Monitoring of disinfection effect and analysis of microbial distribution characteristics in a general Grade III hospital in Gansu province from 2019 to 2021

Objective  To understand the quality of environmental disinfection and sterilization work in a comprehensive Grade III hospital in Gansu province from 2019 to 2021, to understand the distribution of microorganisms after disinfection and the drug resistance of the main pathogens of nosocomial infections, to find the problems and hidden dangers in disinfection and sterilization work, to effectively prevent and control the outbreak and prevalence of infectious diseases, and to provide a scientific basis for the 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, table, hands of medical staff, endoscope, oral water, pressure steam sterilization and medical sewage were sampled to determine whether they met the hygienic standards, and the isolated pathogens were tested for drug sensitivity by microbroth dilution method.

Results  In 2019-2021, a total of 1,054 samples were taken and 843 were qualified, with a pass rate of 79.98%. Among them, the qualified rate of air is 88.15%, the qualified rate of physical meter is 85.34%, the qualified rate of surgical hand is 56.16%, the qualified rate of hygienic hand is 79.64%, the qualified rate of medical water (oral water) is 33.33%, the qualified rate of medical water (other water) is 85.42%, the qualified rate of endoscopes is 86.42%, the qualified rate of pressure steam sterilizer is 100%, and the qualified rate of sewage is 83.33%. The top five microorganisms in the post-disinfection environment 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%), five strains of Staphylococcus aureus (0.55%), two strains of Pseudomonas aeruginosa (0.22%), one strain of Escherichia coli (0.11%), and one strain of Klebsiella pneumoniae subspecies pneumoniae (0.11%), the main pathogenic bacteria in hospital-acquired infections were detected. The identification of pathogenic bacteria was dominated by Gram-positive bacteria, and the main hospital infections were detected in key departments such as operating rooms and intensive care units, and showed the phenomenon of multi-drug resistance.

Conclusion  Overall disinfection quality is slightly lower, and the disinfection effect is not stable, common hospital infection pathogens are detected, and the drug resistance situation is not optimistic, the need to strengthen the supervision and management of hospital disinfection, the development of preventive and curative measures, and improve the effectiveness of disinfection.