如何降低移動式數位X光機攝影時造成病人交互感染

How to Reduce the Patient's Cross-infection when Mobile Digital X-ray Machine Photography

李國樑(Kuo-Liang Lee) ； 林佳美(Chia-Mei Lin) ； 鄭文傑(Wen-Jie Cheng) ； 魏一虹(Yi-Hung Wei) ； 郭光華(Kuang-Hua Kuo) ； 鐘正國(Chen-Kuo Chung) ； 洪建福(Chien-Fu Hung)

《臺灣醫事放射期刊》 7卷2期 (2019/12) Pp. 15-22

https://doi.org/10.6717/JTMRT.201912_7(2).0003

摘要

醫療院所是一個充滿各種多重抗藥性以及多樣性的微生物菌叢的複雜環境，而醫院中的病人以及醫護人員都可能透過雙手、身體觸碰成為傳播細菌的媒介，進而造成院內交互感染。移動式數位X光機運用在緊急狀態不宜離開病房之病人，因為放射師與機器周旋在病人間，因此身上或儀器上可能有極高的帶菌性而成為傳播的媒介。因此在接觸病人前後都必須洗手，為感控的標準規範。本次研究統計2018年6月至9月某一間外科加護病房，探討抗萬古黴素腸球菌（vancomycin-resistant Enterococcus, VRE）的傳播，並且分成對照組以及實驗組來做比較。在對照組中，放射師手部的細菌培養結果皆為陽性，靈敏性為100%，平均每平方英吋細菌含量為37428；而DR板的細菌培養結果也是皆為陽性，靈敏性為100%，平均每平方英吋細菌含量為4050。在實驗組中，放射師手部的細菌培養結果陽性有2例，靈敏性為25%，平均每平方英吋細菌含量為100，陰性有6例，靈敏性為75%，平均每平方英吋細菌含量為0；而DR板的細菌培養結果皆為陰性，靈敏性為100%，平均每平方英吋細菌含量為0。因此確實的洗手以及儀器的清潔消毒，可以有效的降低細菌的傳播，避免院內感染的傳播。

關鍵字

交互感染 ； 洗手 ； 抗藥性

並列摘要

Hospital is a complex environment filled with various multi-drug resistant and diverse microbial flora. Patients and hospital staff who in hospitals may become a medium for transmitting bacteria through hands and body touch inducing nosocomial infection. Mobile digital X-ray machines are used in patients, not allowed to leave the ward in an emergency. Because the radiologist and the machine are interspersed between the patients, the body or the instrument may have a high degree of bacteria and become a medium of transmission. Therefore, it is necessary to wash hands before and after touching the patient, which is the standard specification for sensory control. This study explores the spread of VRE in a surgical intensive care unit from June to September 2018, and divided it into a control group and an experimental group for comparison. In the control group, the radiation culture results of the hands of the radiologist were all positive, the sensitivity was 100%, and the average of bacterial content per square inch was 37,428; while the bacterial culture results of the DR plate were all positive, the sensitivity was 100%, and the bacteria content per square inch was 4050. In the experimental group, there were 2 cases of positive bacterial culture in the hands of the radiologist, the sensitivity was 25%, the average of bacterial content per square inch was 100. The negative was 6 cases, the sensitivity was 75%, and the average of bacterial content per square inch was 0. The bacterial culture results of the DR plate were all negative, with a sensitivity of 100% and an average of bacterial content per square inch was 0. Therefore, the washing hands and the cleaning and disinfection of the instrument can effectively reduce the spread of bacteria and avoid the spread of nosocomial infections.

並列關鍵字

interactive infection ； washing hands ； drug resistance