泵辅助采样与传统采样法在内镜消毒质量监测中的效果比较

Comparison of pump-assisted sampling and conventional flushing sampling in microbiological monitoring of endoscope

摘要:

摘要：目的 对比泵辅助采样与传统采样法在内镜消毒质量监测中的效果。方法 2016年4月－2017年10月采用普查的方法调查内镜中心基本信息，在内镜中心采用随机抽样的方法抽取内镜并对内镜管腔冲洗水进行采样，检测细菌菌落总数。采用倾向评分匹配的方法均衡可能影响监测结果的指标。结果 共采集184条内镜管腔冲洗液样本，涉及59家内镜诊疗中心，样本合格率为82.07%。采用泵辅助法检测的样本合格率低于传统采样法（65.52% vs 89.68%）。倾向评分获得78例1∶1匹配的两组数据，经多因素非条件Logistic分析，泵辅助法是危险因素（OR=6.058，95%CI=1.681～21.837），三级医院是保护性因素（OR=0.075，95%CI=0.020～0.279）。结论 被调查的内镜再处理合格率较低，泵辅助法可以提高采样监测的敏感性，三级医院对于内镜再处理落实较好。

Abstract:

Abstract: Objective To compare the effect of pump-assisted sampling and conventional flushing sampling method in the quality monitoring of endoscope disinfection. Methods From April 2016 to October 2017, the basic information of endoscope was investigated, and the method of random sampling was used to sample the flushing water of the endoscope biopsy channel to detect the total number of bacterial colonies. The propensity score matching method was used to matching the bias that may affect the results. Results 184 endoscope samples were collected, involving 59 endoscopy units, with a sample qualified rate of 82.07%. The qualified rate of the samples collected by pump-assisted method was lower than that of conventional sampling method (65.52% vs. 89.68%). The 78 pairs of 1:1 matching data obtained from the propensity score were analyzed by multivariate unconditional logistic analysis. The pump-assisted method was a risk factor (OR = 6.058, 95%CI 1.681 to 21.837). The tertiary hospital was a protective factor (OR = 0.075, 95%CI 0.020 to 0.279). Conclusion The qualified rate of reprocessing of endoscopes under investigation was low. The pump-assisted method can improve the sensitivity of sampling and monitoring. The tertiary hospitals have better implementation of reprocessing of endoscopes.