Examining the association between surface bioburden and frequently touched sites in intensive care
Examining the association between surface bioburden and frequently touched sites in intensive care
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DOI：
10.1016/j.jhin.2016.11.002
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发表时间：
2017-01-01
影响因子：
6.9
通讯作者：
Dancer, S. J.
中科院分区：
文献类型：
--
作者：
Adams, C. E.;Smith, J.;Dancer, S. J.
背景：重症监护患者感染的风险增加。患者附近的表面充当微生物污物的储存库，其中可能含有病原体。目的：方法：在一个有10张床位的ICU中，每个床位周围的5个地点每月进行总微生物土壤（cfu/cm（2））和金黄色葡萄球菌的筛查，共10个月。选择的部位为输液泵和心脏监护仪、左右床栏和床桌。10个1小时的秘密审计这些网站的手触摸频率，以提供一个平均的手触摸计数，这是仿照从微生物screening.Findings获得的土壤水平：10个葡萄球菌中的7个被发现与总污染的一个特定的网站（P = 0.005）和相同的比例，从三个最经常接触的网站（床栏杆和床表）。有四个网站之间的线性关系，证明总微生物污染（>12 cfu/cm（2））和平均数量的手触摸计数（P = 0.08）。床桌被处理得最多，但不是污染最严重的场所。我们怀疑将酒精凝胶容器习惯性地放置在床桌上可能会降低微生物产量。从一张桌子上移除凝胶容器证实了其在重新筛选后对微生物污染的抑制作用（19% vs 50% > 12 cfu/ cm（2）：P - 0.007）。结论：ICU中患者附近部位的表面生物负载与工作人员和访客的手接触频率相关。这支持了在高风险医疗环境中进行有针对性的卫生清洁的需求。(C)2016年医疗感染学会。由爱思唯尔有限公司出版。保留所有权利。
Background: Critical care patients are at increased risk of infection. Near-patient surfaces act as reservoirs of microbial soil, which may contain pathogens. Aim: To correlate soil levels with hand-touch frequency of near-patient sites in an intensive care unit (ICU).Methods: Five sites around each bed in a 10-bed ICU were screened for total microbial soil (cfu/cm(2)) and Staphylococcus aureus every month for 10 months. Selected sites were infusion pump and cardiac monitor, left and right bedrails, and bed table. Ten 1 h covert audits of hand-touch frequency of these sites were performed in order to provide an average hand-touch count, which was modelled against soil levels obtained from microbiological screening.Findings: Seven of 10 staphylococci were found in conjunction with gross contamination of a specific site (P = 0.005) and the same proportion from three most frequently touched sites (bedrails and bed table). There was a linear association between four sites demonstrating gross microbial contamination (>12 cfu/cm(2)) and mean number of hand-touch counts (P = 0.08). The bed table was handled most but was not the most contaminated site. We suspected that customary placement of alcohol gel containers on bed tables may have reduced microbiological yield. Removing the gel container from one table confirmed its inhibitory effect on microbial contamination after rescreening (19% vs 50% > 12 cfu/ cm(2): P - 0.007).Conclusion: Surface bioburden at near-patient sites in ICU is associated with hand-contact frequencies by staff and visitors. This supports the need for targeted hygienic cleaning in a high-risk healthcare environment. (C) 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.