内镜管腔细菌生物膜的抵抗性和清除的研究和探讨课件

内镜管腔细菌生物膜的抵抗性和清除的研究和探讨3ThemeGalleryPowerTemplate课题背景研究问题和研究目的技术路线和关键技术课题预计效益3ThemeGalleryPowerTemplate由数百万微生物构成通过产生胞外多糖的方式

粘附在表面生成微菌落（生成各种菌落）最终形成生物膜对抗生素有抵抗性对许多杀菌剂的杀菌作用具有

较高的抵抗力无法通过HLD、常规表面

处理而清除细菌生物膜（biofilm)3ThemeGalleryPowerTemplate2002年美国CDC指出80%人体细菌感染是由生物膜引起的5%患者体内插管滋生生物膜从而引发严重感染DavidG等人在《Science》首次阐述了在生物膜包裹的细菌群中存在一个Cell-to-Cell的信号传导机制：这个机制能够传递生物膜中细菌的耐药性，这个机制依赖于细菌自生的基因易突变特点。如果敲除突变基因，那么生物膜抗杀菌剂的能力就显著下降。K,Vickery等人首次发现在13个活检管腔中的5个以及12个气/水管腔中的9个有明显的细菌生物膜，残留细菌生物膜可导致内镜相关感染。生物膜和医院相关感染Science1998;280:295-7.JournalofHospitalInfection(2004)58,224–2293ThemeGalleryPowerTemplate内镜生物膜检出情况电子显微镜（90×）扫描显示内窥镜送气/水管道表面的生物膜电子显微镜（6344×）扫描显示被生物膜所覆盖的“健康的”细菌，它们能逃脱高水平消毒和灭菌Biofilm(bacteriaplusexopolysaccharidesmatrix)waspresentonthesuction/biopsychannelsoffiveof13instruments,andwasveryextensiveononeofthese.Bacteriaandmicrocolonieswereoftenbutnotnecessarilyassociatedwithsurfacedefectsonthetubing.All12air/waterchannelsexaminedshowedbiofilm,andthiswasextensiveonninesamples.5条内镜活检管路和12条注水注气管路中发现细菌生物膜JournalofHospitalInfection(2004)58,224–2293ThemeGalleryPowerTemplate细菌生物膜对消毒剂抵抗性BiofilmsofaBacillussubtilisHospitalIsolateProtectStaphylococcusaureusfromBiocideActionNDmedical从医疗环境中获得的细菌菌种过氧乙酸对医疗环境中获得的细菌生物膜杀灭能力显著降低无细菌检出vs杀灭对数=3.93ThemeGalleryPowerTemplate研究问题和目的研究问题研究内镜细菌生物膜对目前内镜常用高水平消毒液的抵抗情况,揭示内镜细菌生物膜残留可能导致内镜感染的风险。寻找探索有效清除内镜生物膜污染的方法，从而提高内镜清洗消毒效果研究目的成功建立内镜管路模拟生物膜污染物模型，该模型建立能够用于内镜生物膜相关课题研究，能够作为评价内镜清洗消毒的一个重要评估手段。探索和研究内镜相关高水平消毒剂对内镜管路生物膜模型抵抗性，首次在国内得到相关高水平消毒作用于内镜生物膜杀灭数据，客观指导内镜高水平消毒液的使用。寻找合理正确的清除内镜生物膜的方法，提高临床内镜清洗消毒质量。3ThemeGalleryPowerTemplate对比内镜管腔生物膜模型建立扫描电子显微镜模型评价方法常规微生物培养定性定量模型合格生物膜对高水平消毒液抵抗性研究生物膜清除方法研究不同消毒剂对生物膜模型杀灭能力测定不同消毒剂对细菌悬液杀灭能力测定不同方法对生物膜清除效果评价生物膜对不同消毒剂抵抗性比较评价最佳清除生物膜方法评价有效去除生物膜方法能够减少生物膜对消毒液抵抗3ThemeGalleryPowerTemplate关键技术细菌生物膜培养

建立一个细菌生物膜培养系统，用于培养PVC管路细菌生物膜模型，模型上细菌密度须达到106CFU/cm2以上。SEM电镜观察生物膜结构

能够通过扫描电镜工具成功获得内镜样品以及PVC模拟管路内壁生物膜显微结构。消毒剂抵抗性确认

通过常规微生物培养计数方法获得不同高水平消毒剂对内镜细菌生物膜和细菌悬液杀灭对数数据。3ThemeGalleryPowerTemplate课题预计效益3ThemeGalleryPowerTemplate3ThemeGalleryPowerTemplateDiagramAddyourtitleinhereAddyourtitleinhereAddyourtitleinhereThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.3ThemeGalleryPowerTemplateHotTipHowdoIincorporatemylogotoaslidethatwillapplytoalltheotherslides?

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