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目的:调查国内医院对眼科诊断用接触镜的消毒现状,评估其消毒效果。方法:采用方便抽样的方法对10所医院进行调查,发现氯霉素滴眼液冲洗、75%乙醇搽拭和0.05%的二氯异氰尿酸钠(NaDCC)浸泡是目前我国临床最常用的眼科诊断用接触镜消毒方法。将被金黄色葡萄球菌、表皮葡萄球菌或铜绿假单胞菌污染的眼科检查用接触镜,用上述三种消毒剂按照以下方式进行消毒:1)擦拭;2)浸泡消毒5min;3)浸泡消毒10min,n=9.然后镜面采样,对细菌群落培养并计数以评估细菌量,观察消毒效果。同时评估消毒后镜头的清晰度。结果:细菌负荷量为1×108/mL×50μL/镜头等于5×106/镜头。NaDCC或乙醇消毒显著降低了细菌量;擦拭消毒时,75%的乙醇和NaDCC的消毒效果与氯霉素滴眼液比较差异显著(P≤0.01),但不能达到临床消毒要求,仍然存在交叉感染的风险。浸泡消毒效果与时间正相关,75%的乙醇和NaDCC浸泡10min最有效,能完全达到临床消毒要求,氯霉素滴眼液浸泡10min仍然不能达到临床要求。但乙醇会影响镜头的清晰度。结论:NaDCC浸泡消毒10min或更长时间是一种简单有效的眼科诊断用接触镜消毒方法。
Objective: To investigate the disinfection status of ophthalmology diagnostic contact lenses in domestic hospitals and evaluate its disinfection effect. Methods: Convenient sampling method was used to investigate 10 hospitals. It was found that chloramphenicol eye drops washing, 75% ethanol swab and 0.05% sodium dichloroisocyanurate (NaDCC) soaking were the most commonly used ophthalmology Diagnostic contact lens disinfection methods. The ophthalmic examination contact lens contaminated with Staphylococcus aureus, Staphylococcus epidermidis or Pseudomonas aeruginosa was disinfected with the above three disinfectants in the following manner: 1) wipe; 2) immersion sterilization for 5 minutes; 3) immersion sterilization 10 min, n = 9. Then, the samples were specularly sampled, the bacterial communities were cultured and counted to evaluate the bacterial amount, and the disinfection effect was observed. Also evaluate the sharpness of the lens after disinfection. Results: The bacterial load was 1 × 108 / mL × 50 μL / lens equals 5 × 106 per lens. NaDCC or ethanol disinfection significantly reduced the amount of bacteria; wipe disinfection, 75% ethanol and NaDCC disinfection effect and chloramphenicol eye drops were significantly different (P ≤ 0.01), but can not meet the requirements of clinical disinfection, there are still cross-infection risks of. Soaking disinfection effect is positively correlated with time, 75% ethanol and NaDCC soak 10min the most effective, can fully meet the clinical disinfection requirements, chloramphenicol eye drops soak 10min still can not meet the clinical requirements. But ethanol will affect the clarity of the lens. Conclusion: NaDCC immersion disinfection 10min or longer is a simple and effective contact lens disinfection method for ophthalmology diagnosis.