消毒供应中心（CSSD）的器械清洗是保障医疗安全的关键环节。本文综述了影响 CSSD 器械清洗质量的主要因素，涵盖人为因素、器械因素、环节因素和管理因素，并从实践层面、培训层面和管理层面进一步探讨了提升清洗质量的干预策略，但复杂器械的清洗、新技术的普及应用以及确保各项标准和指南的严格执行仍面临挑战，未来研究需聚焦于新型复杂器械的清洗方案、干预措施的成本效益分析以及促进指南有效转化和持续改进的策略，以期不断提升 CSSD 器械清洗质量，最大限度地降低医院相关感染风险，保障患者安全。

Objective To study the influencing factors of intracranial infection in patients after neuronavigation-assisted puncture drainage for intracerebral hemorrhage, and to provide the prevention and control of postoperative infection. Methods The clinical data and laboratory etiological examination data of patients with intracranial infection after neuronavigation-assisted puncture drainage for spontaneous intracerebral hemorrhage in a hospital were investigated retrospectively. Univariate and multivariate logistic regression analysis were used to analyze the influencing factors of intracranial infection. Results A total of 145 patients undergoing hematoma puncture and drainage were enrolled in this study. Postoperatively, intracranial infection occurred in 36 cases, with an infection rate of 24.8%. Among these infected patients, 5 strains of pathogenic bacteria were identified in cerebrospinal fluid, including 4 Gram-positive strains and 1 Gram-negative strain. Multivariate analysis indicated that preoperative GCS score≤8, no preoperative administration of antibiotics, and drainage tube indwelling time≥3 d were independent risk factors for intracranial infection following neuronavigation-assisted hematoma puncture and drainage. Conclusion The incidence of intracranial infection in patients undergoing intracerebral hematoma drainage in this hospital is relatively high. Patients with preoperative coma, no antibiotics, and drainage tube indwelling time ≥3 d are at high risk for intracranial infections, and the perioperative management of such patients should be strengthened.

Objective To investigate the in vitro antimicrobial activity of antimicrobial peptide RP557 and its mechanism, and to evaluate its safety. Methods The minimum inhibitory concentration (MIC) of RP557 against various clinical isolates was determined using the microdilution broth method. The bactericidal mechanism of RP557 against Gram-negative bacteria was analyzed through time-kill assays, biofilm inhibition, outer and inner membrane disruption, and ion leakage detection. The safety of RP557 at the animal level was assessed through histopathological examination and hepatic and renal function tests. Results MIC values of RP557 were≤32 µg/mL against multidrug-resistant and hypervirulent Gram-negative and Gram-positive clinical isolates. Biofilm formation could be completely inhibited at 1×MIC. Treatment with 2×MIC induced a 1.5-fold increase in outer membrane disruption, 10-fold increase in inner membrane damage, and significant Na⁺/K⁺ leakage. No significant differences in hepatic/renal function indices or lung histopathology scores were observed in mice after 400 µg/mL aerosol exposure compared to controls. Conclusion RP557 induces bacterial death through a dual-membrane disruption mechanism. At certain exposure doses, it shows no toxic side effects, highlighting its potential as a novel bactericidal agent.

Objective To evaluate the dynamic disinfection efficacy of a 222 nm ultraviolet (UV) sterilizer on high-frequency contact surfaces and airborne bacteria in a respiratory intensive care unit (RICU). Methods Seven isolated rooms within the RICU of a tertiary hospital in Zhejiang, China, were selected. Rooms were assigned to either a control group (Room 2, 4, 6) receiving routine cleaning and ventilation, or an intervention group (Room 1, 3, 5, 7) receiving additional disinfection using a 222 nm UV sterilizer. Environmental samples were collected continuously for 3 days, with air and surface samples taken every 2 hours from 8:00 to 16:00 daily, totaling 1 050 samples. Bacterial colony counts and detection rates of Acinetobacter baumannii (AB) and Klebsiella pneumoniae (KP) were measured. Results The intervention group showed significantly lower mean colony counts on both surfaces and in air samples compared to the control group (P<0.05). Surface bacterial load was reduced from (161.63±464.17) cfu/cm² to (54.64±220.59) cfu/cm², while airborne bacterial load decreased from (215.14±303.88) cfu/m² to (150.65±106.52) cfu/m². The detection rates of AB and KP also decreased significantly in both surface and air samples. Conclusion The 222 nm ultraviolet sterilizer demonstrates significant disinfecting efficacy in the RICU environment. It effectively reduces microbial contamination on surfaces and in the air. Notably, it exhibits more stable and sustained efficacy for air disinfection. This device serves as a robust supplementary measure to routine disinfection protocols.

近年来，通过空气传播的各类新发传染病频繁发生，使得空气消毒技术也备受关注；空气消毒技术是利用不同方法对空气中的微生物、病毒和有害气体进行消毒和净化的技术。随着空气消毒技术的迅速发展，紫外线消毒技术由于其高效、安全的特点，成为当前研究和应用的热点，此外，等离子体消毒技术凭借其广谱杀菌能力和持续消毒效果，也逐渐受到关注；与此同时，传统的化学消毒方法在特定环境下仍具有一定的应用价值。本文以空气消毒技术为主题，介绍了各种技术的基本原理，并梳理了其研究脉络，详细叙述了空气消毒技术的研究现状和进展，分析讨论了应用场景和实用性前景，探讨空气消毒技术的发展趋势。

Objective To analyze the awareness and risk factors of infectious occupational exposure among medical staffs. Methods 186 medical staff who were employed in our hospital from July 2023 to June 2024 were selected and divided into an exposed group (n=79) and an unexposed group (n=107) based on the occurrence of occupational exposure. The cognitive level and risk factors of occupational exposure among medical staff were investigated, and their correlation was analyzed. Results The incidence of infectious occupational exposure among medical staff in our hospital was 42.47%, and there was a statistically significant difference (P<0.05) in education level, operating procedures, length of service, self-protection, compliance with protective measures, and Occupational Exposure Risk Perception Scale scores between the exposed and unexposed groups; Spearman correlation analysis showed that the scores of various dimensions of the Occupational Exposure Risk Perception Scale were negatively correlated with infectious occupational exposure (P<0.05); Multivariate logistic regression analysis showed that short length of service, low awareness of self-protection, and low scores of Occupational Exposure Risk Perception Scale were independent risk factors for infectious occupational exposure among medical staff (P<0.05). Conclusion The incidence of infectious occupational exposure among medical staff is relatively high, and its occurrence is closely related to awareness, length of service, and self-protection.

Objective To study the disinfection efficacy of 9 chemical disinfectants on bacteria isolated from clean areas and to provide a reference for effective disinfection in clean areas. Methods The suspension quantitative bactericidal test was adopted. Three concentrations of high, medium and low were selected to observe the bactericidal effects of nine common disinfectants on six types of bacterial vegetative cells such as Staphylococcus epidermidis and three types of bacterial spores such as Bacillus cereus spores. Results Effective disinfection of six types of bacterial vegetative cells was achieved by treating with 500 mg/L didecyldimethylammonium chloride or 600 mg/L sodium hypochlorite for 2 min. Effective disinfection of Bacillus cereus spores was achieved by treating with a combination of 55 g/L hydrogen peroxide and 800 mg/L peracetic acid and 5 g/L didecyldimethylammonium chloride acting for 30 min. Effective disinfection of Bacillus subtilis spores was achieved by using a complex of 1 500 mg/L benzalkonium chloride and 150 mg/L polyhexamethylene biguanide hydrochloride for 3 min. Effective disinfection of Bacillus licheniformis spores was achieved by treating with 2 g/L benzalkonium bromide for 2 min. Conclusion The nine types of chemical disinfectants can effectively kill the selected experimental microorganisms, and the concentration and duration of action are verified to ensure the expected disinfection effect.

Objective To observe the inactivation effect of commonly used chemical disinfectants on enterovirus 71 (EV-71), and provide reference for practical disinfection applications. Methods The virus inactivation test method was used to observe the effect of commonly used chemical disinfectants on inactivating EV-71. Results After being treated with 5 000 mg/L polyhexamethylene biguanide and 2 000 mg/L polyhexamethylguanidine hydrochloride for 10 min, the inactivation logarithmic values of EV-71 in suspension were 3.55 and 3.61, respectively. When treated with a chlorine-containing disinfectant with an available chlorine concentration of 200 mg/L for 1 min, EV-71 in suspension could be inactivated completely. When treated with 1 000 mg/L peracetic acid for 5 min and 10 g/L hydrogen peroxide for 10 min, the inactivation logarithmic values of EV-71 were all >4.0. Two kinds of quaternary ammonium salt disinfectants could not effectively inactivate EV-71 at the experimental concentrations. Conclusion Both chlorine-containing disinfectants and peroxide disinfectants can effectively inactivate EV-71, while guanidine disinfectants and quaternary ammonium salt disinfectants have poor inactivation effects on the virus under experimental conditions.

留置导尿是目前临床无法取代的一种膀胱排空方式，被广泛应用于尿潴留、排尿困难、病情监测等，但是极易出现导尿管相关性尿路感染（CAUTI）、尿道损伤、导管堵塞等并发症。研究可持续预防尿路感染的抗菌导尿管至关重要，本文主要对国内外不同抗菌涂层导尿管的类型、应用及效果进行综述，为新型抗菌导尿管产品的研发与性能改进提供参考，以期有效解决临床留置导尿的感染难题。

耳念珠菌是一种新型真菌病原菌，可引起严重的感染，死亡率高。耳念珠菌环境抵抗力强，可在患者皮肤和环境中长期定植，不易鉴别且具有多药耐药的特点，易造成医院感染暴发，因此对耳念珠菌的感染控制至关重要。本文综述了国内外针对耳念珠菌的感染控制方法、消毒措施和常用消毒剂，为完善耳念珠菌医院感染控制措施以及制订相关消毒标准提供参考。

目的 探讨视觉追溯工作站在消毒供应中心的应用及效果。方法 分别选取视觉追溯工作站运用前后的各500件医疗器械分为对照组和观察组，分别观察2组医疗器械的交接时间、丢失率、错误率。并通过随机工号选取50名医务人员作为使用视觉追溯工作站前后满意度调查对象，调查其对医疗器械流程、使用效率和科内管理的满意度。结果 在器械管理效果方面，观察组各环节交接时间降低到15 min；在临床使用满意度方面，观察组使用效率满意度提高到96%，科内管理满意度提高到90%；差异有统计学意义（P<0.05）。结论 视觉追溯工作站在消毒供应中心的运用可以降低器械交接时间、丢失率和错误率，也可以提高临床一线医务工作者使用的满意度。

随着临床诊疗技术的不断更新，临床科室使用的医疗器械种类多种多样。各类待灭菌物品的材质、性能对于灭菌技术有不同要求。根据适应性的不同，以温度为基础的灭菌技术分为低温和高温2大类。在实际应用中，如何保障灭菌质量是重中之重。生物监测是灭菌保障和风险控制的金标准，其关键评价指标是生物指示物的抗力，生物监测出现的阳性结果不能全部归为灭菌失败。目前灭菌操作规范中对于生物监测阳性原因分析及对策还未形成统一的标准。本文以万方医学网、中国知网、Pubmed、Science Direct、DOAJ等国内外数据库检索生物监测阳性案例，旨在探讨消毒供应中心高、低温灭菌生物监测阳性原因和相应对策，以期为灭菌质量的科学监测和质量循证提供参考。

目的 探讨PDCA循环在血液净化室医院感染管理中的应用效果。方法 便利选取温州市中医院血液净化室2020年10月—2021年3月患者54例，医务人员31人作为对照组，2021年5月—2021年10月患者58例，医务人员31人作为观察组。对照组采用常规医院感染管理方法，观察组采用PDCA循环管理方法，比较2组血管通路感染发生率、医院感染环境监测相关指标以及医务人员手卫生依从性。结果 观察组半永久置管感染率、血管通路感染发生率、空气细菌培养水平、物品表面细菌培养水平低于对照组，差异有统计学意义（P<0.05）。观察组医务人员手卫生依从性高于对照组，差异有统计学意义（P<0.05）。结论 PDCA循环管理方法可以降低血液净化室血管通路感染发生率，尤其是半永久导管感染率；通过降低空气细菌培养水平与物品表面细菌培养水平，提高医务人员手卫生依从性改善了血透室医院感染管理重点环节，值得推广。

Objective To investigate the physicochemical properties of a novel compound potassium monopersulfate disinfectant and to provide references for its disinfection applications. Methods Physicochemical testing techniques were used to investigate and observe the relevant physicochemical properties of this novel disinfectant containing potassium monopersulfate compound salt, including the effective component content, pH, and metal corrosivity. Results The novel compound potassium monopersulfate disinfectant was a white powder with an active oxygen content of 2.87%. After preparing a disinfectant solution with a concentration of 1 000 mg/L and leaving it for 1 h, the active oxygen content reached a peak of 49.7 mg/L; within 3 days, the active oxygen content could be maintained at over 90% of the initial concentration. The pH range of the disinfectant solution with a concentration of 1 000-6 000 mg/L was 2.43-3.00. 3 types of disinfectants showed moderate corrosion to aluminum, carbon steel, and copper wafers, but had essentially no corrosion to stainless steel wafers. Conclusion The compound potassium monopersulfate disinfectant shows stable physicochemical properties. The decrease in effective components in the solution is related to its preparation concentration and storage time, and it exhibits corrosivity to metals.

目的 了解消毒供应中心医用清洗刷在管腔类器械中的使用与管理现状，提出改进意见。方法 采用面对面、半结构式访谈法，对上海市20家医院60名消毒供应中心工作人员进行深入访谈，调查医用清洗刷在管腔器械手工清洗时使用的规格数量、刷洗方式、刷洗次数、使用后的清洗和消毒方式、存放方式、更换标准及满意度情况，采用Colaizzi现象学分析法对访谈资料进行分析。结果 提炼出3个核心主题：（1）医用清洗刷在管腔器械手工清洗中的使用及处置方法不一。使用1种规格清洗刷的人数占比最低（8.33%），使用3种规格清洗刷的人数占比最高（56.67%）；90.00%的人员采用贯通法辅以水枪冲洗；80.00%的人员刷洗次数不固定。（2）医用清洗刷使用重要性的认知较低。41.67%的工作人员认为正确使用清洗刷不重要，38.33%的人员认为比较重要，20.00%的人员认为重要。（3）使用者对目前使用的医用清洗刷满意率不高，为35.00%~58.33%。结论 医用清洗刷作为可复用的重要清洗工具，在实际应用中差异较大，应制订其使用和处置相关规范，加强清洗刷使用培训和考核，改进清洗刷质量和功能。

Objective To evaluate the disinfection efficacy of plasma air disinfection machines in the dynamic hospital environment and to analyze the correlation between airborne colony counts and bioaerosol concentration along with influencing factors. Methods The natural sedimentation method and aerosol monitors were employed to measure airborne bacterial colony counts and aerosol concentrations in two groups of hospital wards—one equipped with plasma air disinfection devices and the other without. A multivariate linear regression analysis and correlation analysis were conducted to examine the relationship between airborne bacterial colony counts and aerosol concentrations in the experimental and control groups. Results After disinfection, the airborne colony count in the test group (2.66 ± 0.74) cfu/(plate · 5 min) was significantly lower than that in the control group (4.74 ± 2.59) cfu/(plate · 5 min) (P< 0.05). Correlation analysis revealed a positive correlation between airborne colony counts and the total bioaerosol concentration (r= 0.170, P< 0.05), with a significant association specifically with particles≥2.5 µm in diameter (P< 0.001). Factors such as window ventilation, use of other respiratory medical devices, total number of people in the ward, and toilet usage showed statistically significant effects on airborne colony counts (P< 0.05). Room temperature, mask-wearing rate in the ward, and toilet usage might influence the concentration of bioaerosols in the air (P< 0.05). Conclusion The application of a plasma air disinfector under dynamic hospital operating conditions demonstrates certain disinfection efficacy. Routine monitoring of aerosol concentration, particularly bioaerosol concentration, is beneficial for assessing the transmission risk of airborne pathogenic microorganisms.

Objective To test in vitro and field bactericidal efficacy of normal temperature and low temperature formulations of potassium monopersulfate composite salt disinfectant against bacterial vegetative cells, and to evaluate their disinfection performance on object surfaces. Methods The quantitative bactericidal test method using cloth carrier immersion and on-site disinfection test method were used to assess the efficacy of 1 500 and 1 000 mg/L potassium monopersulfate composite salt disinfectant formulations both at normal temperature and low temperature against Escherichia coli and Staphylococcus aureus. Results Under normal temperature (20℃), the 1 000 mg/L potassium monopersulfate composite salt disinfectant reduced the bacterial count of Escherichia coli and Staphylococcus aureus on cloth carriers by more than 4.0 log within 5 min. Under low temperature (-18℃), the low temperature disinfectant with a concentration of 1 000 mg/L reduced the bacterial count of Escherichia coli and Staphylococcus aureus by more than 4.0 log and 3.0 log within 7.5 min, respectively. The 1 000 mg/L normal temperature formulations potassium monopersulfate composite salt disinfectant eliminated the natural bacterial count on object surfaces within 10 min, with an average killing rate of 95.59%. Conclusion Both normal temperature and low temperature potassium hydrogen peroxymonosulfate compound disinfectants can effectively eliminate bacterial vegetative cells, and they are suitable for disinfecting object surfaces under normal and low temperature conditions.

Objective To evaluate the disinfection effect of two disinfectants on bacteria in the dust accumulated in centralized air-conditioning return air filters, and to explore the effect of air conditioner filter cleaning and disinfection methods on the total number of relevant indoor air bacteria. Methods During the period from 2018 to 2024, the dust accumulated in the return air filters of centralized air-conditioning units in some wards of three tertiary hospitals in Wuhan was sampled, and the total number of bacteria was calculated. Simulated on-site and on-site disinfection tests were conducted on air-conditioning filters using a chlorine disinfectant with an effective chlorine level of 500 mg/L and a complex quaternary ammonium salt disinfectants with a level of 3 000 mg/L, and the disinfection effects were evaluated. Changes in bacterial counts in indoor air before and after direct rinsing of air-conditioning filters with tap water and after disinfection and then rinsing were detected using the plate exposure method and the air sampler method in the dirty washroom of a hospital department. Results The amount of dust accumulated in the air conditioner return air filters was positively correlated with the total number of bacteria, with a correlation coefficient of 0.77. The results of the simulated on-site disinfection test showed that the concentration of chlorine-containing disinfectant and compound quaternary ammonium salt disinfectant failed to disinfect the filter when the concentration decreased to 31.20 mg/L and 1 820.70 mg/L, respectively. The results of on-site disinfection test showed that when the concentration of chlorine-containing disinfectant and compound quaternary ammonium salt disinfectant were lower than 50 mg/L and 2 000 mg/L, respectively, the filter disinfection failed. Both the plate exposure method and the air sampler method showed that the direct use of tap water to rinse the filters significantly increased the total number of airborne bacteria in the room of interest. After disinfecting and then rinsing the filter with tap water, the total number of indoor air bacteria was similar to that before cleaning. Conclusion Chlorine disinfectant (effective chlorine 500 mg/L) and compound quaternary ammonium salt disinfectant (3 000 mg/L) can effectively kill bacteria in the dust of centralized air-conditioning return air filter after 5 minutes disinfection. The use of pre-sanitization followed by cleaning reduces bacterial contamination of the relevant indoor air environment.

Objective To understand the trend of changes in the prevalence of nosocomial infections among inpatients and to provide evidence for improving nosocomial infection management and prevention and control levels. Methods A cross-sectional survey method was used to analyze the prevalence of nosocomial infections among inpatients in a hospital from 2011 to 2022. Results A total of 9 249 inpatients were actually surveyed in the hospital, with an actual survey rate of 99.12% and an average prevalence of nosocomial infections of 2.02%. The sites of nosocomial infections were mainly lower respiratory tract infections, accounting for 31.37%. Among the pathogens causing nosocomial infections, Gram-negative bacteria accounted for 58.77%. The antibiotic usage rate among inpatients was 28.05%, with therapeutic antibiotics accounting for 83.85%. The pathogen testing rate was 70.45%, and the pathogen testing rate before antibiotic use showed a trend of increasing year by year. Conclusions The prevalence of nosocomial infections among inpatients in this hospital is within the national control standards. The pathogen testing for antibiotic use and therapeutic antibiotic use is relatively effective, and close attention should be paid to the monitoring and management of drug-resistant bacterial infections.

Objective To investigate and analyze the disinfection measures and efficacy of drinking water in rural of Zhoukou City, so as to provide a basis for ensuring rural drinking water safety. Methods Data on disinfection facilities and disinfectant usage in rural drinking water systems from 2020 to 2023 were collected. Residual disinfectant levels and total bacterial counts in drinking water were analyzed. Disinfection efficacy was evaluated according to GB 5749-2006 Standards for Drinking Water Quality. Results From 2020 to 2023, a total of 183, 183, 181 and 180 rural water treatment plants were monitored annually. The proportion of plants using disinfection facilities as required increased from 64.48% in 2020 to 74.44% in 2023 (χ²=3.571, P=0.059). Chlorine dioxide and sodium hypochlorite remained the predominant disinfectants, with the proportion of plants using sodium hypochlorite rising from 26.78% in 2020 to 43.89% in 2023 (χ²=6.808, P=0.009). Pass rates of residual disinfectant for sodium hypochlorite, chlorine dioxide and liquid chlorine treated samples were 67.04%, 89.23% and 90.83%. Chlorine dioxide-treated samples showed the lowest total bacterial count compliance (93.80%) (χ²=10.465, P=0.005). Residual disinfectant compliance was lower in finished water than in terminal water (χ²=4.579, P=0.032). Microbial compliance was higher in finished water than in terminal water (χ²=6.645, P=0.010). Residual disinfectant compliance was higher in the wet season than in the dry season (χ²=5.385, P=0.020). Microbial compliance was lower in the wet season than in the dry season (χ²=19.273, P<0.001). Residual disinfectant compliance was higher in conventionally treated reservoir water than in disinfected deep well water (χ²=9.166, P=0.002) (χ²=1.212, P=0.271). Conclusion Rural drinking water in Zhoukou City exhibits a high compliance rate for residual disinfectant levels. Disinfectant type, water sample type, season, water supply method, and water source classification exert varying degrees of influence on disinfection efficacy.

Objective To explore the cleaning and disinfection effects of two different disinfection methods on high-frequency contact surfaces in hemodialysis rooms, for providing a reference for selecting appropriate cleaning and disinfection methods for object surfaces. Methods Two methods were used to wipe and disinfect the high-frequency contact surface in the hemodialysis room, namely Dian'erkang surface disinfectant and chlorine containing disinfectant. Microbial samples were taken from the object surfaces before and 3 min, 1 h, 2 h, and 4 h after disinfection to detect the qualified situation of total bacterial count. The disinfection effects of different disinfection methods at different times after disinfection were compared. Results The difference in disinfection effect between the two disinfection methods before and after disinfection was statistically significant (P<0.05). There was no significant difference in disinfection effect at 3 min, 1 h, 2 h, and 4 h after disinfection (P>0.05). The disinfection effect was the best at 1 h and 2 h after disinfection, and there was a varying degree of decrease at 4 h after disinfection. Conclusion Both disinfectants have good disinfection effects on high-frequency contact surfaces in hemodialysis rooms.

Objective To investigate the cleaning and disinfection efficacy of disinfectant wipes on the object surfaces of comprehensive dental treatment equipment, and to provide the theoretical evidence for prevention and control nosocomial infection. Methods Object surface samples were collected from dental units across 25 campuses of municipal hospitals in Beijing. Rapid detection methods were employed to assess the level of surface contamination. The cleaning and disinfection efficacy was evaluated after using disposable disinfectant wipes containing quaternary ammonium compounds. Results A total of 900 samples were collected from the comprehensive dental treatment equipment, including 450 samples contaminated by high splash treatment, and 450 samples after cleaning and disinfection. After the high splash treatment, the qualified rate of the contaminated object surfaces was 64.89%, among which the qualified rate of the spittoons (37.33%) was lower than other points. After cleaning and disinfection, the qualified rate of the object surfaces increased to 90.00%, the qualified rate of the patient’s armrests (both sides) was the lowest (82.67%), and the qualified rate of the operating table and panel (doctor’s side) was the highest (94.67%). Conclusion The disinfectant wipes can effectively clean and disinfect the object surfaces of the comprehensive dental treatment equipment. Medical institutions should strengthen the management of the cleaning and disinfection process of comprehensive dental treatment equipment, and pay attention to the dental water lines and high-frequency contact points of patients.

随着微创外科技术的快速发展，达芬奇机器人手术系统因其显著优势获得广泛应用。然而，该系统的器械结构精细复杂，清洗灭菌难度较大，直接关乎手术安全与医疗成本控制，且其器械清洗、监测及灭菌面临挑战和标准的缺失。本综述系统梳理了近年来该领域的进展现况，围绕清洗方法、效果监测与灭菌技术三大主题，依操作流程的逻辑框架展开论述。发现手工联合机械清洗、多种监测手段结合使用，以及依据器械属性选择压力蒸汽或低温灭菌方式，成为当前共识性的实践方向。尽管如此，该领域仍存在标准化流程尚未统一、清洗效果评估仍偏主观等关键局限。展望未来，人工智能技术在实现智能化清洗监测与灭菌参数优化方面具备广阔应用前景。

Objective To establish and optimize a high performance liquid chromatography-tandem mass spectrometry method for the determination of five disinfection byproducts in drinking water, and compare it with ion chromatography. Methods The samples were separated by an 0.22 m microporous membrane on a Dionex IonPac AS16 column (2 mm ×250 mm, 9 m), and then treated with acetonitrile-0.7 mol /L methylamine (60:40)，electrospray ion source and negative ion mode. At the same time, the samples were separated through 0.45 m microporous filter membrane by Metrosep A Supp 18-250 column. The leached solution was 9 mmol/L KOH, 1.25 mmol/L Na₂CO₃ and 1% sulfuric acid, then analyzed by ion chromatogram. Results The linear correlation coefficient (r) of the five disinfection byproducts of the two methods was >0.999 4. The detection limit was 0.001-0.004 mg/L, and the determination limit was 0.003-0.001 2 mg/L. The average recovery rate was 89.4%-105.4%. The relative standard deviation was 1.0%-5.4%. Both method were used to test 30 samples of drinking water, in which no bromates or hypochlorites were detected. The mean values of dichloroacetic acid measured by HPLC-MS/MS and IC were 0.032 and 0.034 mg/L, and the mean values of chlorate were 0.069 and 0.066mg/L, respectively(P>0.05). The detection rates of trichloroacetic acid were 90.0% and 53.3%, respectively (P<0.05). Conclusion The two methods have their own advantages and disadvantages. The appropriate method should be selected according to actual situation.

Objective To investigate the correlation between disinfection quality monitoring in nurseries and data on clustered epidemics of hand, foot, and mouth disease in a district of Chengdu in the past 10 years, in order to provide relevant suggestions for future preventive disinfection and control of clustered outbreaks of hand, foot, and mouth disease. Methods The disinfection quality monitoring data of nurseries in this district from 2014 to 2023 were collected, as well as data on clustered outbreaks of hand, foot, and mouth disease during the same period. The correlation between disinfection quality and outbreak frequency was analyzed. Results A total of 353 disinfection quality monitoring assessments were conducted in the nurseries of this district, among which the qualified rate of hand disinfection among caregivers in nurseries was relatively low (75.64%). The qualified rate of disinfection for object surfaces, toys, hand towels, and caregivers' hands in nurseries without clustered outbreaks of hand, foot, and mouth disease was higher than that in nurseries with clustered outbreaks, and the more clustered outbreaks occur, the lower the qualified disinfection rate, showing a negative correlation (P<0.05). The qualified rate of hand disinfection for staff in nuseries with low incidence of hand, foot and mouth disease was higher than that in nuseries with high incidence, and the difference is statistically significant (P<0.05). Conclusion The disinfection quality of object surfaces, toys, hand towels, and staff hand in nurseries is associated with the occurrence and frequency of clustered outbreaks of hand, foot, and mouth disease. The quality of hand disinfection for nusery's staff is associated with the incidence of clustered epidemics of hand, foot, and mouth disease in classes.

Objective To understand the current situation of quality management of central sterile supply department (CSSD) in Gansu Province, and to provide a basis for further improving the quality of CSSD work. Methods A questionnaire survey was used to investigate and analyze the quality of CSSD management in 62 hospitals in Gansu Province. Results The proportion of secondary hospitals and tertiary hospitals with a floor area-to-hospital bed ratio ≥0.8 was 68.18% and 33.33%, respectively. The number of CSSD personnel per 100 beds >2 in secondary and tertiary hospitals accounted for 65.91% and 16.67%, respectively. Hospitals that adopt centralized management accounted for 85.48%, while hospitals that use centralized processing of soft endoscopes had the lowest proportion (27.42%). The implementation rates of CSSD for quantitative cleaning effect monitoring and temperature-pressure monitoring of cleaning and disinfection equipment were 46.77% and 50.91%, respectively. The pass rate of overall work quality and the pass rate of work quality evaluation in secondary and tertiary hospitals were 88.89%, 72.58% and 65.91%, respectively. Conclusion It is necessary to further optimize basic infrastructure, strengthen centralized management and standardized awareness, and to improve the quality of work.

Objective To understand the current status of disinfection quality in childcare agencies in some districts of Shanghai, and to provide a basis for improving the quality of disinfection work in childcare agencies. Methods On-site sampling and testing methods were used to monitor and analyze the disinfection quality of childcare agencies in three districts in the southwest of Shanghai. Results From 2016 to 2023, a total of 1 092 childcare agencies under the jurisdiction of Minhang District, Xuhui District, and Songjiang District in Shanghai were sampled and monitored, with an average overall qualified rate of 72.62%. 83.28% of childcare agencies failed only in 1 category of sample, and 76.59% of the staff failed in hand hygiene. There was a significant difference in the qualified rate of childcare agencies in different jurisdictions (X²=29.929, P<0.05), with the highest qualified rate of 80.39% in Xuhui District and the lowest qualified rate of 61.20% in Songjiang District. The qualified rate of public childcare agencies was 76.32%, while that of private childcare agencies was 65.98%, with a significant difference (X²=13.483, P<0.05). Conclusion Among childcare agencies in the three districts in the southwest of Shanghai, the disinfection quality in central urban areas (Xuhui District) is better, and the supervision and management of hygiene quality in suburban (Songjiang District) childcare agencies should be strengthened.

Objective To investigate the current status of multidrug-resistant organism (MDRO) infections in a general hospital and to establish a time series model to forecast the incidence trends of MDRO-associated nosocomial infections. Methods Using retrospective investigation and statistical analysis methods, MDRO infection data among hospitalized patients in a hospital from 2010 to 2023 was conducted. The optimal time series prediction model for hospital MDRO infection was established. The prediction effect of MDRO infection data from January to June 2024 was validated. Results A total of 342 069 hospitalized patients were surveyed, among whom 2 198 cases had MDRO infections with an average prevalence rate of 0.64%. 382 cases of MDRO hospital-acquired infections, representing incidence nosocomial infection rate of 0.11%. The in-hospital prevalence rate of MDRO showed a increasing trend from 2010 to 2023 ($\chi$²_趋势=44.891, P<0.001). The MDRO nosocomial infection department primarily involved the intensive care unit (51.57%) and neurosurgery (11.26%). The most common infection sites were the respiratory system (71.47%) and urinary tract (18.06%). The predominant pathogens were Acinetobacter baumannii (46.60%), Escherichia coli (16.23%), and Staphylococcus aureus (15.18%). The ARIMA (2,0,2)(0,0,1) model demonstrated the best predictive performance for MDRO-associated nosocomial infection incidence rates, achieving a stable coefficient of determination (R²) of 0.746.The application of this model predicted the prevalence of MDRO hospital-acquired infections in the first half of 2024, and the predicted values were within the 95% confidence interval of the actual values. Conclusion Hospitals should strengthen the monitoring of MDRO infections and analyze infection rate trends in key departments and critical areas. The ARIMA(2,0,2)(0,0,1) model has demonstrated strong short-term predictive performance for MDRO-associated nosocomial infections.

Objective To analyze the positive rate of cerebrospinal fluid culture, pathogen distribution, and drug resistance in patients with post-craniotomy intracranial infection (PCII), and to provide evidence for the accurate prevention and control of PCII and the spread of multidrug-resistant organisms. Methods A cross-sectional study was conducted, and patients with PCII admitted to a level-A tertiary hospital in Shanghai from January 2015 to December 2021 were selected as the research subjects. Relevant infection data of the patients were retrospectively collected to analyze the positive rate of cerebrospinal fluid culture, composition of pathogens, and detection rate of multidrug-resistant organisms. Results Among the 228 enrolled patients, 85 were positive for cerebrospinal fluid culture, with a positive rate of 37.28%. The pathogens detected in cerebrospinal fluid cultures were mainly Gram-positive bacteria, accounting for 64.66%. The distribution of pathogens was dominated by coagulase-negative Staphylococci, accounting for 41.35%, of which the detection rate of methicillin-resistant strains were 67.35%. The most common Gram-negative bacteria were Acinetobacter baumannii and Klebsiella pneumoniae, accounting for 8.27% and 6.02%, respectively. The detection rates of carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Klebsiella pneumoniae (CRKP) were 90.91% and 62.50%, respectively. Conclusion The positive rate of cerebrospinal fluid culture in patients with PCII is relatively low, and the pathogens are mainly coagulase-negative Staphylococci. However, intracranial infections caused by CRAB and CRKP are currently major challenges for nosocomial infection prevention and control in patients undergoing craniotomy.

Objective To compare the disinfection effects of different chemical disinfectants on water used in dental unit. Methods Through on-site sampling and quantitative bacterial detection, the effects of different chemical disinfectants on disinfection of dental unit waterlines were observed. Results The over standard rate of total bacterial count of dental handpiece spray water before disinfection was 100%, and the over standard rate of total bacterial count of triple syringes water was 76.7%. The total bacterial count of all water samples disinfected by the 5 methods did not exceed the standard. For the dental handpiece spray water, Group D (30 g/L hydrogen peroxide disinfectant) maintained the longest duration where the average bacterial colony count in post-disinfection water samples was≤100 cfu/mL and the compliance rate remained at 100%. For the three-in-one syringe water, Group D (30 g/L hydrogen peroxide disinfectant) maintained the longest duration where the average bacterial colony count in post-disinfection water samples was≤100 cfu/mL. Group A (500 mg/L chlorine-based disinfectant) maintained the longest duration where the compliance rate of post-disinfection water samples was 100%.Conclusion Among several different chemical disinfectants, the 30 g/L hydrogen peroxide disinfectant has the best disinfection effect and the longest maintenance time.

Objective To understand the current situation of disinfection work in some medical institutions in Xinxiang City from 2023 to 2024, and to provide scientific basis for effectively improving the disinfection quality and infection control work of medical institutions in the city. Methods A retrospective analysis was conducted to statistically analyze the disinfection quality monitoring data of Xinxiang City from 2023 to 2024. Results From 2023 to 2024, a total of 86 medical institutions were monitored for disinfection quality, with 1 275 samples collected and 1 151 qualified samples. The total qualified rate was 90.27%, and there was a statistically significant difference in the qualified rate between the years(χ²=0.036, P<0.05); Among different types of medical institutions, tertiary hospitals had the highest qualification rate (93.28%) and private hospitals and clinics had the lowest qualification rate (85.85%). The difference in the overall qualification rate of disinfection quality was statistically significant (χ²=12.958, P<0.05); Among different monitoring items, the overall pass rates of pressure steam sterilizers (100.00%), medium risk medical equipment (100.00%), low-risk medical equipment (96.94%), and disinfectants in use (96.91%) were relatively high, while the overall pass rates of medical staff hands (77.41%) and medical institution sewage (80.70%) were relatively low. There was no significant difference in the qualified rate of each monitoring item between the two years (P > 0.05). Conclusion The overall disinfection quality of medical institutions in Xinxiang City is good from 2023 to 2024, but there are still deficiencies in medical water, hand hygiene, and sewage discharge. The disinfection quality of private medical institutions needs to be strengthened.

Objective To compare the consistency of UV radiation dose indicator cards and photometers in evaluating the effect of UV sterilization on medical environment objects, and to provide a basis for rapid evaluation of UV disinfection effect in medical environment. Methods Test points on high-frequency contact surfaces within the ward were selected, and UV radiation photometers, a dose indicator card, and three types of bacterial carriers (Escherichia coli, Staphylococcus aureus, and Bacillus subtilis var. niger) were placed respectively. The ultraviolet disinfection lamp was activated for 30 min, and UV radiation photometers readings and the color changes of the dose indicator card were recorded. The bacterial carriers for colony count were collected. Results All 60 UV radiation dose indicator cards exhibited color change and passed the qualification test. The cumulative UV radiation dose displayed by the dose indicator cards was consistent with that shown by the photometer, and the main data showed significant positive correlation ( P<0.001 ) with the average logarithmic value of microbial inactivation for the three indicator microorganisms. Conclusion Using the ultraviolet radiation dose indicator card to evaluate the ultraviolet disinfection effect in a medical environment is convenient and reliable.

Objective To investigate the efficacy of hydrogen peroxide spray, peracetic acid spray, and ultraviolet (UV) germicidal lamp irradiation in removing nucleic acids from MS2 bacteriophage-contaminated aerosols. Methods Bacteriophage aerosols (10¹⁰ PFU/mL) were sprayed at 100 mL into each of five 60 m³ laboratory chambers. Disinfection was performed by spraying with 30 g/L hydrogen peroxide, 5 g/L peracetic acid, or by irradiation using 60, 90, and 120 W UV germicidal lamps. The copy number of the MS2 bacteriophage lysis protein gene was quantified via quantitative RT-PCR to compare the nucleic acid clearance efficacy of the different disinfection methods. Results The average copy numbers of the MS2 gene in the 30 g/L hydrogen peroxide group and the 5 g/L peracetic acid group were lower than that in the positive control group, measuring 1.49×10⁹, 9.85×10⁷ and 8.14×10¹¹, respectively (F=217.396, P < 0.05). The 120 W UV lamp demonstrated the best nucleic acid clearance efficacy, with an average copy number of 7.26×10⁸, which was significantly lower than the control group's 8.14×10¹¹ (F=217.396, P < 0.05). The 120 W UV lamp achieved a nucleic acid clearance rate of 99.91%, higher than that of the 60 W and 90 W lamps, although residual nucleic acids were still detected. Conclusion Hydrogen peroxide, peracetic acid, and UV germicidal lamps exhibit a certain degree of efficacy in removing nucleic acids from highly concentrated aerosol contamination, but cannot achieve complete clearance.

Objective To establish a headspace gas chromatography (GC-ECD) method for determination of the residual content of sterilizing agents in medical intraocular lens after sterilization treatment with ethylene oxide (EO). Methods The GC-ECD analysis method was used to determine and analyze the residues of EO and other substances in medical intraocular lens sterilized with EO. Results The GC-ECD determination method established in this study showed a good linear relationship between the mass concentration of the target substance and the chromatographic peak area for residual EO and ethylene chlorohydrin (ECH) in sterilized medical intraocular lens in the ranges of 0.5 ~ 20 μg/mL and 2 ~ 200 μg/mL, respectively. The correlation coefficients were r_(EO) = 0.999 0 and r_(ECH) = 0.999 9, and the limits of quantitation of calculation method were EO:0.05 μg/mL and ECH:0.2 μg/mL. The recovery rate was 79.20%~97.54%, and RSD was <5.0%. Conclusion The GC-ECD method established in this study has the advantages of good specificity, high resolution, short chromatographic procedure time, and wide linear range, and can be used for rapid detection of EO and 2-ECH residues in medical intraocular lens.

目的 将风险预测模型与分级的医院感染控制措施相结合，构建一套动态的门急诊和医技科室流感病毒医院感染风险管理体系。方法 以流感样病例数为研究对象，利用滑动自平均模型预测未来一周门急诊可能接诊的流感样病例患者数，再以世界卫生组织提供的风险阈值计算方法划分未来可能处于的风险等级。利用专家咨询法构建一套分级防控管理建议，再与前述风险预测结果进行关联，对门急诊及医技科室的流行性感冒医院感染风险进行分级、动态的防控。结果 滑动自平均模型的预测结果与相应真实数据间的平均绝对百分比误差为8.63%。分级防控管理建议包括个人防护、环境消毒、预检分诊和隔离预防等内容的管理建议。结论 该体系可以根据流感病毒的流行强度，为门急诊和医技科室提供动态、精准、高效的感染控制措施建议。

目的 了解2019—2023年山东某三甲医院重症监护病房（ICU）医院感染发生率，为急性呼吸系统传染病疫情防控提供参考。方法 采用回顾性调查方法，对2019—2023年该医院ICU医院感染成年患者的临床资料和病原学检查资料进行调查，分析医院感染发生率及病原菌分布变化。结果 2019—2023年ICU医院感染发生率为3.36%，年份间感染发生率呈上升趋势（χ²_趋势=13.212，P<0.05）。共检出病原菌365株，构成比居前3位分别为肺炎克雷伯菌（25.21%）、鲍曼不动杆菌（16.44%）和铜绿假单胞菌（12.88%）。检出多重耐药菌136株，以CRAB为主（40.44%）。结论 该医院2023年ICU医院感染率与2022年相比未有明显降低，应加强ICU医院感染控制薄弱环节，尤其需降低多重耐药菌的传播风险。

目的 了解某医院环境清洁消毒效果及医务人员手卫生状况，分析医院环境卫生学监测合格率对医院感染发生率的影响，为有效控制医院感染提供依据。方法 采用现场采样和细菌学检测方法，监测2020—2022年医院室内空气、物体表面、使用中消毒剂、内镜内腔、纯化水卫生及消毒效果、医务人员手卫生合格情况，分析年份间或监测项目间合格率差异，分析监测合格率与医院感染发生率的相关性。结果 共收集1 761份样本，总监测合格率为97.33%。3年监测合格率依次为99.17%、96.13%和96.69%，差异有统计学意义（χ²=12.201，P=0.002）；不同监测项目中，内镜内腔和纯化水总合格率达100.00%，室内空气和使用中消毒剂合格率>98.00%，物体表面和医务人员手卫生合格率<96.00%。手卫生合格率以2020年最高（99.32%）。卫生学监测合格率和院内感染率呈负相关（r=-0.997，P<0.05）。结论 医院环境卫生学监测合格率较高，环境卫生学及消毒效果越好，医院感染发生率越低。医院应完善环境卫生及消毒管理，进一步降低医院感染发生率。

N-亚硝胺类化合物具有特定的致癌性、遗传毒性和细胞毒性。N-亚硝胺类氯化消毒副产物在氯化消毒后的饮用水中并不以单一形式存在，并且浓度往往较低。目前关于其对人体毒性作用的研究尚不够全面和深入。本文综述了饮用水中N-亚硝胺类氯化消毒副产物的生成与转化，低剂量混合N-亚硝胺类氯化消毒副产物的细胞毒性、遗传毒性和致癌性，以及相关毒性作用机制，为改善饮用水氯化消毒过程，有效减少消毒副产物生成，探索混合低剂量亚硝胺的潜在健康效应提供科学依据。

Objective To establish a method for determining prohibited local anesthetic components in antibacterial products. Methods Ultra-high performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) detection method was used to detect and evaluate prohibited anesthetics in antibacterial products. Results Using the method established in this study, the detection of 8 types of caine anesthetics showed good linearity within the range of 0.5-30.0 μg/L, with linear correlation coefficients greater than 0.997. The average spiked recovery rate was 80.5%-116.1%, and the relative standard deviation was 1.8%-6.1%, while the method quantification limit was 0.40-1.00 μg/kg. Conclusion The established detection method is convenient, efficient, accurate and sensitive, and can be used for rapid batch determination of 8 types of caine anesthetics in antibacterial products.

Objective To evaluate the effects of different air disinfection methods on the air quality and the disinfection effect of stored endoscopes in endoscopic repositories. Methods The endoscopic repositories of Gastrointestinal Endoscopy Center of our hospital were selected for the study. The experimental group used an air sterilization station to continuously and dynamically disinfect endoscopic repositories, while the control group used routine timed air disinfection. Both groups were monitored for PM_0.5 concentration and air bacterial count before air disinfection and at 1, 6 and 12 h after air disinfection. At the same time, 20 stored endoscopes were randomly selected for microbial culture. Results Compared with PM_0.5 concentration and air bacterial count before air disinfection, there were statistically significant differences in PM_0.5 concentration and air bacterial count 1 h after air disinfection in both group (P<0.05). At 6 and 12 h of air disinfection, PM_0.5 concentration and air bacterial count in the repositories of the experimental group were lower than those in the control group, and the differences were statistically significant (P<0.01). PM_0.5 concentration and air bacterial count in the repositories of the experimental group were both lower and had a small fluctuation range. The control group showed a significant increase over time in PM_0.5 concentration and airborne bacterial count in the storage repository. After 12 h of air disinfection, the qualified rate of biological culture in endoscopes stored in the repositories of the experimental group was still 100%, while that of the control group was 98.33%. Conclusion Using the air sterilization station for continuous dynamic air disinfection can effectively improve air quality, increase the effect of air disinfection, and guarantee the safe storage of sterilized endoscopes.