Abstract:
Objective To understand the quality of environmental disinfection and sterilization in a grade III general hospital in Gansu province from 2019 to 2021, understand the distribution of microorganisms after disinfection and the drug resistance of the main pathogens causing nosocomial infections, find the problems and hidden dangers in disinfection and sterilization, and provide evidence for the effective prevention and control of infectious disease outbreak and development of nosocomial infection prevention and control measures.
Methods According to the Technical Specification for Disinfection and Hygienic Standard for Disinfection in Hospitals, the hospital air, subject surfaces, hands of medical staff, endoscopes, oral water, pressure steam sterilizers and medical sewage were sampled to evaluate whether they met the hygienic standards, and the isolated pathogens were tested for drug susceptibility by using microbroth dilution method.
Results During 2019−2021, a total of 1 054 samples were taken, in which 843 met the disinfection requirement (79.98%). The rate was 88.15% for air samples, 85.34% for subject surface samples, 56.16% for surgical hand swabs, 79.64% for hygienic hand swabs, 33.33% in medical water (oral water) samples and 85.42% in other medical water samples, and the qualified rate of disinfection was 86.42% for endoscopes, 100.00% for pressure steam sterilizer and 83.33% in sewage samples. The top five microorganisms in the post-disinfection environment samples were Staphylococcus hominis (13.60%), Staphylococcus epidermidis (13.05%), Micrococcus luteus (7.68%), Staphylococcus voorhees (6.03%), and Staphylococcus koch (5.81%), respectively. Five strains of Acinetobacter baumannii (0.55%), 5 strains of S. aureus (0.55%), 3 strains of Enterococcus faecalis (0.33%),2 strains of Pseudomonas aeruginosa (0.22%), 1 strain of Escherichia coli (0.11%), and 1 strain of Klebsiella pneumoniae subspecies pneumoniae (0.11%), the main pathogenic bacteria in hospital-acquired infections, were detected. The pathogenic bacteria were mainly gram-positive, which were mainly detected from operation rooms and intensive care units and showed multi-drug resistance.
Conclusion Problems still existed in the disinfection in this grade III general hospital, indicated by unstable disinfection effect and the detections of common pathogens causing nosocomial infection and the drug resistance of the pathogens detected. It is necessary to strengthen the supervision and management of hospital disinfection, develop prevention and control measures to improve the effect of the disinfection in hospitals.
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