译文：ICU内用过氧化氢汽雾去污染后环境中MRSA的快速再污染
Journal of Hospital InfectionVolume 66, Issue 4, August 2007, Pages 360-368
Rapid recontamination with MRSA of the environment of an intensive care unit after decontamination with hydrogen peroxide vapour
Pages 360-368
K.J. Hardy, S. Gossain, N. Henderson, C. Drugan, B.A. Oppenheim, F. Gao and P.M. Hawkey
Abstract | Full Text + Links | PDF (287 K) |
Summary
Meticillin-resistant Staphylococcus aureus (MRSA) persists in the hospital environment and conventional cleaning procedures do not necessarily eliminate contamination. A prospective study was conducted on an intensive care unit to establish the level of environmental contamination with MRSA, assess the effectiveness of hydrogen peroxide vapour (HPV) decontamination and determine the rate of environmental recontamination. MRSA was isolated from 11.2% of environmental sites in the three months preceding the use of HPV and epidemiological typing revealed that the types circulating within the environment were similar to those colonising patients. After patient discharge and terminal cleaning using conventional methods, MRSA was isolated from five sites (17.2%). After HPV decontamination but before the readmission of patients, MRSA was not isolated from the environment. Twenty-four hours after readmitting patients, including two colonized with MRSA, the organism was isolated from five sites. The strains were indistinguishable from a strain with which a patient was colonized but were not all confined to the immediate vicinity of the colonized patient. In the eight weeks after the use of HPV, the environment was sampled on a weekly basis and MRSA was isolated from 16.3% sites. Hydrogen peroxide vapour is effective in eliminating bacteria from the environment but the rapid rate of recontamination suggests that it is not an effective means of maintaining low levels of environmental contamination in an open-plan intensive care unit.
Keywords: Meticillin-resistant Staphylococcus aureus; Environment; Hydrogen peroxide
ICU内用过氧化氢汽雾去污染后环境中MRSA的快速再污染
MRSA持续存在于医院环境中，用常规的清洁方法不能有效消除污染。在ICU进行一项前瞻性研究来确定MRSA环境污染水平， 评估过氧化氢汽雾（ＨＰＶ）去污染的效果并确定环境再污染的几率。MRSA可以从三个月以来使用HPV的11.2%环境采样点中分离到，而且流行病学分析显示循环在环境中的与定植病人的MRSA分型类似。病人出院后用常规的方法清洁后，MRSA可以从五个采样点（17.2％）分离到。用ＨＰＶ去污染后病人重新入住以前，ＭＲＳＡ没有从环境中分离到。病人（包括两名定植患者）重新入住２４小时后，ＭＲＳＡ可以从五个采样点分离到。这些菌株与一名定植病人的菌株相同但并不都局限在这个病人的近距离周围。使用ＨＰＶ８周后，每周采样一次，ＭＲＳＡ可从16.3％的环境采样点分离到。过氧化氢汽雾能有效消除环境中的细菌，但是其快速的再污染提示在一个即将开放使用的ＩＣＵ中，它不是维持环境低污染水平的有效方法。
请批评指正！ 在今年6月份美国APIC会议上，我见过hydrogen peroxide vapour (HPV) 过氧化氢气雾的机器展示，当时关注不多，现在看来是有效果，可以作为终末消毒，但不能维持长久的功效。 能了解到新类型的消毒产品不错，不过再污染的速度确实是够快的，不能把消毒产品作为预防感染的保护伞啊。。。。。 东富龙医疗研发生产的过氧化氢气雾的机器对空气、物体表面、床单元都有较好的消毒效果。
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