不同消毒方法对静脉采血皮肤消毒效果的比较

杨旭; 刘琦迎; 冯丽萍; 何薇; 何子倩; 王清

不同消毒方法对静脉采血皮肤消毒效果的比较

昆明医科大学第二附属医院检验科

基金项目:

基金：云南省临床护理研究中心基金资助项目 (2016-NS-255);

计量
- 文章访问数: 1563
- HTML全文浏览量: 564
- PDF下载量: 158
- 被引次数: 0
出版历程
- 收稿日期: 2017-03-19

Comparative Analysis of Disinfectant Efficacy of Different Skin Disinfection Methods on Venous Sampling

Funds:

基金：云南省临床护理研究中心基金资助项目 (2016-NS-255);

摘要

摘要: 目的比较不同消毒方法对静脉采血皮肤消毒的效果, 找到一种操作简便、快速适用的方法, 适于采集血培养标本.方法随机抽取某三甲医院2016年2月到5月的住院患者303例, 每例患者取左、右手肘窝及右手前臂3个部位, 按照采血前使用不同的皮肤消毒方法分为3组.第1组是美国临床实验室标准协会 (clinical laboratory standards institute, CLSI) 规定的血培养采集消毒方法, 第2组是安尔碘顺时针消毒1次, 第3组是安尔碘顺逆时针各消毒1次.各组在消毒前、后的同一部位各取1次皮肤拭子, 进行细菌培养及菌落计数, 用χ2检验进行统计分析.结果 3种消毒方法在消毒前后的细菌阳性率差异有统计学意义 (P<0.01) .CLSI的血培养采集消毒与安尔碘顺逆时针各1次消毒, 差异无统计学意义 (P>0.05) ;CLSI的血培养采集消毒与安尔碘顺时针1次消毒, 差异有统计学意义 (P<0.01) ;安尔碘顺逆时针各1次消毒与安尔碘顺时针1次消毒, 差异有统计学意义 (P<0.01) .结论安尔碘顺逆时针各消毒1次消毒效果与CLSI的血培养采集消毒等效, 可运用于经静脉采集血培养标本的皮肤消毒, 并比其简单、快速、经济适用.
- 消毒方法 /
- 血培养 /
- 静脉采血 /
- 皮肤消毒
Abstract: Objective To compare the effects of different disinfection methods on skin disinfection effects in blood sampling, and to find a rapidly applicable method which is easy to operate and suitable for sampling of bloodculture. Methods We randomly sampled 303 patients in a 3A Grade Hospital from February 2016 to May2016, and chose three parts, the fossa of left and right elbow and the cubitus of right arm, from every patient.Then those patients were divided into three groups according to skin disinfection methods used before blood sampling. The first group underwent the disinfection method of blood sampling stipulated by America Clinical Laboratory Standards Institute (CLSI) ;the second group was applied on Anerdian clockwise for one time;the third group was applied on Anerdian both clockwise and counter-clockwise each once. A skin swab on the same spot of every group was conducted before and after the disinfection for bacterial culture and colony counting, which was statistically analyzed by χ2test. Results The difference of positive rate was statistically significant among three disinfection methods before and after disinfection (P1 <0.01; P2 <0.01; P3 <0.01) . No statistical significance was found in the difference between CLSI disinfection and both clockwise and counter-clockwise each once of Anerdian disinfection (P >0.05) ; statistical significance was found in the difference between CLSI disinfection and clockwise Anerdian disinfection once for each time (P <0.01) ; and there was statistical significance in the difference between both clockwise and counter-clockwise and clockwise Anerdian disinfection once for each time ( P <0.01) .Conclusions The effect of clockwise and counter-clockwise Anerdian disinfection once for each time is equivalent to that of the CLSI disinfection method for blood culture and sampling. Anerdian can be applied on skin disinfection for blood culture specimen via venous sampling, and it is more easy, rapid and economic to operate.
- Disinfection method /
- Blood culture /
- Venous sampling /
- Skin disinfection

HTML全文

参考文献(16)

[1]	[1]WENJIE LIU, YUCHEN DUAN, WENYAO CUI, et al.Skin antiseptics in venous puncture site disinfection for preventing blood culture contamination:A Bayesian network meta-analysis of randomized controlled trials[J].International Journal of Nursing Studies, 2016, 59 (6) :156-162.
[2]	[2]STORY-ROLLER E, WEINSTEIN M P.Chlorhexidine versus tincture of iodine for reduction of blood culture contamination rates:A prospective randomized crossover study[J].J Clin Microbiol, 2016, 54 (12) :3007-3009.
[3]	[3]WASHER L L, CHENOWETH C, KIM H W, et al.Blood culture contamination:A randomized trial evaluating the comparative effectiveness of 3 skin antiseptic interventions[J].Infection Control and Hospital Epidemiology, 2013, 34 (1) :15-21.
[4]李春卉, 孙艳美, 董薇, 等.两种皮肤消毒法及干预措施对消毒效果影响的研究[J].中华医院感染学杂志, 2010, 20 (2) :229-231.
[5]梁宇杰, 姜新, 王春艳, 等.两种皮肤消毒方法的效果对比研究[J].中华医院感染学杂志, 2015, 25 (18) :4315-4316, 4320.
[6]吴颖.加强血培养标本采集环节的规范化管理[J].中华医院感染学杂志, 2012, 22 (4) :781.
[7]王云华, 高秀芝.血培养阳性仪器报警时间及病原菌分布[J].昆明医科大学学报, 2015, 365 (5) :148-149.
[8] 蔡芸.血培养污染及判定[J].医学信息:下旬刊, 2009, 1 (10) :221-222.
[9]	[9]HOSSAIN B, ISLAM M S, RAHMAN A, et al.Understanding bacterial isolates in blood culture and approaches used to define bacteria as Contaminants:A literature review[J].Pediatr Infect Dis J, 2016, 35 (5 Suppl 1) :S45-S51.
[10]车小琼, 刘文文, 张彦, 等.无针接头不同消毒方式对预防导管相关性感染的影响[J].川北医学院学报, 2016, 31 (1) :116-118.
[11]夏峥嵘, 黄靖雄.皮肤消毒剂的研究进展[J].中华医院感染学杂志, 2011, 21 (8) :1716-1718.
[12]王辉, 张悦娴, 谢秀丽, 等.血培养凝固酶阴性葡萄球菌阳性的临床意义[J].中国抗感染化疗杂志, 2001, 1 (2) :79-82.
[13]曹慧玲, 李岷, 魏源华, 等.血培养病原菌分布及污染菌判定的实验室检查[J].国际检验医学杂志, 2011, 32 (18) :2067-2068, 2071.
[14]李艳, 杨崇勤.改进皮肤与瓶盖消毒方法对血培养凝固酶阴性葡萄球菌检出率的影响[J].中国感染控制杂志, 2016, 15 (5) :324-326.
[15]朱岷.不同皮肤消毒剂在献血人群采血前应用效果对比观察[J].中国感染控制杂志, 2013, 12 (1) :50-51, 58.
[16]唐毅, 萧晨路, 李和姐, 等.安尔碘皮肤消毒剂对常见耐药细菌的体外杀菌试验[J].中华医院感染学杂志, 2011, 21 (4) :722-723.

相关文章(20)

[1]	钱为民, 曹良菊, 蒋愉, 蒲丹, 母凤婷, 潘永圣. 光活化消毒辅助治疗慢性牙周炎的疗效, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20240123
[2]	吕扬, 李桂鼎, 鲁少文, 余滨兵, 翟秋菊, 彭艺. 3种消毒剂对超声洁牙机单元水路的消毒效果研究, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20240928
[3]	苏锡雄, 许薇, 许立奇, 杨琴, 杨云丽. 开放手术辅助PTA治疗血透患者上肢动静脉内瘘I型合并II型狭窄的疗效, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220626
[4]	杨镕羽, 宋飞, 魏云林, 杨向红, 段开文, 向盈盈. 不同富集培养方法对噬菌体PEf771的滴度影响, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220218
[5]	武彧, 杨德兴, 王虹, 王强, 周维钰, 唐杰夫, 王振方, 付凯, 刘荣. 脓毒性休克患者早期动、静脉血乳酸相关性及乳酸、乳酸清除率的预后评估价值, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210927
[6]	尹赛格, 张恒睿, 陈滟, 孙俊. 小鼠小胶质细胞原代培养的高产改良方法, 昆明医科大学学报.
[7]	MUHAMMAD Usman, 王继华, YADAV SVKENDRA PARSAD, 汤婷, 张颖佳, 杨蔚琪. 耳后皮肤扩张行小耳畸形耳再造（英文）, 昆明医科大学学报.
[8]	张艳, 胡顺勇, 杨选英, 马丽菊. 布鲁氏菌病的实验室特征与临床分析, 昆明医科大学学报.
[9]	马莎. 三种培养原代滑膜成纤维细胞方法的比较, 昆明医科大学学报.
[10]	杨德兴. 急诊医学住院医师规范化培养引入临床决策方法临床能力效果评价, 昆明医科大学学报.
[11]	高丽萍. 大肠癌细胞原代培养方法的研究进展, 昆明医科大学学报.
[12]	王云华. 血培养阳性仪器报警时间及病原菌分布, 昆明医科大学学报.
[13]	杨棕嘉. 三种根管消毒药用于急慢性根尖周炎感染根管消毒的临床疗效观察, 昆明医科大学学报.
[14]	秦亚辉. 非接触消毒方法对生物材料表面细菌生物膜的清除效果评价, 昆明医科大学学报.
[15]	胡霄. 静脉留置针在大鼠尾静脉注射中的方法和技巧, 昆明医科大学学报.
[16]	马珊. 凉血活血中药含药血清对人脐静脉内皮细胞增殖的影响, 昆明医科大学学报.
[17]	张艳. 血培养分离菌的种类及药物敏感性分析, 昆明医科大学学报.
[18]	王滔. 人大网膜间充质干细胞的体外培养、鉴定及诱导化分方法, 昆明医科大学学报.
[19]	. 两种空气消毒方法对心脏导管室接台手术空气消毒效果比较, 昆明医科大学学报.
[20]	杨锋. 两种培养方法在猪自体骨髓间充质干细胞培养的比较研究, 昆明医科大学学报.