.26%(55/188).Of the 188 bacterial culture positive specimens,213 strains were isolated,including 113 strains of gram-negative bacteria(53.05%),68 strains of gram-positive bacteria(31.92%)and 32 strains of fungi(15.02%).Multivariate logistic analysis showed that surgery time of>3 hours,age of>60 years old and endoscopic surgery were the independent risk factors for the contamination of breathing-circuit-systems in the anesthetic machine(P<0.05).CONCLUSION Surgical time,patient age and endoscopic surgery were the risk factors for the contamination of breathing-circuit-systems in the anesthetic machine.These patients are more susceptible to lower respiratory infection during postoperative hospitalization.
作者
刘彦
王舒
石建华
LIU Yan;WANG Shu;SHI Jian-hua(Occupational Disease Prevention and Control Hospital of Tianjin,Tianjin 300011,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第23期3660-3663,共4页
Chinese Journal of Nosocomiology
基金
天津市医学科学研究基金资助项目(WX11C10)
关键词
麻醉机
污染
影响因素
医院感染
Anesthesia machine
Pollution
Risk factor
Nosocomial infection
