维修内镜复用前微生物染菌量超标的危险因素

Risk factors for excessive microbial contamination levels of repaired endoscopes before reuse

  • 摘要:
    目的 分析维修内镜复用前微生物染菌量检测超标的危险因素,并针对性地制定相应的管理策略,为处置该类事件提供参考。
    方法 选择2021年10月-2024年6月山西某医院消化内镜室复用维修内镜54条作为研究对象,共维修105次,对所有维修内镜于复用前进行微生物染菌量检测,并根据检测结果分为阳性组(菌落数>20 CFU/件)和阴性组(菌落数≤20 CFU/件),归纳维修内镜复用前染菌量超标的危险因素。比较干预前(2021年10月-2024年6月)和干预后(2024年7月-2024年12月)维修内镜复用前的微生物染菌量检测阳性率。
    结果 针对105次维修内镜复用前微生物染菌量检测的结果显示,阳性率为27.62%(29/105)。缩短检修前后清洗消毒间隔时长(OR=0.285)是保护因素,内镜管道划痕/凹槽/补漏情况(OR=3.211)、清洗消毒不规范(OR=5.257)、酶洗刷洗次数少(OR=2.438)是维修内镜复用前染菌量超标的危险因素(P < 0.05)。干预前,维修内镜微生物染菌量检测阳性率高于非维修内镜(27.62% vs. 3.45%,P < 0.001);干预后,维修内镜微生物染菌量检测阳性率与非维修内镜相比差异无统计学意义(5.26% vs. 4.17%,P=0.681),但维修内镜微生物染菌量检测阳性率低于干预前(5.26% vs. 27.62%,P=0.004)。
    结论 维修内镜复用前微生物染菌量检测超标事件高发,应制定相应的管理策略并实施,有利于保证维修内镜复用前清洗消毒的合格率,提高维修内镜复用的安全性。

     

    Abstract:
    OBJECTIVE To analyze the risk factors for excessive microbial contamination level tested for repaired endoscopes before reuse and to formulate targeted management strategies, providing a reference for handling such events.
    METHODS A total of 54 repaired endoscopes reused in the Digestive Endoscopy Room of a hospital in Shanxi Province from Oct. 2021 to Jun. 2024, with a total of 105 repairs, were selected as the study subjects. Microbial contamination levels were tested for all repaired endoscopes before reuse, and they were divided into a positive group (colony count >20 CFU/item) and a negative group (colony count ≤20 CFU/item) based on the test results. The risk factors for excessive microbial contamination levels of repaired endoscopes before reuse were summarized. The positive rates of microbial contamination level tests for repaired endoscopes before reuse were compared between the pre-intervention period (from Oct. 2021 to Jun. 2024) and the post-intervention period (from Jul. 2024 to Dec. 2024).
    RESULTS The results of microbial contamination level tests of endoscopes with 105 repairs before reuse showed a positive rate of 27.62% (29/105). Shortening duration between cleaning and disinfection before and after repair (OR=0.285) was a protective factor, scratches/grooves/leak repairs in the endoscope tubes (OR=3.211), improper cleaning and disinfection (OR=5.257) and the less number of enzymatic brushing washes (OR=2.438) were identified as risk factors for excessive microbial contamination levels of repaired endoscopes before reuse (P < 0.05). Before the intervention, the positive rate of microbial contamination level tests for repaired endoscopes was higher than that for non-repaired endoscopes (27.62% vs. 3.45%, P < 0.001). After the intervention, there was no statistically significant difference in the positive rate of microbial contamination level tests between repaired and non-repaired endoscopes (5.26% vs. 4.17%, P=0.681), but the positive rate for repaired endoscopes was lower than that before the intervention (5.26% vs. 27.62%, P=0.004).
    CONCLUSIONS The occurrence of excessive microbial contamination levels of repaired endoscopes before reuse frequemly occur. Formulating and implementing targeted management strategies may guarantee the qualified rate of cleaning and disinfection of endoscopes before the reuse, and enhance the safety for the reuse of repaired endoscopes.

     

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