医院重症监护病房细菌气溶胶浓度水平影响因素研究
摘要：为研究影响医院重症监护病房(ICU)内细菌气溶胶浓度水平的影响因素，对若干医院ICU内的细菌气溶胶浓度和粒子数进行了监测和分析。结果表明：在实际使用过程中，设置净化器的万级净化室内环境中细菌气溶胶浓度水平在万级和十万级净化要求之间；无论是否设置净化器，有人员活动组的细菌气溶胶浓度均高于无人员活动组，在有人员活动情况下，净化器可快速有效降低细菌气溶胶浓度水平；有人员活动组的细菌中值直径大于无人员活动组，有人员活动会增加大颗粒物数量；ICU环境中细菌气溶胶浓度与粒径≥0.5μm粒子数、粒径≥5μm粒子数之间均有显著关联性。
关键词：医院重症监护病房ICU)净化器细菌气溶胶浓度粒子数人员活动
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[2] MAGIRA E E,ISLAM S,NIEDERMAN M S.Multi-drug resistant organism infections in a medical ICU:association to clinical features and impact upon outcome[J].Medicina intensiva,2018,42:225- 234.
[3] ARIZA X,CASTELLOTE J,LORA-TAMAYO J,et al.Risk factors for resistance to ceftriaxone and its impact on mortality in community,healthcare and nosocomial spontaneous bacterial peritonitis[J].Journal of hepatology,2012,56(4):825- 832.
[4] TSAY M D,TSENG C C,WU N X,et al.Size distribution and antibiotic—resistant characteristics of bacterial bioaerosol in intensive care unit before and during visits to patients[EB/OL].[2020-08-11].https://doi.org/10.1016/j.envint.2020.106024.
[5] HE C,MACKAY I M,RAMSAY K,et al.Particle and bioaerosol characteristics in a paediatric intensive care unit[J].Environment international,2017,107:89- 99.
[6] TANG C S,CHUNG F F,LIN M C,et al.Impact of patient visiting activities on indoor climate in a medical intensive care unit:a 1-year longitudinal study[J].American journal of infection control,2009,37(3):183- 188.
[7] 赖文娇.重症监护病房空气微生物检测和净化效果的评价[D].广州：广州医科大学，2020:25- 27.
[8] 室内空气品质标准[EB/OL].(2012-11-23)[2021-06-01].http://www.docin.com/p-615388610.htm1.
[9] JO W K,SEO Y J.Indoor and outdoor bioaerosol levels at recreation facilities,elementary schools,and homes[J].Chemosphere,2005,61(11):1570- 1579.
[10] Institute of Environment Epidemiology.Guidelines for good indoor air quality in office premises[S].Singapore:Ministry of the Environment,1996:44.
[11] 香港特别行政区政府室内空气质素管理小组.办公室及公众场所室内空气质素管理指引[R].香港特别行政区：香港特别行政区政府室内空气质素管理小组，2019:20.
[12] ASIF A,ZEESHAN M,HASHMI I,et al.Microbial quality assessment of indoor air in a large hospital building during winter and spring seasons[J].Building and environment,2018,135:68- 73.
[13] 中国疾病预防控制中心环境与健康相关产品安全所，中国环境科学研究院环境标准研究所，中国疾病预防控制中心辐射防护安全所，等.室内空气质量标准：GB/T 18883—2002[S].北京：中国标准出版社，2003:3.
[14] 中国疾病预防控制中心环境与健康相关产品安全所，江苏省疾病预防控制中心，黑龙江省卫生监管所，等.公共场所卫生指标及限值要求：GB 37488—2019[S].北京：中国标准出版社，2019:3.
[15] 中国疾病预防控制中心环境与健康相关产品安全所.公共场所卫生检验方法第3部分：空气微生物：GB/T 18204.3—2013[S].北京：中国标准出版社，2013:2- 3.
[16] 中国建筑科学研究院.医院洁净手术部建筑技术规范：GB 50333—2013[S].北京：中国建筑工业出版社，2013:43- 47.
[17] HSU Y C,KUNG P Y,WU T N,et al.Characterization of indoor-air bioaerosols in southern Taiwan[J].Aerosol and air quality research,2012,12(4):651- 661.
[18] 张金萍，张翠林，王智，等.北京地区医院建筑冬季室内微生物气溶胶浓度水平及暴露评价[J].建筑科学，2020,36(8):180- 186.
Influencing factors of bacterial aerosol concentration level in hospital intensive care units
Abstract: In order to study the environmental factors that affect the concentration of bacterial aerosol in the hospital intensive care unit(ICU), the concentration and particle number of the bacterial aerosol in the ICUs of several hospitals are monitored and analysed. The results show that the bacterial aerosol concentration level in the 10 000-level purification indoor environment of the purifier during actual use is between the 10 000-level and 100 000-level purification requirements. Regardless of whether a purifier is installed, the concentration of bacterial aerosol in the group with personnel activities is higher than that without personnel activities. In the case of personnel activities, the purifier can quickly and effectively reduce the concentration level of bacterial aerosol. The median diameter of bacteria in the group with personnel activities is larger than that in the group without personnel activities, and the activities of personnel will increase large particles. There is a significant correlation between the bacterial aerosol concentration and the number of particles ≥0.5 μm and ≥5 μm in the ICU environment.
Keywords: hospital; intensive care unit(ICU); purifier; bacterial aerosol; concentration; particle number; personnel activity;
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