某區域教學醫院醫療人員手機消毒前後細菌移生情形探討

Bacterial Colonization on Medical Staff’s Cell Phones and The Benefits of Disinfection in A Regional Teaching Hospital

在醫療環境中院內感染的發生無法避免，但是由醫源性造成之感染是可以被預防的，醫療入員隨身之手機，已經成為上班時不可或缺的配備，手機雖非無菌物品，但是手機表面細菌移生情形確實存在。本研究主要目的，在於了解醫療人員隨身攜帶手機細菌移生情形及使用70%酒精消毒後之效益，藉由採取研究對象共107人，手機消毒前、後之檢體數為214並進行採檢培養。配合問卷調查、卡方檢定等統計結果得知，消毒前採集手機共107支，有106支手機培養出細菌，培養陽性率為99.1%，總菌株數共171株，大部分是表皮的固有細菌，但也包含：Staphylococcus aureus、glucosenon-fermentation Gram（-）bacilli及Escherichia coli等致病性細菌；消毒後採集手機共107支，有66支手機培養出細菌，培養陽性率為61.7%，總菌株數共80株；而在消毒前、後細菌之菌落數下降率為92.3%，相同細菌名稱平均菌落數顯著降低（尸<0.05）。問卷部分學歷、性別、年齡對於手機清潔相關習慣無顯著差異，但資料分析顯示每天在醫院接手機頻率最高的主治醫師及醫務助理，本身對隨身使用物品可能帶菌之警戒心並不足。依目前現行之醫院感染管制政策，著重於醫院環境的清潔與消毒，對於工作人員於每天手部頻繁接觸的工具卻被忽略，此研究的結果再次驗證接觸病人前後洗手的重要性。

Nosocomial infections occurring in the medical environment are unavoidable, but infections caused by iatrogenic factors can be avoided. Cell phones for the medical staff are indisppensable at work. A high number of bacteria colonize cell phone surfaces. The purpose of this study was to determine the bacterial colonization on medical staff ' s cell phones and the benefit of using 70% alcohol for disinfection. A total of 107 staff were recruited and a total of 214 specimens were obtained before and after disinfection. Of the 107 cell phones sampled, a total of 171 bacterial isolates were identified from 106 cell phones (positive rate, 99.1%). Of these isolates, the majority was resident flora of the skin. However, some pathogenic bacteria such as Staphylococcus aureus, glucose non-fermenting gram-negative bacilli, and Escherichia coli were also identified. After disinfection, bacterial colonization was noted on 66 cell phones (positive rate, 61.7%) with 80 bacterial isolates identified. Compared to that before disinfection, the bacterial count of any particular species reduced by about 92.3% (P < 0.05) after disinfection. The survey indicated that the academic degree, gender, and age of the staff did not show any relationship with the habit of disinfecting cell phones. However, the data showed that attending physicians and medical assistants, who use cell phones most, did not pay attention to the bacterial colonization on cell phones. The present hospital infection control policy emphasizes on disinfection and cleanliness of the hospital environment but ignores the articles touched everyday. Therefore, this study highlights the importance of disinfection and washing hands for the management and administration of nosocomial infections.