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題名 | 探討胃內視鏡檢查導致幽門螺旋桿菌交互感染之途徑及其預防方式=Investigation of Possible Routes and Prevention of Helicobacter Pylori Cross Infection in Endoscopic Units |
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作者 | 林淑娟; 邱艷芬; 陳宏曙; Lin, Shwu-jiuan; Chiou, Yann-fen; Chen, Hong-shu; |
期刊 | 護理研究 |
出版日期 | 19971200 |
卷期 | 5:6 1997.12[民86.12] |
頁次 | 頁474-486 |
分類號 | 415.5 |
語文 | chi |
關鍵詞 | 胃內視鏡; 幽門螺旋桿菌; 交互感染; Gastroscope; Helicobacter pylori; Cross-infection; |
中文摘要 | 許多臨床及基礎研究顯示慢性胃炎及消化性潰瘍與幽門螺旋桿菌( Helicobacter pylori, Hp )之感染有極密切的關係,本研究旨在探討胃鏡檢查導致 Hp 交互感染之可能 生、途徑及其預防方法。研究中首先對已感染 Hp 之患者,於胃鏡檢查後,將該胃鏡之各部 份組件、操作者手套、環境表面,在消毒前後採樣,以確定須消毒之範圍及消毒方法能否達 到殺菌之效果。其次再以高濃度之 Hp 懸浮液,模擬污染胃鏡各部組件,用不且清潔、消毒 程序來消毒,期能找出一個安全且合理之消毒方法。 研究中以 PCR 及細菌培養方法作為測 量工具。研究結果:在傳染途徑方面,細菌培養結果顯示在 19 處有可能被污染之區域,僅 組織切片夾、切片通道及切片出口三處呈現陽性反應。 而 PCR 部份,除組織切片夾、切片 通道外,另外:胃鏡控制握把、胃鏡管身下段、操作者手套,亦呈現陽性反應。而消毒方法 實驗室作業部份, 細菌培養結果顯示以「水」沖洗污染之區域, 即能有效的清除有活性的 Hp。 而 PCR 偵測則發現以「水」沖洗、Cidex 浸泡、及自動清洗機等繁覆之清洗消毒程序 後,仍可於各部份組件中檢測到 Hp DNA 之存在。然據本研究細菌培養結果而推論此等 PCR 偵測到之 Hp DNA 應屬於無致病力及無繁殖力之 Hp 殘餘物。由於此而進一步推論 Hp 在經 由 Cidex 浸泡及自動清洗機清洗後,已被消毒殺菌了。 |
英文摘要 | Much clinical and basic research indicates that incidence of chronic gastritis and peptic ulcer is closely linked to infection with Helicobacter pylori (Hp). This study aims to explore the risk, the route, and the prevention of Hp cross-infection caused by gastroscopy. Following the gastroscopic examination of Hp-infected patients, specimens were taken from the parts of the gastroscope, the gloves worn by the operator, and exposed surfaces in the environment before and after disinfection to determine if complete disinfection was achieved. Next, high concentration Hp suspension was used to simulate gastroscope contamination; the parts of the gastroscope were then subjected to different cleansing and disinfection processes to find out an effective and feasible method. The study employed PCR and bacterial culturing as measuring tools. The results are summarized as follows: in terms of infection route, the findings of bacterial culture indicated that among 19 potentially infected sites, only three exhibited positive reactions-tissue biopsy forcepts, biopsy channel and biopsy channel exit. In PCR measurements, in addition to biopsy forcepts and biopsy channel, gastroscope control handle, lower section of the gastroscope body, and gloves worn by the operator were also found positive. In respect of disinfection method used for the laboratory, bacterial culture indicated rinsing the contaminated area with "water" could effectively eliminate active Hp. By PCR detection, it was found that following the procedures of "water" rinsing, Cidex soaking and automatic washer, Hp DNA could still be detectable on various parts of the gastroscope. According to the result of bacterial culture, we can conclude that such Hp DNA by PCR detection are probably Hp residues that are non-pathogenic and non-reproductive. We also can conclude that after Cidex soaking and automatic washer, Hp will be disinfected thoroughly. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。