2007－ICAAC－病人环境去污和监测的新方法－待翻译
New Methods for Decontaminating and Monitoring the Patient Environment.PHILIP C. CARLING, MD.;
Carney Hosp., Boston, MA.
The evolving understanding of the epidemiology of healthcare associated infections has led to a reconsideration of the importance of contamination of surfaces and objects surrounding patients in the transmission of environmentally resistant pathogens such as Clostridium difficile, VRE, MRSA, Acineobacter baumanii and noro viruses. Although currently used disinfectant chemicals are relatively effective in killing most environmental pathogens, more potent and rapidly acting disinfectants as well as innovative technologies are being developed and tested to better rid environmental surfaces of potentially transmissible pathogens. Despite the use of liquid disinfectants with good invitro efficacy for cleaning high touch objects, recent studies have confirmed an increased risk of subsequent ICU room occupants acquiring MRSA, VRE and A. baumanii when prior room occupants were colonized or infected with these pathogens. These observations as well as a recent study which documented transmission of PGFE identical strains of MRSA from prior room occupants to patients in the Intensive Care setting suggest that the thoroughness of environmental cleaning may potentially be suboptimal. Recent culture based environmental monitoring and studies using direct observation as well as investigation using indirect monitoring tools have confirmed the suboptimal thoroughness of disinfection cleaning of the near-patient environment in individual hospitals. Most recently an indirect methodology using a fluorescent marker was used to evaluate more than twenty acute healthcare facilities ranging in size from 25 to 800 beds. The preliminary results of these studies suggest that the thoroughness of disinfection cleaning may not be optimal in many hospitals and that structured educational interventions and ongoing objective performance feedback to the Environmental Services staff can significantly improve the such cleaning activities.
While optimizing hand hygiene compliance and isolation procedures will remain as critical interventions to limit the transmission of infectious pathogens in health care settings, improving the effectiveness as well as monitoring and improving the thoroughness of disinfection cleaning of the near patient environment has the potential for further improving patient and health care worker safety.
回复 #1 icchina 的帖子
这篇文章短点，我翻译试试，大家不要跟我抢哦，icchina今天发了很多，要抢就抢俺剩下的吧。;P ;P 原帖由 楚楚 于 2007-9-23 14:31 发表 http://bbs.sific.com.cn/images/common/back.gif这篇文章短点，我翻译试试，大家不要跟我抢哦，icchina今天发了很多，要抢就抢俺剩下的吧。;P ;P
很高兴看到楚版主以实际行动带头支持本版块的活动和发展！ The evolving understanding of the epidemiology of healthcare associated infections has led to a reconsideration of the importance of contamination of surfaces and objects surrounding patients in the transmission of environmentally resistant pathogens such as Clostridium difficile, VRE, MRSA, Acineobacter baumanii and noro viruses（随着对医疗相关性感染流行病学的进一步认识，使我们再次认识到病人周围物表及物品耐药菌污染的重要性，如艰难梭菌、耐万古霉素肠球菌、耐甲氧西林金黄色葡萄球菌、鲍曼不动杆菌、诺沃病毒）. Although currently used disinfectant chemicals are relatively effective in killing most environmental pathogens（虽然目前使用的化学消毒剂能比较有效地杀灭大多数环境中的病原菌）, more potent and rapidly acting disinfectants as well as innovative technologies are being developed （但是人们正在研究新的消毒技术和更有效、更快速的消毒剂）and tested to better rid environmental surfaces of potentially transmissible pathogens（而且证明可以较好地消除环境表面的潜在感染性病原菌）. Despite the use of liquid disinfectants with good invitro efficacy for cleaning high touch objects（虽然具有良好体外有效性的液体消毒剂用于频繁接触物品的清洁）, recent studies have confirmedan increased risk of subsequent ICU room occupants acquiring MRSA, VRE and A. baumanii when prior room occupants were colonized or infected with these pathogens（但最近的研究已经证实，之前入住ICU的病人感染或定植过MRSA、VRE、A. baumanii时，以后入住ICU的病人增加了获得这些病原菌的危险性）. These observations as well as a recent study which documented transmission of PGFE identical strains of MRSA from prior room occupants to patients in the Intensive Care setting suggest that the thoroughness of environmental cleaning may potentially be suboptimal（这些观察和最近的一项研究，该研究证明MRSA与之前入住ICU的病人的病原体具有同源性，认为环境的清洁并不彻底）. Recent culture based environmental monitoring and studies using direct observation as well as investigation using indirect monitoring tools have confirmed the suboptimal thoroughness of disinfection cleaning of the near-patient environment in individual hospitals（最近的环境监测培养和直接观察研究，以及间接的监测工具调查已经证实在个别医院病人邻近环境的清洁和消毒欠彻底）. Most recently an indirect methodology using a fluorescent markerwas used to evaluate more than twenty acute healthcare facilities ranging in size from 25 to 800 beds（最近大多数使用一种荧光标记法用于评估二十家急救医疗机构，这些急救医疗机构的病床数从25张到800张）. The preliminary results of these studies suggest that the thoroughness of disinfection cleaning may not be optimal in many hospitals（这些研究的初步结果认为在许多医院清洁消毒并不彻底） and that structured educational interventions and ongoing objective performance feedback to the Environmental Services staff can significantly improve the such cleaning activities.（而且对环境服务人员有计划的教育指导和动态的客观工作反馈能显著地改善这样的清洁效果）
While optimizing hand hygiene compliance and isolation procedures will remain as critical interventions to limit the transmission of infectious pathogens in health care settings（虽然优化手卫生的依从性和隔离程序是卫生保健机构限制感染性病原菌传播的关键干预措施）, improving the effectiveness as well as monitoring and improving the thoroughness of disinfection cleaning of the near patient environment has the potential for further improving patient and health care worker safety（但监督和促进病人邻近环境清洁消毒的彻底有可能进一步改善病人和医务人员的安全性）.
回复 #4 楚楚 的帖子
是强调环境消毒的重要性！原帖由 楚楚 于 2007-9-23 22:10 发表 http://bbs.sific.com.cn/images/common/back.gif
The evolving understanding of the epidemiology of healthcare associated infections has led to a reconsideration of the importance of contamination of surfaces and objects surrounding patients in...
很高兴看到楚版主的参与！榜样的力量是无穷的:lol
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