Objective To investigate the effects of thermal washing disinfection and cold washing combined with chlorine-based disinfectants on the performance of novel textile packaging materials. Methods Sixty pieces of textile with sewn RFID chips were randomly divided into two groups, with 30 pieces in each group. The thermal washing group water temperature were 80 ℃ . The cold washing group water temperature were 40 ℃，with 500 mg/L of chlorine disinfectant to disinfect. The hydrostatic pressure resistance, damage rate, sterilization qualification rate, and wet pack were measured. Results After 20 washes, the hydrostatic pressure resistance of thermal washing group was significantly higher than that of the the cold washing group (P<0.05). The average values of hydrostatic pressure resistance were (22.0±1.56) and(16.1±0.62) cmH2O. The sterilization qualification rates for both groups were 100%, and no instances of wet pack were observed. The thermal washing group exhibited no damage after 30 rounds of washing, with a damage rate of 6.7% after 40 rounds of washing. In the cold washing group, there was no damage after 10 rounds of washing, with a damage rate of 6.7% after 20 rounds of washing. Conclusion The thermal washing disinfection method has a minimal impact on the waterproof performance and damage rate of the novel textile materials. The appropriate cleaning method should be selected based on the requirements of packaging materials.
Objective To identify effective neutralizers for multi-purpose disinfecting solutions containing polyhexamethylenebiguanide(PHMB) as a biocide and hydrogen peroxide-based disinfecting solutions. Methods To evaluate the effectiveness of the selected neutralizers in removing residual PHMB and hydrogen peroxide, Pseudomonasaeruginosa Staphylococcus aureus, Escherichia coli, Candida albicans, and Fusariumsolani were used in tests. Three experimental groups including diluent group, neutralizer group and product of neutralization group were designed. For each group, 10 mL of the corresponding solution was mixed with above microorganisms separately and incubated for 10 min, followed by post-culture counting. The recovery rate from the neutralizer group or product of neutralization group was at least 50% of the recovery in the diluent group. Results For multi-purpose disinfecting solutions containing PHMB, the recovey rates of five microorganisms in product of D/E neutralizer broth or Letheen broth were at least 83%. For hydrogen peroxide-based disinfecting solutions, the recovey rates of Pseudomonas aeruginosa and Escherichia coli were 3% and 2% respectively in product of D/E neutralizer broth; the recovey rates of five microorganisms in 1 mg/mL eatalase solution were at leat 84%. Conclusion D/E neutralizer broth and Letheen broth can be used as neutralizers for multi-purpose disinfecting solutions containing PHMB. 1 mg/mL catalase solution can be used as a neutralizer for hydrogen peroxide-based disinfecting solutions.
Objective To study the effects of diluent type, soaking time and ultrasonic time on the spore count of Geobacillus stearothermophilus of stainless steel hydrogen peroxide bioindicator. Methods Geobacillus stearothermophilus spores biological indicator were soaked in water, normal saline, 0.1% Tween 80 aqueous solution and 0.1% Tween 80 saline for 2 h, and then sonicated for 40 min to screen the dilution with the highest spore recovery. The ultrasonic time and soaking time with the highest spore recovery were screened under different combination conditions of ultrasonic 0~80 min and soaking 0~4 h, and three parallel samples were set up for each combination to calculate the spore recovery rate. Results With 0.1% Tween 80 aqueous solution as dilution, the spore recovery rate was the highest, reaching 118.25%. The spore recovery rate of 40 kHz ultrasound frequency and 40 min ultrasound at 200 W power was 105.25%, which were higher than those of other ultrasound times. After soaking for 2 h, the spore recovery rate was the highest, reaching 91.9%. Conclusion After soaking in 0.1% Tween 80 aqueous solution for 2 h and ultrasonic for 40 min for spore counting, the spore recovery rate of biological indicator is the highest, reaching 118.25%.
Objective To develop a high recovery method to determine the bioburden of surgical drapes, gowns and clean air suits. Methods Nine different materials were chosen, and the microbial recovery rate of YY/T 0506.7—2014 "Surgical drapes, gowns and clean air suits for patients, clinical staff and equipment-Part 7: Test methods for determination of cleanliness-microbial" was compared with that of the new method. Results The elution recoveries of microorganisms of 9 different materials by the new method were all about 70%, two times higher than that of YY/T 0506.7—2014, far higher than the requirements of pharmacopoeia for microbial recovery (0.5-2). Statistical analysis of the detection results of the new method showed that the coefficient of variation was less than 10%, indacating that the dispersion degree between the results of the new method was small, and the stability was good. Conclusion Compared with YY/T 0506.7—2014, the new method is more suitable for the detection of bioburden of surgical drapes, gowns and clean air suits.
Objective To investigate the sterilization effect of the new cold evaporative hydrogen peroxide transfer window in the process of transferring goods, and to verify the concentration attenuation and sterilization effect of disinfectant after opening. Method The particle size of the dry mist generated by the generator was characterized and analyzed by particle size analyzer, and the sterilization effect was verified by biological indicators. The accelerated disinfectant decay test was simulated to explore the concentration and sterilization effect of four brands of disinfectants. Results The particle size distribution of the dry fog produced by the transfer window was concentrated, and the particle size of <5 μm accounted for 93%. The logarithmic value of killing steatobacterium thermophilus spores could reach 6 within 1 h of the sterilization cycle, and the sterilization effect was stable. In addition, the transfer window could achieve a stable and good sterilization effect for disinfectants with different ingredients. In the case of open placement, the concentrations of the four disinfectants showed a downward trend, but the downward trend was different, with the concentrations of brand A decreasing slowly, only 25% and 32%; while the concentrations of brands B and C decreased rapidly, reaching 76% and 62%. Conclusion The hydrogen peroxide transfer window has good sterilization performance and stable effect.
Objective To establish the sterility testing technology in the definition, development and maintenance of sterilization process of medical protective masks, disposable surgical gowns and alginate dressings, and to confirm its efficacy. Methods Firstly, a new sterility testing method was established, including sample selection, test quantity determination, medium selection, culture condition determination, and result judgment, and then the specificity, detection limit, durability, and reproducibility of the established method were verified. Results The specificity results showed that the specificity of the medium was good, and it could be used for the culture of five indicator microbial strains. The results of the detection limit showed that 50% of the samples could be detected by the pharmacopoeia method after inoculation with ≤5 cfu, and there was no significant difference in the detection rate between the new method and the pharmacopoeia method (P>0.05).The durability results showed that when there was a small change in the incubation temperature, the detection results were not affected, and the durability was good.The reproducibility results showed that the data were reproducible in different laboratories, different personnel, and different times, using the new method to test. Conclusion The newly established method is suitable for sterility testing in the definition, development and maintenance of sterilization process of medical protective products.
Objective To investigate and analyze current situation of central sterile supply department(CSSD). Methods A self designed questionnaire was used in this study. The general information, the number of operation, CSSD area、 management model、 equipment、 human resources in CSSD of 3 080 hospitals in 31 provinces (autonomous regions and municipalities) in China were investigated in September 2023. Results A total of 3 080 questionnaires were collected and 3 077 were valid, and the recovery rate was 99.90%. 79.62％ of CSSD was managed by nursing department, and centralized management ratio was 91.19%. Grade III hospital was higher than Grade II hospital, and there were statistical significance between Grade III level A/B hospitals and Grade II/other hospital (P<0.001). Average ratio of CSSD area to bed was 0.78，and average staff total number was 2.27 per 100 beds， while nurses was 74.17% and specialty nurses was 14.83%. The Class III level A hospital has the highest monthly average number of sterilization packs and staff, with 23 521 sterilization packs and 45 staff members, and steam sterilizer was 2.76 every hospital, low temperature hydrogen peroxide sterilizer which increased rapidly was 1.66, automatic washer-disinfector was 2.34, however, automatic endoscope re-processor was 0.52. Conclusion The management model， area, equipment, human resources of CSSD has improved in different extent，but area，human resource of CSSD did not meet the rapid increasing needs.
Objective To investigate and analyze the adverse reactions and influencing factors of air disinfection with hydrogen peroxide disinfectant, and to provide improvement measures, so as to provide basis for scientific disinfection. Methods A questionnaire survey was conducted to understand the adverse reactions of people exposed to hydrogen peroxide air disinfection during/after the environment, and relevant influencing factors and causes were analyzed and solutions were provided. Results Among 238 individuals exposed to an environment disinfected with hydrogen peroxide, 43 （18.1%） experienced respiratory irritation. Additionally, there were 38 （16.0%） cases of ocular conjunctival irritation, and skin irritation was noted in 13 （5.5%） patients. Univariate analysis revealed statistically significant differences in adverse reactions based on gender, exposure duration, mask type, timing of exposure, and concentration levels （P<0.05）. Contact frequency, duration of stay, and mask type significantly influenced the respiratory irritation response （P<0.05）, while timing of contact had a notable impact on conjunctival irritation response （P<0.05）. Furthermore, both contact frequency and timing were statistically significant concerning skin irritation responses （P<0.05）. Multi-factorial analysis indicated that exposure frequency, mask type, and concentration might serve as independent factors contributing to adverse reactions. Conclusion It is imperative to utilize appropriate respiratory protective equipment during disinfection processes. Concentrations may be judiciously reduced while working durations are minimized to mitigate accidental exposure.
Objective To analyze and reveal the current situation and trend of the researches of 222nm disinfection, and to provide evidence for the subsequent researches. Methods Relevant literature from the Web of Science Core Collection, PubMed, Embase, and Scopus database before July 20, 2022 was conducted a search. Year of publication, number of articles, authors and keyword distribution information was analyzed, using the VOSviewersoftware. Results Totally 110 related 222 nm ultravioletarticleswere retrieved, with an overall increasing trend in the number of publications. There were 45 core authorsand 4 core teams, distributed in the United States, Japan and Germany. There were 6 research hotspots, which were the effects of far-ultraviolet light on bacteria and fungi, animal research on UV radiation mutagenesis, research on the radiation effect of far-ultraviolet light on cells and skin, the application of far-ultraviolet light in food safety, the sterilizing effect of far-ultraviolet light on coronaviruses, and the effects of far-ultraviolet light equipment on new coronaviruses Conclusion 222 nm ultraviolet disinfection is in a rapidly increasing stage. The current research focus is on the application and safety of far-UVC.
Objective To understand the health status and disinfection quality of key places in Suzhou City, and to find out the weak links in the disinfection work, so as to provide technical basis and support for good disinfection work. Methods The 63 key places in Suzhou were randomly selected to carry out health status survey, including indoor air, object surface, staff hands, tableware, disinfection equipment, medical fabrics, etc., and sampling, testing, and evaluation of disinfection effectiveness was implemented. Results A total of 1 587 samples were collected in Suzhou City, with a qualified rate of 85.70%. Among them, the qualified rate was 81.29% in kindergartens, 78.64% in secondary schools, 95.85% in medical institutions, and 78.82% in pension institutions. The fever clinic had the highest qualified rate, and there was no significant difference in qualified rate among other key places s (P>0.05). The items with low pass rate were mainly distributed in object surfaces, tableware and staff hands. The low pass rate of object surface was mainly concentrated in the object surface of high-frequency contact area and hand-washing equipment. The main items with lower qualification rates in catering utensils were cutting boards and plates. The qualified rate of hand hygiene among logistics personnel was relatively low among the staff. There were statistically significant differences in the pass rates of tableware in public and private kindergartens, and the hand pass rates of staff in medical-nursing and non-medical-nursing integrated care institutions (P<0.05). Conclusions The disinfection quality of key places in Suzhou needs to be further improved. The object surface, tableware and staff hands are weak links in daily cleaning and disinfection.
Objective To investigate the effect of disinfection quality control management in improving the quality of cleaning and disinfection of rigid endoscopes. Method A total of 130 rigid endoscopes instruments were selected before and after the implementation of disinfection quality control management in a hospital, and the cleaning pass rate, damage rate, disinfection pass rate, sterilization pass rate, packaging pass rate, and department use satisfaction were compared. Result The pass rate of cleaning, disinfection, sterilization, packaging and department satisfaction in the quality control group were higher than those in the traditional management group (P<0.05). The breakage rate and incidence of nosocomial infection in the quality control group were lower than those in the traditional management group (P<0.05). The work quality scores in the quality control group were (95.73±4.08). The scores of teamwork were (96.36±3.12) and those of professional skills were (94.45±4.06), all of which were higher than those in the traditional management group (P<0.05). Conclusion Disinfection quality control management can improve the quality of rigid endoscopic cleaning in central sterile supply departments.
Objective To understand the knowledge of domestic hospital CSSD sterilizers and managers about the process indicators of the wet pack quality management system, and to provide a reference for standardizing the management of CSSD wet packs. Methods The questionnaire was developed by experts of the Hubei Provincial Sterilization and Supply Professional Committee, and the electronic questionnaire was distributed through the WeChat web platform from October 23, 2023 to October 31, 2023 to conduct a cross-sectional survey of 1, 751 CSSD sterilizers and managers in 1, 153 hospitals in China. Results CSSD sterilizers and managers' perceptions of the correctness of some of the process indicators of the wet pack quality management system varied widely, ranging from 25.59% to 92.75%. The overall knowledge of sterilizers and managers in tertiary hospitals was stronger than that of sterilizers and managers in secondary hospitals (P<0.05); the knowledge of sterilizers and managers with >5 years of experience was higher than that of sterilizers and managers with ≤5 years of experience (P<0.05); the knowledge of managers of the statement “There should be no bundling of sterilized items” was higher than that of sterilizers, and the knowledge of sterilizers of the statement “There should be no bundling of sterilized items” was higher than that of sterilizers. Sterilizers had a higher awareness of “there should be a gap between two adjacent sterilized packages” than managers (P<0.05); cognitive ability was not positively correlated with job title level. Conclusion Sterilizers and managers with ≤5 years of experience in secondary hospitals have relatively poor knowledge of some of the process indicators of the wet pack quality management system and need to be improved.
Objective To compare the cleaning effectiveness and corrosion properties of strong alkaline electrolyzed water at different pH values on surgical instruments. Methods The cleaning effect of strong alkaline electrolyzed water immersion, immersion + ultrasound on specific surgical instruments was compared, and the cleaning effect of strong alkaline electrolyzed water with different pH values on different types of surgical instruments was compared. The corrosive properties of alkaline electrolyzed water on martensitic stainless steel, austenitic stainless steel and other commonly used metals were compared by weighing method. Results The higher the pH value, the stronger the cleaning ability of the strong alkaline electrolyzed water was. When the pH value reached 13.0, the effect by immersion at room temperature could reach that of multi-enzyme cleaning agent and ultrasonic co-treatment at 45°C. The removal of ATP from toothed articulated devices, toothless articular devices, toothless articulated devices and lumen devices reached 98.81%, 99.35%, 98.30% and 99.22% respectively. There was no significant difference in cleaning ability with the multi-enzyme group (P>0.05). The corrosion rate of strong alkaline electrolyzed water on martensitic stainless steel and austenitic stainless steel were lower than 0.0100 mm/a. Conclusion Strong alkaline electrolyzed water with pH 13.0 has a good cleaning effect on surgical instruments and has little corrosive effect on instruments.
Objective To fabricate an assistive device for checking the clarity of rigid endoscope lenses, and to observe the application effec. Methods A total of 800 rigid endoscope lenses used in a tertiary hospital from July 2021 to October 2021 were selected as the research objects by convenience sampling method, and they were divided into control group and observation group according to the chronological order of recovery, with 400 lenses in each group. The observation group was treated with lens clarity check aids, and the control group was observed with the naked eye. The detection time, the incidence of human-object cross-contamination, and the pass rate of lens clarity detection were compared between the two groups. Results The time required to check the clarity of a single lens was <4 s, and 63.5% of the lens was in the observation group, which was significantly higher than that in the control group (49.3%) ( x2 =16.540, P <0.05). Compared with the control group (92.5%), the incidence of human-object cross-contamination in the observation group decreased to 2% ( x2 =657.208, P<0.05), which only occurred in the protective mask. The pass rate of lens sharpness detection in the observation group was significantly lower than that in the control group ( x2 =13.330, P<0.05), which were 80.3% and 89.5%, respectively. During the use of the department, there was no unqualified clarity of the lens in the observation group. Conclusion The assistive device for checking the clarity of the lens of the rigid endoscope can effectively shorten the time of checking the clarity of the lens, reduce the incidence of human-object cross-contamination, and improve the detection of unqualified lenses.
Objective To investigate the microbial contamination of dental unit waterlines in Suzhou, and to analyze its influencing factors. MethodsA questionnaire was designed. The basic information, the disinfection method and monitoring frequency of the waterlines in the stomatology department or dental clinic of the hospital were collected by on-site inquiry. The water samples were collected for colony counting and divided in to two groups according to exceeding the standard or not. The basic information of the medical institutions and the disinfection of the waterlines were compared. Results A total of 111 oral diagnosis and treatment institutions were surveyed, and 393 water samples were collected, of which 202 were qualified, with a pass rate of 51.40%. There was a significant difference in the total number of colonies in the handpiece output water of different medical institutions (P<0.05). There were statistically significant differences in the distribution of daily treatment volume, water source types and the proportion of DUWLs in each treatment unit between the medical institutions with and without exceeding the standard(P<0.05). Compared with municipal water, the use of sterilized water, purified water and water containing disinfection factor as oral treatment water could reduce the risk of DUWLs microbial contamination (P<0.05). There was no significant difference in the disinfectants used for regular disinfection between the exceedance group and the non-exceedance group (P>0.05). ConclusionThe microbial contamination of oral water in medical institutions in Suzhou is serious. It is related to the amount of treatment, the type of water source and the mode of water supply.
Objective To explore the application effect of suction toothbrush with chlorhexidine oral care kit in ICU patients with mechanical ventilation. Methods 118 patients with mechanical ventilation admitted to ICU of West China Hospital of Sichuan University from December 2021 to April 2022 were randomly divided into experimental group (n=62)and control group(n=56).The experimental group received oral care with suction toothbrush set, and the control group received traditional oral care.The oral colony count, oral Beck score, oral nursing time, incidence of ventilators associated pneumonia and adverse events, and subjective feelings of patients were compared between the two groups. Results The growth rate of oral bacteria in experimental group was significantly lower than that in control group one hour after oral protection (P<0.05). The oral Beck score of the experimental group was significantly lower than that of the control group on the 7th day after intervention (t=0.009, P=0.003). The preparation time and operation time of oral care products in experimental group were significantly less than those in control group (t=9.870, P<0.05; t=2.537, P< 0.05).There was no increase in complications related to oral care in the experimental group, and patients' comfort was better. Conclusion Suction toothbrush combined with chlorhexidine oral care kit can inhibit the growth of oral bacteria in ICU patients with mechanical ventilation.
Objective To understand contamination status of dental unit water lines (DUWL) in private dental institutions in Longgang district of Shenzhen, so as to provide scientific basis for the development of DUWL quality control measures. Methods The water quality of DUWL in 269 private dental institutions in the area was randomly selected to investigate the bacterial contamination status. Results Totally 1 575 DUWL water samples were collected, and the qualified rate was 51.87%. The qualified rate of mouthwash was the highest(65.40%), and there was significant difference in the qualified rate of DUWL water sample monitoring between private hospitals and individual dental clinics ( x2=14.435, P< 0.05).The main microorganisms detected were strains of Acidovorax spp., Cuprophilus spp., Halomonas spp. and Bacillusspp.. Conclusion DUWL in private dental institutions in Longgang district of Shenzhen is seriously comtaminated, it is necessary to strengthen the daily cleaning, disinfection and maintenance of DUWL.
Objective To review and analyze the quality results of endoscope reprocessing in medical institutions monitored by District-level Center for Disease Control and Prevention in Tianjin from 2019 to 2023. Methods The basic information of endoscope center was investigated by general survey. Endoscopes were sampled by random sampling in endoscope center, and the total number of bacterial colonies was detected by sampling of endoscope lumen rinse water and final rinse water. Results A total of 603 reprocessed endoscope were sampled from each district CDC in 5 years, and the overall qualified rate was 96.85%. The average total number of bacterial colonies was 0 (0-3) cfu/channel, and the highest total number of bacterial colonies was 1.4×104 cfu/channel. 504 samples of final rinse water were collected, and the overall qualified rate was 85.70%. The average total number of bacterial colonies was 0 (0-7) cfu/100 mL, and the highest total number of bacterial colonies was 562 cfu/100 mL. Multivariate logistic analysis showed that unqualified final rinse water was a risk factor (OR=6.280, 95%CI 2.244-17.578), and automatic reprocesser was a protective factor (OR=0.029, 95%CI 0.015-0.058). Conclusion The qualified rate of endoscope reprocessing is on the rise, and the final rinse water is the focus of future supervision.
Objective To examine the clinical characteristics and drug resistance patterns of Carbapenem-resistant Klebsiella pneumoniae (CRKP) in a tertiary hospital in Shanghai, aiming to guide the clinical use of antibiotics. Methods Specimen types, departmental distribution, and drug resistance analysis were performed on CRKP isolates collected from January 2017 to December 2022. Results From 2017 to 2022, a total of 694 CRKP strains were isolated. The top three specimen types were sputum (30.4%), urine (16.4%), and blood (10.7%), while the leading departments with CRKP isolates were the general ICU, emergency ICU, and hematology department. The resistance rate of Klebsiella pneumoniae strains to imipenem from 2017 to 2022 showed a significant difference ( x2=12.150, P=0.033), with the highest rate of 13.3% in 2021 and the lowest rate of 7.4% in 2017. Meanwhile, the detection rate of CRKP from 2017 to 2022 also showed a significant difference (x2=36.449, P<0.001), with the highest rate of 27.2% in 2021 and the lowest rate of 13.1% in 2018. CRKP exhibited relatively low resistance rates to Polymyxin B, Colistin, Tigecycline, and Ceftazidime-Avibactam, with resistance rates of 3.9%, 4.3%, 7.6%, and 17.9%, respectively. Testing of Carbapenemases revealed that KPC-type Carbapenemases accounted for 86.6% (264/305), while NDM-type Carbapenemases accounted for 13.4% (41/305). Conclusion The drug resistance situation of CRKP is quite severe. It is urgent to further standardize the use of antimicrobial drugs in clinical practice through measures such as carbapenemase detection and combined drug susceptibility testing.
