評估高效能紫消燈裝置應用於環境終期清消之成效

The Effectiveness of High-efficiency Ultraviolet-C Devices for Terminal Environmental Disinfection

評估高效能紫消燈裝置（ultraviolet-C 254nm，以下簡稱高效紫消或UV-C紫消）應用於環境終期消毒後，對環境表面及空氣消毒的有效性，以減少多重抗藥性菌株的散佈。醫院內的醫療器械和環境很容易受到多重抗藥菌的污染，而醫院的環境清潔過程很複雜，因此清潔實踐的效果通常並不理想。它取決於人為因素、環境的物理和化學特性以及微生物的生存能力。2018年4月至2018年6月期間，於中部某醫學中心內科加護病房陸續收集病人轉出/出院之病室環境表面、空氣樣本。於紫消前、紫消後及紫消後加入漂白水程序等三階段的高接觸環境表面，進行同檢測點重複採檢，並以ATP生物冷光檢測法、菌落數計數及菌種種類數目進行分析，及紫消前後空氣菌落數計數及菌種種類數目的評估。
共收集2,110份環境表面樣本，發現紫消前、紫消後及紫消後加入漂白水程序等三階段，在10個高接觸表面採檢點的ATP值檢測、菌落數計數及菌種種類數目分析結果均呈顯著下降。收集144份空氣樣本（含紫消前、後樣本），分析結果皆呈顯著下降：菌落數計數（p<0.001）及菌種種類數目（p=0.0039）。多重抗藥性菌株清除率為93.8%（15/16）。高效能紫消燈裝置應用於病室終期環境消毒，可有效改善環境表面及空氣清潔，減少總菌落量及菌種種類，可做為醫院環境清消的方法，尤其對多重抗藥性菌環境的消毒更具優勢。

Hospital environments and medical devices are prone to contamination by multidrug-resistant bacteria. The effectiveness of environmental cleaning practices in hospitals is often suboptimal due to various factors, including human error, the physical and chemical properties of the environment, and the survival capabilities of microorganisms. This study, conducted from April to June 2018 at a medical center in central Taiwan, involved collecting surface and air samples from patient rooms in the medical intensive care unit during patient discharge or transfer. The samples underwent analysis in three stages: before UV-C treatment, after UV-C treatment, and after UV-C treatment followed by a bleach procedure, to assess the efficacy of disinfecting high-contact surfaces. The analysis included ATP bioluminescence testing, colony counting, and bacterial species identification. Air samples were also evaluated for colony counting and bacterial species identification before and after UV-C treatment.
A total of 2,110 surface samples were collected. The results indicated a significant decrease in ATP values, colony counts, and bacterial species diversity at ten high-contact surface locations across three stages: before UV-C treatment, after UV-C treatment, and after UV-C treatment followed by a bleach procedure. Additionally, 144 air samples, including those taken pre- and post-UV-C treatment, were collected. The findings revealed a significant reduction in colony counts (p < 0.001) and bacterial species diversity (p = 0.0039). The clearance rate for drug-resistant strains reached 93.75%. The use of high-performance UV-C germicidal devices for terminal cleaning in patient rooms markedly improved the cleanliness of environmental surfaces and air by reducing the total colony count and bacterial species. This method should be considered an effective strategy for hospital environmental disinfection, especially in combating drug-resistant bacterial contamination.