內鏡管腔細菌生物膜的抵抗性和清除的研究和探討3ThemeGalleryPowerTemplate課題背景研究問題和研究目的技術路線和關鍵技術課題預計效益3ThemeGalleryPowerTemplate由數百萬微生物構成通過產生胞外多糖的方式

粘附在表面生成微菌落（生成各種菌落）最終形成生物膜對抗生素有抵抗性對許多殺菌劑的殺菌作用具有

較高的抵抗力無法通過HLD、常規表面

處理而清除細菌生物膜（biofilm)3ThemeGalleryPowerTemplate2002年美國CDC指出80%人體細菌感染是由生物膜引起的5%患者體內插管滋生生物膜從而引發嚴重感染DavidG等人在《Science》首次闡述了在生物膜包裹的細菌群中存在一個Cell-to-Cell的信號傳導機制：這個機制能夠傳遞生物膜中細菌的耐藥性，這個機制依賴于細菌自生的基因易突變特點。如果敲除突變基因，那么生物膜抗殺菌劑的能力就顯著下降。K,Vickery等人首次發現在13個活檢管腔中的5個以及12個氣/水管腔中的9個有明顯的細菌生物膜，殘留細菌生物膜可導致內鏡相關感染。生物膜和醫院相關感染Science1998;280:295-7.JournalofHospitalInfection(2004)58,224–2293ThemeGalleryPowerTemplate內鏡生物膜檢出情況電子顯微鏡（90×）掃描顯示內窺鏡送氣/水管道表面的生物膜電子顯微鏡（6344×）掃描顯示被生物膜所覆蓋的“健康的”細菌，它們能逃脫高水平消毒和滅菌Biofilm(bacteriaplusexopolysaccharidesmatrix)waspresentonthesuction/biopsychannelsoffiveof13instruments,andwasveryextensiveononeofthese.Bacteriaandmicrocolonieswereoftenbutnotnecessarilyassociatedwithsurfacedefectsonthetubing.All12air/waterchannelsexaminedshowedbiofilm,andthiswasextensiveonninesamples.5條內鏡活檢管路和12條注水注氣管路中發現細菌生物膜JournalofHospitalInfection(2004)58,224–2293ThemeGalleryPowerTemplate細菌生物膜對消毒劑抵抗性BiofilmsofaBacillussubtilisHospitalIsolateProtectStaphylococcusaureusfromBiocideActionNDmedical從醫療環境中獲得的細菌菌種過氧乙酸對醫療環境中獲得的細菌生物膜殺滅能力顯著降低無細菌檢出vs殺滅對數=3.93ThemeGalleryPowerTemplate研究問題和目的研究問題研究內鏡細菌生物膜對目前內鏡常用高水平消毒液的抵抗情況,揭示內鏡細菌生物膜殘留可能導致內鏡感染的風險。尋找探索有效清除內鏡生物膜污染的方法，從而提高內鏡清洗消毒效果研究目的成功建立內鏡管路模擬生物膜污染物模型，該模型建立能夠用于內鏡生物膜相關課題研究，能夠作為評價內鏡清洗消毒的一個重要評估手段。探索和研究內鏡相關高水平消毒劑對內鏡管路生物膜模型抵抗性，首次在國內得到相關高水平消毒作用于內鏡生物膜殺滅數據，客觀指導內鏡高水平消毒液的使用。尋找合理正確的清除內鏡生物膜的方法，提高臨床內鏡清洗消毒質量。3ThemeGalleryPowerTemplate對比內鏡管腔生物膜模型建立掃描電子顯微鏡模型評價方法常規微生物培養定性定量模型合格生物膜對高水平消毒液抵抗性研究生物膜清除方法研究不同消毒劑對生物膜模型殺滅能力測定不同消毒劑對細菌懸液殺滅能力測定不同方法對生物膜清除效果評價生物膜對不同消毒劑抵抗性比較評價最佳清除生物膜方法評價有效去除生物膜方法能夠減少生物膜對消毒液抵抗3ThemeGalleryPowerTemplate關鍵技術細菌生物膜培養

建立一個細菌生物膜培養系統，用于培養PVC管路細菌生物膜模型，模型上細菌密度須達到106CFU/cm2以上。SEM電鏡觀察生物膜結構

能夠通過掃描電鏡工具成功獲得內鏡樣品以及PVC模擬管路內壁生物膜顯微結構。消毒劑抵抗性確認

通過常規微生物培養計數方法獲得不同高水平消毒劑對內鏡細菌生物膜和細菌懸液殺滅對數數據。3ThemeGalleryPowerTemplate課題預計效益3ThemeGalleryPowerTemplate3ThemeGalleryPowerTemplateDiagramAddyourtitleinhereAddyourtitleinhereAddyourtitleinhereThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.ThemeGalleryisaDesignDigitalContent&ContentsmalldevelopedbyGuildDesignInc.3ThemeGalleryPowerTemplateHotTipHowdoIincorporatemylogotoaslidethatwillapplytoalltheotherslides?

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