| Summary: | 碩士 === 元培醫事科技大學 === 環境工程衛生系碩士班 === 105 === The health care institute is one of the major reservoirs for pathogenic microorganisms that may be related to health associated infections (HAI). In this study, Real-time Quantitative Polymerase Chain Reaction (Real-time PCR) was applied to build an assessment platform of disinfection efficiency in wards and investigate the effects of different disinfection patterns on the environmental distribution of pathogens. One respiratory care center (RCC) and one medical intensive care unit (MICU) of a regional teaching hospital located in Hsinchu were enrolled in this study. The RCC only performs final disinfection after the patient discharged from the bed. In addition to the terminal disinfection, the MICU also performs daily cleaning. Surface samples were collected by standard procedures from many instruments or equipment in two wards after disinfection of sickbeds. After extraction of nucleic acid, Real-time PCR technique was applied to determine the absolute concentrations of Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Staphylococcus aureus. The results showed that positions with peak concentrations of each measured bacterial pathogens in MICU and RCC were: Acinetobacter baumannii on the knob of sputum drawing (MICU: 3.5 pg / cm2, RCC: 1.5 pg / cm2); Escherichia coli on the knobs of sputum drawing (MICU: 10 pg / cm2, RCC: <0.5 pg / cm2); Klebsiella pneumoniae on the stethoscopes in MICU (0.03 pg / cm2) and on the knobs of sputum drawing in RCC (0.3 pg / cm2); Pseudomonas aeruginosa on the stethoscopes in MICU (20 pg / cm2) and on the knobs of sputum drawing in RCC (12 pg / cm2); Staphylococcus aureus on the stethoscopes in MICU (2 pg / cm2) and on the knob of sputum drawing in RCC (8 pg / cm2). In the RCC ward (only performs final disinfection), concentrations of bacteria on surface samples decreased gradually with the day after final disinfection. This trend reveals that five common pathogens may not be the dominant species in the RCC ward. Both final disinfection and daily cleaning were performed in MICU; however, concentrations of five measured bacteria on surfaces of various equipment increased with the days after final disinfection. This result indicates that five common pathogens may be the dominant species in the environment. It suggests that the hospital should perform more comprehensive disinfection procedure in MICU ward.
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