PLOS ONE ( IF 2.9 ) Pub Date : 2018-03-16 , DOI: 10.1371/journal.pone.0194246 Ya-Chi Li , Hui-Ling Lin , Fang-Chun Liao , Sing-Siang Wang , Hsiu-Chu Chang , Hung-Fu Hsu , Sue-Hsien Chen , Gwo-Hwa Wan
Background
Few studies have investigated the difference in bacterial contamination between conventional reused ventilator systems and disposable closed ventilator-suction systems. The aim of this study was to investigate the bacterial contamination rates of the reused and disposable ventilator systems, and the association between system disconnection and bacterial contamination of ventilator systems.
Methods
The enrolled intubated and mechanically ventilated patients used a conventional reused ventilator system and a disposable closed ventilator-suction system, respectively, for a week; specimens were then collected from the ventilator circuit systems to evaluate human and environmental bacterial contamination. The sputum specimens from patients were also analyzed in this study.
Results
The detection rate of bacteria in the conventional reused ventilator system was substantially higher than that in the disposable ventilator system. The inspiratory and expiratory limbs of the disposable closed ventilator-suction system had higher bacterial concentrations than the conventional reused ventilator system. The bacterial concentration in the heated humidifier of the reused ventilator system was significantly higher than that in the disposable ventilator system. Positive associations existed among the bacterial concentrations at different locations in the reused and disposable ventilator systems, respectively. The predominant bacteria identified in the reused and disposable ventilator systems included Acinetobacter spp., Bacillus cereus, Elizabethkingia spp., Pseudomonas spp., and Stenotrophomonas (Xan) maltophilia.
Conclusions
Both the reused and disposable ventilator systems had high bacterial contamination rates after one week of use. Disconnection of the ventilator systems should be avoided during system operation to decrease the risks of environmental pollution and human exposure, especially for the disposable ventilator system.
Trial registration
ClinicalTrials.gov PRS / NCT03359148
中文翻译:
传统的重复使用的呼吸机系统和一次性封闭的呼吸机吸气系统中存在细菌污染的潜在风险
背景
很少有研究调查传统的重复使用的呼吸机系统和一次性封闭的呼吸机吸气系统之间细菌污染的差异。这项研究的目的是调查重复使用和一次性使用的呼吸机系统的细菌污染率,以及系统断开与呼吸机系统的细菌污染之间的关系。
方法
入组的插管和机械通气患者分别使用常规的重复使用的呼吸机系统和一次性的封闭式呼吸机抽吸系统,为期一周。然后从呼吸机回路系统中收集标本,以评估人和环境细菌的污染。在这项研究中还分析了患者的痰标本。
结果
在常规的再用呼吸机系统中,细菌的检出率大大高于在用后的呼吸机系统中。一次性封闭式呼吸机吸气系统的吸气和呼气肢体比常规的重复使用的呼吸机系统具有更高的细菌浓度。重新使用的通风机系统的加热加湿器中的细菌浓度显着高于一次性通风机系统中的细菌浓度。在重复使用和一次性呼吸机系统中,不同位置的细菌浓度之间分别存在正相关。在重复使用和一次性呼吸机系统中发现的主要细菌包括不动杆菌属,蜡状芽孢杆菌,伊丽莎白女王属。,假单胞菌属(Pseudomonas spp。)和嗜麦芽窄食单胞菌(Snotropomohomonas(Xan)Maltophilia)。
结论
使用一周后,重复使用的通风系统和一次性通风系统都具有较高的细菌污染率。在系统运行期间,应避免呼吸机系统的断开连接,以减少环境污染和人体暴露的风险,尤其是对于一次性呼吸机系统而言。
试用注册
ClinicalTrials.gov PRS / NCT03359148