- 期刊
噴霧治療後小量噴霧器細菌污染情形之研究
A Study on Bacterial Contamination of Small-volume Nebulizers after Aerosol Therapy
摘要
小量噴霧器常用來做爲呼吸道疾病急性發作時吸入給藥的治療工具。然而，一旦因清洗方法不當造成噴霧器遭受污染，得到呼吸器相關肺炎的危險性也將隨之增加。本研究於93年7月1日至9月30日期間於某署立醫院內外科加護病房，對於使用呼吸器及小量噴霧器之病患，共收案21人。醫護人員以無菌蒸餾水清洗晾乾使用後之小量噴霧器，於不同時間採檢病患之痰液及噴霧器做細菌培養，再分別計算噴霧器使用後6小時、24小時、72小時之污染率。結果顯示，其污染率分別爲19.0%、14.3%、53.3%，總污染率則爲26.3%。其中使用後72小時的污染率明顯上升，可能意謂小量噴霧器於使用後72小時，即使以無菌蒸餾水清洗後晾乾，其污染仍將使病患有較大的風險。雖然，本研究對於所分離菌株並未做脈衝式膠體電泳來比較其異同，僅以相同菌名做爲菌株定否爲相向來源的參考，可能高估污染率的重要性。但本研究基於不同時蘭噴霧器方染情形的結果，仍然建議小量噴霧器除每次治療後之常規清潔外，也應訂定固定時間予以消毒或更換。
並列摘要
Small-volume nebulizer is often used as a tool of aerosol therapy in acute respiratory tract diseases, However, once it is contaminated due to inappropriate cleaning methods, the risk of having ventilator-associated pneumonia (VAP) will be increased tremendously. This study was conducted from July 1, 2004 to September 30, 2004 in medical and surgical intensive care units of Hsin-Chu hospital, Department of Health. During the study period, 21 patients with ventilator support and using small-volume nebulizer were included. The small-volume nebulizers were cleaned with sterilized distilled water and let dry in the air after each inhalation treatment course. Then, medical personnel took specimen for bacterial culture including the patients' sputum and specimens from nebulizers at three different timepoints, and the contamination rates of nebulizers at 6, 24, and 72 hours after starting usage were calculated. The results showed that the contamination rates were 19.0%, 14.3%, and 53.3% at three different time points respectively. The overall contamination rate was 26.3%. The contamination rate at 72 hours after starting usage increased dramatically, which probably might result in increased risk to acquire infection for the patients. This study didn't compare the clonacity of bacterial isolates from patients' sputum and nebulizer by molecular typing. The significance of the contamination might be overestimated. However, despite of the fact of possible overestimation, we still suggest proper and adequate disinfection and changing the nebulizer in suitable interval to reduce the bacterial contamination and its undesirable consequences based on more studies arc very important.