放射科:耐多药微生物的潜在来源:巴勒斯坦三级医院横断面研究

Zena Odeh, Safaa Abatli, Mohammad Qadi
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摘要

导言。在全球范围内,医疗机构都面临着医院感染(HAIs)的巨大挑战。这些疾病除了会导致发病率和死亡率外,还会造成巨大的经济损失。医学领域对感染传播的研究相当多,但放射科的研究却不多。研究目的本研究旨在确定计算机断层扫描(CT)、磁共振成像(MRI)、超声波(US)、普通 X 射线检查室和便携式射线照相术中经常接触的、易受污染的表面上是否存在耐多药(MDR)微生物,并调查患者和医护人员感染耐多药微生物的潜在危险。材料和方法。本研究在 2022 年 5 月和 6 月期间从放射科采集了 160 份拭子样本。样本从 CT 和 MRI 检查室内外的 80 个预定表面采集两次,也从 US 和普通 X 光机以及便携式 X 光机采集两次。样本于早上 7:00 按照常规清洁程序用棉签采集。用棉签拭擦 100 平方厘米的表面后,计算每平方厘米的细菌菌落形成单位 (CFU)。结果显示几乎所有被测表面都有细菌菌落形成单位。污染率最高的是键盘(1.2-8)CFU/cm2、病人桌边(1.2-20)CFU/cm2、膝关节圈(2.4-3)CFU/cm2 和病人腿部支撑(1.2-8)CFU/cm2。与 5 月份相比,6 月份的污染量明显增加,这与医院隔离病人数量、放射科工作量和转诊病人数量的增加是一致的。在我们的研究中,没有一个受检部位出现耐多药革兰氏阴性菌污染,如产广谱β-内酰胺酶肠杆菌(ESPL)或产碳青霉烯酶肠杆菌(CPE)。另一方面,还检测到耐甲氧西林葡萄球菌(MRS)、耐万古霉素葡萄球菌(VRS)和耐万古霉素肠球菌(VRE)。结论放射科的所有设备和部位都可能是细菌感染(包括 MDR)的源头,因此必须修订并在早上和病人之间执行强制性和承诺性消毒协议。
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Radiology Department: A Potential Source of Multidrug-Resistant Microorganisms: A Cross-Sectional Study at Tertiary Hospital, Palestine
Introduction. Globally, healthcare facilities face a great challenge in the form of hospital-acquired infections (HAIs). Aside from the morbidity and mortality they cause, these illnesses are also extremely costly. Research on infection transmission in the medical field has been considerable, but not so much in the radiology department. Aim. This study aims to identify the presence of multidrug-resistant (MDR) microbes on surfaces that are frequently touched in computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), plain X-ray examination rooms, and portable radiography that are susceptible to contamination as well as to investigate the potential dangers of contracting MDR organisms to patients and healthcare providers. Materials and Method. In this study, 160 swab samples were collected from the radiology department during May and June 2022. Samples were obtained from 80 predefined surfaces twice within and outside of CT and MRI examination rooms as well as from US and plain X-ray machines and portable X-ray machines. Samples were taken at 7:00 a.m. using cotton swabs following the regular cleaning procedure. Bacterial colony-forming units (CFUs) per square centimeter were calculated after swabbing a 100 cm2 surface. Results. Nearly all of the surfaces tested had bacterial CFUs. The highest contamination rate was found on keyboards ranging from (1.2–8) CFU/cm2, the sides of patient tables (1.2–20) CFU/cm2, knee coil (2.4–3) CFU/cm2, and patient leg supports (1.2–8) CFU/cm2. A noticeable increase in the contamination was noticed in June compared to May, and this was consistent with the increase in the number of isolated patients in the hospital, the workload in the radiology department, and the number of patients referred to the hospital. In our study, none of the examined sites showed contamination with MDR Gram-negative bacteria such as extended-spectrum beta-lactamases producing Enterobacterales (ESPL) or Carbapenemase-producing Enterobacterales (CPE). On the other hand, methicillin-resistant Staphylococcus (MRS), vancomycin-resistant Staphylococcus (VRS), and vancomycin-resistant Enterococcus (VRE) were detected. Conclusion. All of the radiology department equipment and sites could be a source of bacterial infection including MDR, so the obligatory and committed disinfection protocol must be revised and implemented in the morning and between patients.
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