Study On The Terminal Sterilization Methods Of Laminar Flow Bioclean Ward

Backgrounds: After high doses of radiotherapy and chemotherapy, patients withempty bone marrow of immunosuppression state are extremely easy to get all sorts ofcomplications, such as infections. If can’t be prevented and controlled well, they notonly affect the success of stem cell transplantation and immune reconstruction, butthreaten patients’ lives. So the total environmental protection for the patients oftransplantation is very important.Laminar air flow bioclean room (LAFR) is the crucial condition of protectiveisolation for the patients undergoing hematopoietic stem cell transplantation. Atpresent, there’s not a unified processing of terminal disinfection for LAFR indomestic, the traditional method is fumigating peracetic acid combining surfacewiping with disinfectants such as active chlorine. Research shows that peracetic acidnot only can damage the eyes and mucous membrane but also has some of thecorrosive. At the same time, active chlorine has the characters of irritating andunstable.There are also some relevant reports about total environmental protection fordomestic transplant ward, but there is no a builded normative system and furtherstudies about terminal disinfects processing is not available now.Objectives：The propose of this study is to change the traditional method offumigation and to find a new way of terminal disinfection for LAFR which is not onlysimple, feasible, economic and safe but also has less damage to patients, medicalstaffs and environment in order to ensure the LAFR’ cleanliness, to provide a moresecurity and more sterile environment, to reduce the incidence of infections, to helppatients survival from suppression period of bone marrow and immune smoothly, toimprove patient’s life quality and rehabilitation and finally to avoid the waste ofMedical resources and reduce the hospitalization costs.Methods：Two groups of LAFR with different terminal disinfections were analyzed inthe current study. In control group, the LAFR were fumigated with peracetic acid andwiped by active Chlorine，while in experimental group the LAFR were wiped bycompound quaternary ammonium salt and disinfected by the air laminar flow.Colony-Forming Units of air settlement and wiped object surface were compared. And the patient’s fever time in the same period of two groups by randomized selectedwas compared as well. Further more, the colony was cultured, and analyzed the typesof common bacteria in LAFR. Meanwhile, the Correlation between the types ofbacteria which was brought by patients after medicated bath in LAFR and the resultsof blood culture when they have fever. And then we compare the types of bacteria,fever time and the relationship among the three. Finally, time consuming and the bedturnover ratio of the two terminal disinfection methods were figured out to analyzeeconomic effects.Results: Colony-Forming Units of air settlement of the central area and thesurrounding area in LAFR of the two groups are no significant difference, and the Pvalues were0.60and0.89, respectively. Colony-Forming Units of wiped objectsurface in LAFR of two groups are no evident difference, either (P=0.98). Fever timeof patients with leukemia and severe aplastic anemia treated with ATG was nosignificantly different (P=0.54). The common kinds of bacteria in LAFR of ourhospital are solidifying enzyme negative grapes bacteria (staphylococcus epidermidis),coryneform bacteria, bacillus subtilis, etc, which widely distribution in air and thehuman bodies. At present, the normal bacteria that cause fever in LAFR of ourhospital are almost the conditions pathogenic bacteria which carried by the patientsthemselves. If LAFR operate is normal and take maintenance regularly, it can makesure the cleanliness of air and therefore can not be the main factors of infections. Thebeds turnover rates of control and experiment groups are147.8%and145.6%,respectively. Thus the experiment group provides more treatment opportunity forpatients, reduce the risk of infection and the cost of hospital, and to create a bettersocial value.Conclusion: After analyzing the experimental and control groups, we can see thatwiping with compound quaternary ammonium salt and disinfected by the air laminarflow can be an effective way of terminal disinfection for LAFR. This method is notonly simple, convenient and feasible, but also has less damage to patients and medicalstaffs. Besides, it can significantly increase the beds turnover rate.