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In recent years, because o-phthalaldehyde has a light smell,Low toxicity, pHValue to adapt to a wide range of characteristics, such as the application of endoscopic processing is more.

The evaluation results are more common in the laboratory sterilization effect.〔1 － 3>> 〕The results of the disinfection treatment of the endoscope are determined by the total number of colonies remaining in the cavity of the endoscope.,Pseudomonas aeruginosa and other pathogenic bacteria as indicator bacteria is more common〔4 － 7>> 〕. In order to observe the simulated field disinfection effect of phthalaldehyde disinfectant on endoscopes, we carried out a simulated field disinfection test in the laboratory, and at the same time carried out continuous use stability observation..The results are reported as follows.

1 Materials and Methods

1. 1Test Materials

Phthalaldehyde disinfectant, produced by a company in Hangzhou, was tested to contain phthalaldehyde.5 880 mg /L,pHValue is 7. 09. Products tested on stainless steel,Aluminum,Copper is substantially non-corrosive,Slightly corrosive to carbon steel, accelerated tests show stability up to two years.Action on spores of Bacillus subtilis var. 7. 0 h, the killing logarithm values are all greater 5. 00; Effect on spores of Bacillus subtilis var. black stained on medical hemostatic forceps carriers14. 0 h, the killing logarithm values are all greater 4. 00After treatment, the number of residual bacteria is ＜10 cfu /Piece.Toxicology tests showed that the disinfectant was actually non-toxic and the micronucleus test was negative..

·265 ·

Chinese Journal of Disinfection 2014;31(6)The experimental endoscopic cleaning and disinfection machine is DSD － 201Fully automatic inside

Mirror decontamination machine, produced by Mingtaike, USA..Endoscopic pipe for simulation is PTFE pipe(OD12 mm, inside diameter 6 mm, length1 000 mm), the carrier for the simulated field sterilization test is PTFE tube (outer diameter6 mm, inside diameter 4 mm, length 4 cm) After degreasing treatment, pressure steam sterilization for standby.

The test index strain was Bacillus subtilis var.(ATCC 9372) Spores, which are provided by the China Microbial Strain Preservation Management Committee, and the bacterial spore suspension is prepared by the laboratory for experimental use, and the number of spores in the bacterial suspension reaches1 × 108 ～5 × 108 cfu /ml.Test neutralizer, qualified by the laboratory, the components are50 g /Ltwain － 80,20 g /LGlycine Tryptone Saline(TPS).

1. 2

Test Method

1. 2. 1preparation of bacterial carrierTake0. 02 mlThe spore suspension is dripped and stained on the inner wall of the carrier, smeared evenly, and placed. 54°CDry in incubator approx.30 min, made into infected bacteria carrier for standby.
2. 1. 2. 2

Cleaning, Disinfection and Detection Methods of Endoscope

Refer to Ministry of Health2003 Year Edition《Technical specification for disinfection effect inspection of endoscope cleaning and disinfecting machine》The requirements of the test, in accordance with the standard cleaning and disinfection machine procedures and manual cleaning and disinfection operation procedures, to the gastroscope as the processing object..①Cleaning procedure for cleaning and disinfecting machineSimulated field disinfection test and continuous use stability test of endoscopes.In Simulated Endoscopic Duct50 mm,500 mmand 950 mmCut the place and place the infected bacteria carrier.a,b,cAt the cutting place, install the simulated endoscope pipe at the position specified in the cleaning and disinfecting machine, and treat it according to the disinfection procedure specified in the instruction manual. See the table for the set procedure. 1. PointsDo not use a concentration of 5 880 mg /Land3 000 mg /Lo-phthalaldehyde disinfection2 Group test.After disinfection, take out the carrier with sterile tweezers,

placed separately containing 10 mlIn the test tube of the neutralizer solution, after full elution, the residual bacteria are recovered and counted by pouring method..At the same time, the bacteria carrier placed at room temperature was used as a positive control group to count viable bacteria to test the same batch of neutralizers.,Negative control for diluent, etc..Test Repeat 9 times.The continuous use stability test is the combination of o-phthalaldehyde and DSD－ 201The full-automatic endoscope decontamination machine is used to disinfect the gastroscope. The set disinfection procedure is the same as the table. 1, and record the number of endoscopes processed one by one.In the continuous use of No. 7,14 dThe disinfectant was collected to test the content of o-phthalaldehyde, and then 14 dSimulated disinfection test of endoscopes.②Manual operation simulation field disinfection test: By Table2 Set manual cleaning and disinfection procedures for disinfection..After treatment, the carriers were placed in 10 mlNeualizer in the test tube, after full elution, by pouring method for residual bacteria recovery count.At the same time, the infected carrier placed at room temperature was counted as a positive control to test the neutralizer of the same batch.,Negative control for diluent, etc..Test Repeat 9 Times.

2 Results

2. 1Simulation test results of cleaning and disinfecting machine 9 The second repeat test showed that. 5 880 mg /Land3 000 mg /Lof o-phthalaldehyde disinfectant DSD － 201Full-automatic endoscope decontamination machine is used to set the program action for one cycle. 25. 5 min(Disinfectant soak5 min), on the black variant bud of Bacillus subtilis placed on the polytetrafluoroethylene-infected bacteria carrier in the simulated endoscope

The logarithmic mean of spore kill was 4. 88,4. 12The number of residual bacteria after treatment was ＜10 ～ 20 cfu /Pieces and 10 ～ 95 cfu /pieces, each testThe number of bacteria recovered in the positive control was7. 20 × 105 ～9. 17 × 105 cfu /Piece.

with a concentration 5 880 mg /LThe disinfectant of o-phthalaldehyde is used in conjunction with the machine for continuous use. 7,14 dAfter that, the content of o-phthalaldehyde was4 590 mg /Land3 960 mg /L, handling endoscopes daily during use 4 ～ 10Piece,Cumulative 81 PieceThe simulated field sterilization test with this concentration of phthalaldehyde solution can achieve the sterilization effect.

·365 · Chinese Journal of Disinfection2014 Year No. 31 Volume No. 6 PeriodRequirements.

2. 2

Results of manual operation simulation field disinfection test 9 The second repeat test shows that one cycle is used to set the program.18. 5 min(3 000 mg /LDisinfectant immersion of o-phthalaldehyde5 min), the mean value of the elimination of Bacillus subtilis black variant spores placed on a polytetrafluoroethylene-infected carrier in a simulated endoscope is 4. 65.,The number of residual bacteria after treatment 20 ～ 175 cfu /Pieces, each test

The number of positive control recovered bacteria was 3. 60 × 106 ～4. 23 × 106cfu /Piece.

3 Discussion

The application of o-phthalaldehyde in endoscopic disinfection treatment has been reported to be more common, mainly to the number of bacterial colonies or pathogenic bacteria remaining in the endoscope after treatment.

Detection or laboratory test results are given priority to, on its endoscopic machine wash,Validity of continuous use of hand wash treatment,The treatment effect of bacterial spore-contaminated simulated endoscopes is still rare..The results of this study show that using the concentration5 880 mg /LThe elimination of Bacillus subtilis black variant spores on the bacteria carrier in the simulated endoscopic body is greater than the elimination of the phthalaldehyde disinfectant solution according to the procedure set by the cleaning and disinfecting machine.4. 0.The concentration of o-phthalaldehyde disinfectant is used continuously in the cleaning and disinfecting machine according to the treatment procedure. 14 d,Cumulative processing 81 pieces of gastroscopy, after o-phthalaldehyde content from5 880 mg /LDropped3 960 mg /L, but this thick

Degree to Bacillus subtilis black variant spore killing value is still 4. 12. Endoscopic simulation field test with manual operation,3 000 mg /Lo-phthalaldehyde disinfectant can meet the above disinfection effect requirements. This study found that the disinfection effect of bacterial spores on bacterial carriers in simulated endoscopes was the degree of drying after infection.,Effective concentration of enzyme lotion,Blow-out frequency of enzyme lotion and disinfectant immersion,Influence of water pressure and flow rate during water flushing.contamination vector in 37 ℃When dried under the same conditions, the elimination effect of bacterial spores after treatment with the same procedure was significantly higher than that of the infected carrier. 54°Cconditions of drying, this 54°CUnder the condition of drying, the bacterial liquid may be hard,The combination with the carrier is not easy to eliminate, or. 37 ℃The phenomenon of spore sprouting or semi-sprouting during drying under conditions is related to the obvious decrease in resistance to various disinfection factors, which needs further observation and study..In the process of hand washing, the simulated endoscopic body is only used in the enzyme washing solution.,Soak in disinfectant or only3 The elimination of spores is generally not more than the value of the purge within the second time. 2. 0(elimination rate not higher99%), this and phthalaldehyde have a weak bactericidal effect on spores,It takes a long time to relate.3,4>> 〕.Based on this phenomenon, o-phthalaldehyde in the use of endoscopic disinfection treatment process, especially in hand washing mode, need to be strictly in accordance with the set procedures for processing, especially need to pay attention to enzyme lotion,Repeated purging during soaking of disinfectant,Brushing steps to ensure endoscopic body with enzyme lotion,Disinfectant fully contact, remove the surface contamination of organic matter,Microorganisms to ensure disinfection effect.

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