종합병원 응급실내의 영상의학과 장비에서의 세균 오염에 관한 보건학적 융합 분석 Analysis of Healthcare Convergence on Bacterial Contamination of Radiological Equipment in Emergency Rooms of General Hospitals원문보기
본 연구는 종합병원 내 응급실에 설치된 CT 장비와 일반촬영장비에 대한 세균 오염도 검사를 실시하여 보건학적 융복합감염관리에 대한 기초자료를 마련하고자 하였다. 연구는 2015년 12월 1일부터 12월 31일까지 수도권 3곳과 전라도 2곳, 충청도 2곳 등 총 7곳의 의료기관을 대상으로하였다. 영상의학과 응급실 내 CT장비의 검출된 표면 오염 균주는 Micrococcus species(4,5%), Stenotrophomonas maltophilia(9%), Enteococcus faecium(4.5%), Providencia stuartii(4.5), Gram negative bacilli(4.5%), 일반촬영장비에서 검출된 표면 오염 균주는 Providencia stuartii(11%), Klebsiella pneumonia(3.5%), Stenotrophomonas maltophilia(11%), Pantoea species(11%), Acinetobacter baumannii(3.5%), Micrococcus species(3.5%), Escherichia coli(3.5%), Enterobacter species(3.5%), Gram negative bacilli(11%) 로 병원 감염의 원인균으로 알려진 균주는 없었고, 특이성을 가진 균주 역시 없었지만 가장 많이 검출된 구역이 모두 환자와 밀접한 관련을 갖는 곳이므로 방사선사는 검사 전후 알코올 등으로 깨끗이 닦아내야 할 것이다.
본 연구는 종합병원 내 응급실에 설치된 CT 장비와 일반촬영장비에 대한 세균 오염도 검사를 실시하여 보건학적 융복합 감염관리에 대한 기초자료를 마련하고자 하였다. 연구는 2015년 12월 1일부터 12월 31일까지 수도권 3곳과 전라도 2곳, 충청도 2곳 등 총 7곳의 의료기관을 대상으로하였다. 영상의학과 응급실 내 CT장비의 검출된 표면 오염 균주는 Micrococcus species(4,5%), Stenotrophomonas maltophilia(9%), Enteococcus faecium(4.5%), Providencia stuartii(4.5), Gram negative bacilli(4.5%), 일반촬영장비에서 검출된 표면 오염 균주는 Providencia stuartii(11%), Klebsiella pneumonia(3.5%), Stenotrophomonas maltophilia(11%), Pantoea species(11%), Acinetobacter baumannii(3.5%), Micrococcus species(3.5%), Escherichia coli(3.5%), Enterobacter species(3.5%), Gram negative bacilli(11%) 로 병원 감염의 원인균으로 알려진 균주는 없었고, 특이성을 가진 균주 역시 없었지만 가장 많이 검출된 구역이 모두 환자와 밀접한 관련을 갖는 곳이므로 방사선사는 검사 전후 알코올 등으로 깨끗이 닦아내야 할 것이다.
It is to establish preliminary data about healthcare convergencr of infection control by performing a bacterial contamination test for CT scanner as well as general radiographic systems in the emergency rooms of general hospitals. The period was December 1 ~ December 31, 2015. It is detect in the em...
It is to establish preliminary data about healthcare convergencr of infection control by performing a bacterial contamination test for CT scanner as well as general radiographic systems in the emergency rooms of general hospitals. The period was December 1 ~ December 31, 2015. It is detect in the emergency rooms of 7 medical facilities including 2 in Seoul, and 1 in Gyeonggi-do Province, and 2 in Jeonla-do Province, and 2 in Chungcheong-do Province. The surface contamination strains detected from CT scanner in the radiology department emergency rooms were Micrococcus species(4,5%), Stenotrophomonas maltophilia(9%), Enterococcus faecium(4.5%), Providencia stuartii(4.5), and Gram negative bacilli(4.5%). Also, the surface contamination strains detected from general radiographic system in the radiology department emergency rooms were Providencia stuartii(11%), Klebsiella pneumonia(3.5%), Stenotrophomonas maltophilia(11%), Pantoea species(11%), Acinetobacter baumannii(3.5%), Micrococcus species(3.5%), Escherichia coli(3.5%), Enterobacter species(3.5%), and Gram negative bacilli(11%). Considering that the regions of most detection were all the places closely related to patients, radiologists would have to thoroughly clean with alcohol before and after a test.
It is to establish preliminary data about healthcare convergencr of infection control by performing a bacterial contamination test for CT scanner as well as general radiographic systems in the emergency rooms of general hospitals. The period was December 1 ~ December 31, 2015. It is detect in the emergency rooms of 7 medical facilities including 2 in Seoul, and 1 in Gyeonggi-do Province, and 2 in Jeonla-do Province, and 2 in Chungcheong-do Province. The surface contamination strains detected from CT scanner in the radiology department emergency rooms were Micrococcus species(4,5%), Stenotrophomonas maltophilia(9%), Enterococcus faecium(4.5%), Providencia stuartii(4.5), and Gram negative bacilli(4.5%). Also, the surface contamination strains detected from general radiographic system in the radiology department emergency rooms were Providencia stuartii(11%), Klebsiella pneumonia(3.5%), Stenotrophomonas maltophilia(11%), Pantoea species(11%), Acinetobacter baumannii(3.5%), Micrococcus species(3.5%), Escherichia coli(3.5%), Enterobacter species(3.5%), and Gram negative bacilli(11%). Considering that the regions of most detection were all the places closely related to patients, radiologists would have to thoroughly clean with alcohol before and after a test.
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문제 정의
This study is designed to investigate infection control for testing devices in radiology department in emergency room of general hospitals. Its purpose is to investigate the factors to cause infectious diseases in immunosuppressed patients or hospital staff, and reduce nosocomial infection.
Therefore, this study investigated both the areas of workers and patients in order to comprehend the reality of infection control about CT room, which accounts for the most of severe patients, and general radiographic room, which is considered for a basic exam, among the tests of radiology in emergency room. This study is designed to investigate the infection status including contamination and hygiene of CT room and general radiographic room in emergency room based on the identified bacteria and to suggest the significance of infection control of workers as well as patients, and the necessity of education.
제안 방법
In the general radiographic device in emergency room of 7 medical facilities, a contamination test was performed in 4 places including stand bucky-grid, stand bucky-chin support, the top of patient table, and exposure controller. Consequently, more than 1 bacterial strain were detected in 5 medical facilities, and no bacteria were detected in all placed in 1 seoul and 1 keonggi province.
Therefore, this study investigated both the areas of workers and patients in order to comprehend the reality of infection control about CT room, which accounts for the most of severe patients, and general radiographic room, which is considered for a basic exam, among the tests of radiology in emergency room. This study is designed to investigate the infection status including contamination and hygiene of CT room and general radiographic room in emergency room based on the identified bacteria and to suggest the significance of infection control of workers as well as patients, and the necessity of education.
대상 데이터
As a result of test in emergency rooms of 7 hospitals, bacteria were detected in 4 emergency CT rooms and 5 general radiographic rooms. As in a previous studies [18] were detected as isolated bacteria, of which Methicillin Resistant coagulase-negative Staphylococci(MRCNS) were detected in 15 cases(62.
For sample collection, 7 medical facilities were selected 2 in Seoul, and 1 in Gyeonggi-do Province, and 2 in Jeonla-do Province, and 2 in Chungcheong-do Province, which all performed at least 30 tests daily, and CT scanner as well as general radiographic systems in the emergency rooms were set to be selected instruments. The period was december 1 ∼ december 31, 2015, and for CT scanner, samples were taken from the top of exposure controller used by radiology workers most, and 3 places including x-ray exposure button, the entire top of patient table which a patient’s skin is in contact with, and the inside of bore [Fig.
When a contamination test was performed in 3 places of CT scanner including exposure controller, top of a patient table, and inside of bore, in emergency room of 7 hospitals, more than 1 bacteria were detected in 4 hospitals, and no bacteria were detected in 2 in Seoul, and 1 in Gyeonggi Province. The detected strain of surface contamination were Micrococcus species, Stenotrophomonas maltophilia, Enterococcus faecium, Providencia stuartii, and Gram negative bacilli, which were known to be causal strains of hospital infection, and no strains exhibited unusual phenominon [Table 1].
성능/효과
As a result of gram stain, the final identification of bacteria was performed by API 20 Strep(BioMerieux SA,France) for gram Postive cocci, and by API 20 E (BioMerieux SA,France) for gram negative bacilli and enterobacteriaceae.
In terms of the distribution of detected bacteria, Providencia stuartii and Stenotrophomonas maltophilia, gram negative bacilli, and Pantoea species were most common with 3 collection sites of stand bucky-chin support(B,C) and exposure controller(B) accounting for about 11%, and Klebsiella pneumonia, Acinetobacter baumannii, Micrococcus species, Escherichia coli, and Enterobacter species were 1 case respectively, each accounting for 3.5%. Also, the bacteria which did no growth in an incubator after 48 hours were 11 cases, accounting for about 38.
In terms of the distribution of detected bacteria, Stenotrophomonas maltophilia was most common with 2 collection sites of inside of bore B and E hospital accounting for about 9%, and Micrococcus species, Enterococcus faecium, Providencia stuartii, and Gram negative bacilli were found in 1 case respectively, each accounting for 4.5%. Also, the bacteria which did no growth in an incubator after 48 hours were 16 collection sites, accounting for about 73%, and no strains were detected in most places [Table 2].
When a contamination test was performed in 3 places of CT scanner including exposure controller, top of a patient table, and inside of bore, in emergency room of 7 hospitals, more than 1 bacteria were detected in 4 hospitals, and no bacteria were detected in 2 in Seoul, and 1 in Gyeonggi Province. The detected strain of surface contamination were Micrococcus species, Stenotrophomonas maltophilia, Enterococcus faecium, Providencia stuartii, and Gram negative bacilli, which were known to be causal strains of hospital infection, and no strains exhibited unusual phenominon [Table 1].
Consequently, more than 1 bacterial strain were detected in 5 medical facilities, and no bacteria were detected in all placed in 1 seoul and 1 keonggi province. The detected strains of surface contamination were Providencia stuartii, Klebsiella pneumonia, Stenotrophomonas maltophilia, Pantoea species, Acinetobacter baumannii, Micrococcus species, Escherichia coli, Enterobacter species, and other gram negative bacilli, which were known to be causal bacteria of hospital infection, and none of them exhibited unusual phenominon [Table 3].
후속연구
Although detected strains do not exhibit unusual phenomena, radiologists, who are most exposed to the risk of nosocomial infection, should raise awareness of the importance of disinfection, and there should be a change in perception of infection control in hospitals, prioritizing medical staff infection in terms of hospital infection prevention. After further research and to study for the infection to other hospital equipment.
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