医疗机构治疗用水持续性监测及其相关医院感染管理对策

Continuous monitoring of medical water and countermeasures for control of health care-associated infections in medical institutions

  • 摘要: 目的 通过持续性监测医院治疗用水的细菌污染情况,为识别污染风险点和制定精准的医院感染管理对策提供依据。方法 医院感染防控人员定期采集口腔科、消毒供应中心、气管镜室、消化内镜室治疗用水样本,多部门协作调查、处置不合格样本,修订并实施管理对策。结果 2020-2024年共监测水样1 561份,平均合格率为96.80%,总合格率呈上升趋势(χ2=17.621,P<0.001)。2020年消化内镜室消毒机用水合格率较低(78.31%),实施干预后合格率上升至100.00%。市政水和储水罐水的合格率均高于水处理系统水(χ2=4.739,P=0.029; χ2=3.797,P=0.051)。气管镜室消毒机水样中无菌占比最高(94.15%),消化内镜室消毒机水样中菌落数>100 CFU/ml占比最高(3.53%)。结论 建立以持续性监测数据为依据的闭环管理模式,通过多部门协作与信息化预警实现由被动处置到主动风险防控的有效转化,显著提升治疗用水合格率,为医疗机构提供可推广的解决方案。

     

    Abstract: OBJECTIVE To continuously monitor the bacterial contamination of medical water in a hospital so as to provide bases for identification of risk points of the contamination and formulation of targeted countermeasures for control of health care-associated infections (HAIs). METHODS The water samples were regularly collected from stomatology department, central sterile supply department, bronchoscopy room and gastroenterology room by the infection control professionals. A multidisciplinary team collaborated to investigate and dispose the unqualified samples. Subsequently, management interventions were revised and implemented. RESULTS A total of 1561 water samples were monitored during 2020 to 2024, the average qualified rate was 96.80%, and the total qualified rate showed an upward trend (χ2= 17.621,P<0.001). The qualified rate of the water for sterilization machines in the gastroenterology room was relatively low (78.31%) in 2020 and increased up to 100.00% after the interventions were implemented. The qualified rates of municipal water and water from storage tanks were higher than those of the water from water processing system (χ2= 4.739,P=0.029;χ2= 3.797,P=0.051). The water from sterilization machines of the bronchoscopy room exhibited the highest proportion of samples with zero colony-forming units (CFU/ml) (94.15%), whereas the water from sterilization machines of the gastroenterology room shows the highest proportion of samples with the bacterial colony counts exceeding 100 CFU/ml (3.53%). CONCLUSIONS It is an effective way to establish a closed-loop management mode based on continuous monitoring of data and achieve the efficient transition from passive disposal to active prevention and control of risks through multidisciplinary collaboration and information-based early-warning system so as to raise the qualified rate of medical water and provide propagable solutions for the medical institution.

     

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