DOI QR코드

DOI QR Code

다제내성균 환경표면 오염도 및 소독 효과 평가

Evaluation of environmental surface contamination and disinfection effects on multidrug-resistant organism

  • 김재연 (건양대학교 일반대학원 간호학과) ;
  • 박정애 (건양대학교 일반대학원 간호학과) ;
  • 이미향 (건양대학교 간호학과) ;
  • 김상하 (건양대학교 일반대학원 보건학) ;
  • 정선영 (건양대학교 간호학과)
  • 투고 : 2020.09.07
  • 심사 : 2021.01.20
  • 발행 : 2021.01.28

초록

본 연구는 다제내성균 환자가 사용한 병실 환경에 대한 환경관리 평가 방법 중 미생물 배양검사와 Adenosin Triphosphate Bioluminescence 방법을 이용하여 오염도를 파악 한 후 환경소독제를 이용하여 소독효과를 평가하고자 시도되었다. 환경표면은 다제내성균으로 격리된 환자병실을 대상으로 하였다. 검체채취는 인퓨전펌프, IV 폴대, 상두대, 침대난간, 키보드 혈압기 커프 5곳을 실시하였고 소독 전, 소독 직후, 소독 후 5분 후 ATP와 미생물배양검사를 실시하였다. 연구결과 Infusion pump의 환경표면이 소독·후 오염도가 통계적으로 유의하게 감소하였다. 또한 IV 폴대, 침상난간, 키보드는 소독 전후 균 검출이 감소하였다. 즉 정기적인 환경표면소독은 환자에게 감염으로부터 안전한 환경을 제공할 수 있다. 따라서 향후 다기관을 대상으로 소독제의 지속성 등을 평가하여 환경표면 소독방법, 소독주기 등의 지침을 마련하는 것이 필요하다.

This study was carried out to evaluate the effects of disinfection using environmental disinfectant after having assessed the extent of contamination through microbial culture testing and the Adenosine Triphosphate Bioluminescence method among the environmental management evaluation methods used for the environment in the hospital ward of patients infected by multidrug-resistant organisms. This study was conducted with the patient wards isolated due to multidrug-resistant organisms as the environmental surface. Specimens were collected from five locations including infusion pumps, IV poles, bedside cabinets, bed railings, keyboards, and blood pressure measurement cuffs. ATP and microbial culture testing were executed prior to, immediately after, and five minutes post-disinfection. According to the result contamination of the infusion pumps was statistically significantly reduced after disinfection. In addition, the bacteria before and after disinfection reduced in IV pole, bed railing, and keyboard. That is, regular environmental surface disinfection can provide safer environments to patients against infection. Therefore, it is necessary to establish guidelines including disinfection methods and intervals for environmental surfaces by evaluating the persistence of disinfectants at various institutions in the future.

키워드

참고문헌

  1. J. H. Kim & K. H. Lim. (2015). The factors influencing complinace of multidrug-resistant organism infection control in intensive care units nurses. Korean Journal of Adult Nursing. 27(3), 325-336. DOI: 10.7475/kjan.2015.27.3.325
  2. J. D. Siegel, E. Rhinehart, M. Jackson, L. Chiarello. (2006). Management of mutlidrug-resistant organisms in healthcare settings, 2006. 1-74.
  3. Y. A. Kim, H. K. Lee & K. W. Lee. (2015). Contamination of the hospital environmental by pathogenic bacteria and infection control. Korean Journal of Nosocominal Infection Control. 20(1), 1-6. DOI: 10.14192/kjnic.2015.20.1.1
  4. S. Dancer (2008). Importance of the environment in methicillin-resistnat staphylococcus aureus acquistion: the case for hospital cleaning. Lancet Infection Disease. 8, 101-113 DOI: 10.1016/S1473-3099(07)70241-4
  5. R. R. W. Brady, J. Verran, N. N. Damani, A. P. Gibb. (2009). Review of mobile communication devices as potential reservoirs of nosocomial pathogens. Journal of Hospital Infection. 71, 295-300. DOI: 10.1016/j.jhin.2008.12.009
  6. T. Y. Tan, J. S. M. Tan, H. Tay, G. H. Chua, L. S. Y. Ng, N. Syahidah. (2013). Multidrug-resistant organisms in a routine ward envronment: differential propensity for environmental dissemination and implications for infection control. Jorunal of Medical Microbiological, 62, 766-772. DOI: 10.1099/jmm.0.052860-0
  7. E. N. Perenveich, A. D. Harris, C. D. Pfeiffer, M. A. Rubin, J. N. Hill, G. J. Baracco, et al. (2018). Establishing a research agenda for preventing transmission of mutlidrug-resistant organisms in acute-care settings in the veterans health administraion. Infection Control & Hospital Epidemiology. 39(2), 189-195. DOI: 10.1017/ice.2017.309
  8. S. Nseir, C. Blazejewski, R. Luret, F. Wallet, R. Courcol & A. Durocher. (2011). Risk of acquiring multidrug-resistant gram-negative bacili from prior room occucpants in the intensive care unit. Clinical Microbiology and Infection, 17(8), 1201-1208. DOI: 10.1111/j.1469-0691.2010.03420.x
  9. B. M. Anderson, M. Rash, K. Hochlin, F.-H. Jensen, P. Wismar, J.-E. Fredriksen. (2006). Decontamination of rooms, medical equipment and ambulances using and aerosol of hydrogen peroxide disinfectant. Journal of Hospital Infection. 62, 149-155. DOI: 10.1016/j.jhin.2005.07.020
  10. B. D. Lewis, M. Spencer, P. J. Rossi, C. J. Lee, K. R. Brown, M. Malinowski, et al. (2015). American Journal of Infection Control. 43, 283-285. DOI: 10.1016/j.ajic.2014.11.023
  11. G. M. Synder, A. D. Holyoak, K. E. Leary, B. F. Sullivan, R. B. Davis, S. B. Wright. (2013). Antimicrobial Resistance & Infection Control. 2(26). DOI: 10.1186/2047-2994-2-26
  12. W. M. Rutala & D. J. Weber. (2016). Monitoring and improving the effectiveness of surface cleaning and disinfection. American Journal of Infection Control. 44, e69-e76. DOI: 10.1016/j.ajic.2015.10.039
  13. M. C. Faires, D. L. Pearl, O. Berke, R. J. Reid-Smith, J. S. Weese. (2013). The identification and epidemiology of methicillin-resistant staphylococcus aureus and clostridium difficile in patient rooms and the ward environment. BMC Infectious Disease. 13:342. DOI: 10.1186/1471-2334-13-342
  14. F. Barbut, S. Yezli, M. Mimoun, J. Pham, M. Chaouat, J. A. Otter. (2013). Reducing the spread of acinetobacter baumannii and methicillin-resistant staphylococcus aureus on a burns unti through the intervention of an infection control bundle. BURNS, 39, 395-403 DOI: 10.1016/j.burns.2012.07.007
  15. C. E. Park, N. Y. Jeong, H. W. Kim, S. I. Joo, K. H. Kim, H. K. Seong, et al. (2018). Study on the standardization of a surveillance culture laboratory in infection control fields. The Korean Journal of Clinical Laboratory Science. 50(3), 359-369. DOI: 10.15324/kjcls.2018.50.3.359