內(nèi)鏡管腔細(xì)菌生物膜的抵抗性和清除的研究和探討課件

內(nèi)鏡管腔細(xì)菌生物膜的抵抗性和清除的研究和探討3ThemeGalleryPowerTemplate課題背景研究問(wèn)題和研究目的技術(shù)路線和關(guān)鍵技術(shù)課題預(yù)計(jì)效益3ThemeGalleryPowerTemplate由數(shù)百萬(wàn)微生物構(gòu)成通過(guò)產(chǎn)生胞外多糖的方式

粘附在表面生成微菌落（生成各種菌落）最終形成生物膜對(duì)抗生素有抵抗性對(duì)許多殺菌劑的殺菌作用具有

較高的抵抗力無(wú)法通過(guò)HLD、常規(guī)表面

處理而清除細(xì)菌生物膜（biofilm)3ThemeGalleryPowerTemplate2002年美國(guó)CDC指出80%人體細(xì)菌感染是由生物膜引起的5%患者體內(nèi)插管滋生生物膜從而引發(fā)嚴(yán)重感染DavidG等人在《Science》首次闡述了在生物膜包裹的細(xì)菌群中存在一個(gè)Cell-to-Cell的信號(hào)傳導(dǎo)機(jī)制：這個(gè)機(jī)制能夠傳遞生物膜中細(xì)菌的耐藥性，這個(gè)機(jī)制依賴于細(xì)菌自生的基因易突變特點(diǎn)。如果敲除突變基因，那么生物膜抗殺菌劑的能力就顯著下降。K,Vickery等人首次發(fā)現(xiàn)在13個(gè)活檢管腔中的5個(gè)以及12個(gè)氣/水管腔中的9個(gè)有明顯的細(xì)菌生物膜，殘留細(xì)菌生物膜可導(dǎo)致內(nèi)鏡相關(guān)感染。生物膜和醫(yī)院相關(guān)感染Science1998;280:295-7.JournalofHospitalInfection(2004)58,224–2293ThemeGalleryPowerTemplate內(nèi)鏡生物膜檢出情況電子顯微鏡（90×）掃描顯示內(nèi)窺鏡送氣/水管道表面的生物膜電子顯微鏡（6344×）掃描顯示被生物膜所覆蓋的“健康的”細(xì)菌，它們能逃脫高水平消毒和滅菌Biofilm(bacteriaplusexopolysaccharidesmatrix)waspresentonthesuction/biopsychannelsoffiveof13instruments,andwasveryextensiveononeofthese.Bacteriaandmicrocolonieswereoftenbutnotnecessarilyassociatedwithsurfacedefectsonthetubing.All12air/waterchannelsexaminedshowedbiofilm,andthiswasextensiveonninesamples.5條內(nèi)鏡活檢管路和12條注水注氣管路中發(fā)現(xiàn)細(xì)菌生物膜JournalofHospitalInfection(2004)58,224–2293ThemeGalleryPowerTemplate細(xì)菌生物膜對(duì)消毒劑抵抗性BiofilmsofaBacillussubtilisHospitalIsolateProtectStaphylococcusaureusfromBiocideActionNDmedical從醫(yī)療環(huán)境中獲得的細(xì)菌菌種過(guò)氧乙酸對(duì)醫(yī)療環(huán)境中獲得的細(xì)菌生物膜殺滅能力顯著降低無(wú)細(xì)菌檢出vs殺滅對(duì)數(shù)=3.93ThemeGalleryPowerTemplate研究問(wèn)題和目的研究問(wèn)題研究?jī)?nèi)鏡細(xì)菌生物膜對(duì)目前內(nèi)鏡常用高水平消毒液的抵抗情況,揭示內(nèi)鏡細(xì)菌生物膜殘留可能導(dǎo)致內(nèi)鏡感染的風(fēng)險(xiǎn)。尋找探索有效清除內(nèi)鏡生物膜污染的方法，從而提高內(nèi)鏡清洗消毒效果研究目的成功建立內(nèi)鏡管路模擬生物膜污染物模型，該模型建立能夠用于內(nèi)鏡生物膜相關(guān)課題研究，能夠作為評(píng)價(jià)內(nèi)鏡清洗消毒的一個(gè)重要評(píng)估手段。探索和研究?jī)?nèi)鏡相關(guān)高水平消毒劑對(duì)內(nèi)鏡管路生物膜模型抵抗性，首次在國(guó)內(nèi)得到相關(guān)高水平消毒作用于內(nèi)鏡生物膜殺滅數(shù)據(jù)，客觀指導(dǎo)內(nèi)鏡高水平消毒液的使用。尋找合理正確的清除內(nèi)鏡生物膜的方法，提高臨床內(nèi)鏡清洗消毒質(zhì)量。3ThemeGalleryPowerTemplate對(duì)比內(nèi)鏡管腔生物膜模型建立掃描電子顯微鏡模型評(píng)價(jià)方法常規(guī)微生物培養(yǎng)定性定量模型合格生物膜對(duì)高水平消毒液抵抗性研究生物膜清除方法研究不同消毒劑對(duì)生物膜模型殺滅能力測(cè)定不同消毒劑對(duì)細(xì)菌懸液殺滅能力測(cè)定不同方法對(duì)生物膜清除效果評(píng)價(jià)生物膜對(duì)不同消毒劑抵抗性比較評(píng)價(jià)最佳清除生物膜方法評(píng)價(jià)有效去除生物膜方法能夠減少生物膜對(duì)消毒液抵抗3ThemeGalleryPowerTemplate關(guān)鍵技術(shù)細(xì)菌生物膜培養(yǎng)

建立一個(gè)細(xì)菌生物膜培養(yǎng)系統(tǒng)，用于培養(yǎng)PVC管路細(xì)菌生物膜模型，模型上細(xì)菌密度須達(dá)到106CFU/cm2以上。SEM電鏡觀察生物膜結(jié)構(gòu)

能夠通過(guò)掃描電鏡工具成功獲得內(nèi)鏡樣品以及PVC模擬管路內(nèi)壁生物膜顯微結(jié)構(gòu)。消毒劑抵抗性確認(rèn)

通過(guò)常規(guī)微生物培養(yǎng)計(jì)數(shù)方法獲得不同高水平消毒劑對(duì)內(nèi)鏡細(xì)菌生物膜和細(xì)菌懸液殺滅對(duì)數(shù)數(shù)據(jù)。3ThemeGalleryPowerTemplate課題預(yù)計(jì)效益3ThemeGalleryPowerTemplate3ThemeGalleryPowerTemplateDiagramAddyourtitleinhereAddyourtitleinhereAddyourtitleinhereThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.3ThemeGalleryPowerTemplateHotTipHowdoIincorporatemylogotoaslidethatwillapplytoalltheotherslides?

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