Environmental monitoring and analysis of Mycobacterium tuberculosis and discussion on the effect of disinfection equipment in a tuberculosis hospital

doi:10.19983/j.issn.2096-8493.20230017

Abstract

Abstract:

Objective: To understand the pollution of Mycobacterium tuberculosis (MTB) in the Wuhan Pulmonary Hospital (Wuhan Institute for Tuberculosis Control), and evaluate the effects of different types of environmental disinfection equipment, so as to provide reference for optimizing the prevention and control measures of tuberculosis in the hospital area. Methods: According to the risk level of the hospital, air and surface samples were taken twice in 44 places in high-risk areas, such as respiratory and critical care medicine wards and tuberculosis wards, dirt rooms, sputum retention rooms, bronchoscopy clinics in endoscopy centers, and cleaning and disinfection rooms. Real-time polymerase chain reaction (qPCR) was used to detect the genome-specific fragment IS6110 of MTB and the culture of mycobacterium, and the types of disinfection equipment in the positive detection areas were analyzed to evaluate the disinfection effect. Results: After 7 days and 10 days of continuous sampling, 55 air samples and 139 surface samples were collected. After qPCR detection, MTB was detected in two air samples and two surface samples respectively, and the positive detection rates were 3.64% (2/55) and 1.44% (2/139), respectively. But the culture of mycobacterium was negative. The disinfection equipments in the qPCR positive detection area were all upper ultraviolet air disinfection lamps without aerodynamic force and ordinary hanging ultraviolet lamps, and the positive rate was 3.25% (4/123) which was not statistically different from that in the area with aerodynamic environmental disinfection equipment (0.00% (0/71))(χ²=1.022, P>0.05). Conclusion: The positive detection rate of MTB in environmental samples was low in the tuberculosis hospital, and there was no influence of aerodynamic force on the disinfection effect of MTB in the environment. But it is still necessary to strengthen disinfection treatment in high-risk areas and to strictly implement hospital control measures.

Key words: Mycobacterium tuberculosis, Disinfection, Purification, Sanitary appliances and equipment, Air microbiology

CLC Number:

Luo Yi, Tao Fengxi, Li Guofei, Zhang Huihui, Peng Peng, Ren Yi, Liu Suyang. Environmental monitoring and analysis of Mycobacterium tuberculosis and discussion on the effect of disinfection equipment in a tuberculosis hospital[J]. Journal of Tuberculosis and Lung Disease , 2023, 4(2): 135-140. doi: 10.19983/j.issn.2096-8493.20230017

Figures/Tables 3

空气样本		物表样本		消毒设备	有无空气动力
地点	份数	地点	份数	消毒设备	有无空气动力
临床病区
ICU结核病患者病房	1	ICU患者通道的门把手、病床围栏	2	层流病房	有
结核病D病区的病房走廊空气	1	结核病D病区的病房走廊患者座椅表面	5	紫外线灯	无
结核病A、B、C、D病区各4间病房内导风槽、空调回风口	16	4个结核病病区部分房间门把手及桌子表面	20	上层紫外线消毒灯	无
PCCM-A病区内5人间病房1间,结核病A、B、C、D病区各1间病房	5	病区门把手、卫生间台面	7	上层紫外线消毒灯	无
PCCM-A病区污物间空气	1	微波炉开关、门框、标本架、垃圾桶表面	12	紫外线灯	无
PCCM-B病区的4间病房内导风槽、空调回风口	4	PCCM-B病区部分房间门把手及桌子表面	20	上层紫外线消毒灯	无
医技科室
CT室患者等候区内走廊空气	1	CT室门把手、座椅、扶贫柜把手	5	移动灭菌站	有
第三CT检查室	1	CT检查床栏、CT机器表面	10	紫外线灯	无
内镜中心气管镜清洗消毒室	2	门把手、消洗池台面、水龙头	4	移动灭菌站	有
内镜中心气管镜第二、第四诊疗室	6	操作台面、办公桌面	5	移动灭菌站	有
内镜中心雾化局麻室	1	痰架表面、医疗器材架子表面	3	上层紫外线消毒灯	无
检验科样本间	1	门把手、操作台面	5	紫外线灯	无
病理科切片室、取材室	1	操作台面	5	紫外线灯	无
门诊区域
耐多药结核病门诊诊室	1	门诊桌面、候诊椅面	10	移动灭菌站	有
门诊大厅1楼	6	门帘、导医台面、候诊区座椅表面	10	移动灭菌站	有
结核病患者侯诊区、留痰室和采血室	2	采血窗口台面、候诊座椅表面、留痰室桌面、报告打印机	5	移动灭菌站/紫外线灯	有
其他区域
医疗楼主楼出风口	4	排风口处门把手、排风口风叶	7	亚高效过滤网	有
医疗废物暂存处	1	门把手、医疗废物专用桶表面	4	紫外线灯	无

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样本分类	qPCR检测				MGIT 960培养
样本分类	阳性(份)	阴性(份)	合计(份)	阳性率(%,95%CI)	阳性(份)	阴性(份)	合计(份)	阳性率(%,95%CI)
空气样本	2	53	55	3.64(0.44~12.53)	0	55	55	0
物表样本	2	137	139	1.44(0.17~5.10)	0	139	139	0
合计	4	190	194	2.06(0.56~5.19)	0	194	194	0

阳性样本	Ct值	对应地点	消毒设备	使用时间(d)	有无空气动力
空气样本1	26.58	结核病C病区某病房排风口	上层空气紫外线消毒灯	24h	无
空气样本2	26.69	结核病D病区某病房排风口	上层空气紫外线消毒灯	24h	无
物体表面样本1	24.31	PCCM-A病区污物间痰杯架	传统悬挂式紫外线灯管	1h	无
物体表面样本2	27.52	PCCM-A病区污物间门框	传统悬挂式紫外线灯管	1h	无

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