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Muhalli mai gurɓataccen yanayi yana taka muhimmiyar rawa wajen yaɗuwar ƙwayoyin cuta masu jure wa magunguna da yawa (MDR) da kuma C. difficile. Manufar wannan binciken ita ce a tantance tasirin ozone da wani reactor na plasma mai jure wa dielectric barrier discharge (DBD) ke samarwa akan aikin Enterococcus faecalis mai jure wa vancomycin (VRE), Klebsiella pneumoniae mai jure wa carbapenem (CRE), Carbapenem mai jure wa ƙwayoyin cuta na kayan daban-daban da aka gurbata da Pseudomonas spp. Pseudomonas aeruginosa (CRPA), Acinetobacter baumannii mai jure wa carbapenem (CRAB) da Clostridium difficile spores. An yi wa kayan da aka gurbata da VRE, CRE, CRPA, CRAB da C. difficile spores magani da ozone a wurare daban-daban da lokutan fallasa. Microscopy na ƙarfin atomic (AFM) ya nuna canjin saman ƙwayoyin cuta bayan maganin ozone. Lokacin da aka shafa maganin ozone na ppm 500 a kan VRE da CRAB na tsawon mintuna 15, an lura da raguwar kimanin log10 ko fiye a cikin bakin karfe, yadi da itace, kuma an lura da raguwar log10 1-2 a cikin gilashi da filastik. An gano cewa ƙwayoyin C. masu wahala sun fi juriya ga ozone fiye da duk sauran halittu da aka gwada. A kan AFM, bayan an yi musu magani da ozone, ƙwayoyin cuta sun kumbura kuma sun lalace. Ozone da DBD Plasma Reactor ke samarwa kayan aiki ne mai sauƙi kuma mai mahimmanci na kawar da gurɓataccen abu ga ƙwayoyin MDRO da C. masu wahala, waɗanda aka san su a matsayin ƙwayoyin cuta da suka zama ruwan dare gama gari na kamuwa da cuta da ke da alaƙa da kiwon lafiya.
Bayyanar ƙwayoyin cuta masu jure wa magunguna da yawa (MDR) yana faruwa ne sakamakon amfani da magungunan kashe ƙwayoyin cuta a cikin mutane da dabbobi ba bisa ƙa'ida ba, kuma Hukumar Lafiya ta Duniya (WHO) ta gano cewa babban barazana ce ga lafiyar jama'a1. Musamman ma, cibiyoyin kiwon lafiya suna fuskantar ƙaruwar kamuwa da cutar MRO. Manyan MRO sune Staphylococcus aureus mai jure wa methicillin da enterococcus mai jure wa vancomycin (VRE), enterobacteria mai samar da beta-lactamase (ESBL), Pseudomonas aeruginosa mai jure wa magunguna da yawa, Acinetobacter baumannii mai jure wa magunguna da yawa, da Enterobacter mai jure wa carbapenem (CRE). Bugu da ƙari, kamuwa da cutar Clostridium difficile babban abin da ke haifar da gudawa da ke da alaƙa da kiwon lafiya, yana sanya babban nauyi ga tsarin kiwon lafiya. Ana ɗaukar MDRO da C. difficile ta hannun ma'aikatan kiwon lafiya, muhallin da ya gurɓata, ko kai tsaye daga mutum zuwa mutum. Binciken da aka yi kwanan nan ya nuna cewa gurɓatattun wurare a wuraren kiwon lafiya suna taka muhimmiyar rawa wajen yaɗa cutar MDRO da C. wahala lokacin da ma'aikatan kiwon lafiya (HCWs) suka haɗu da gurɓatattun wurare ko kuma lokacin da marasa lafiya suka haɗu kai tsaye da gurɓatattun wurare 3,4. gurɓatattun wurare a wuraren kiwon lafiya suna rage yawan kamuwa da cutar MLRO da C. mai wahala ko kuma mamaye wurare 5,6,7. Ganin damuwar duniya game da ƙaruwar juriya ga ƙwayoyin cuta, a bayyane yake cewa ana buƙatar ƙarin bincike kan hanyoyi da hanyoyin kawar da gurɓatattun abubuwa a wuraren kiwon lafiya. Kwanan nan, an gane hanyoyin tsaftace wuraren da ba sa taɓawa, musamman kayan aikin ultraviolet (UV) ko tsarin hydrogen peroxide, a matsayin hanyoyin kawar da gurɓatattun abubuwa masu kyau. Duk da haka, waɗannan na'urorin UV ko hydrogen peroxide da ake samu a kasuwa ba wai kawai suna da tsada ba ne, kashe ƙwayoyin UV yana da tasiri ne kawai a kan gurɓatattun wurare, yayin da kashe ƙwayoyin hydrogen peroxide na plasma yana buƙatar lokaci mai tsawo kafin zagayowar kashe ƙwayoyin cuta ta gaba5.
Ozone yana da kaddarorin hana lalata kuma ana iya samar da shi cikin rahusa8. Hakanan an san shi da guba ga lafiyar ɗan adam, amma yana iya ruɓewa cikin sauri zuwa iskar oxygen 8. Na'urorin samar da wutar lantarki na plasma na Dielectric barrier discharge (DBD) sune mafi yawan masu samar da ozone9. Kayan aikin DBD suna ba ku damar ƙirƙirar plasma mai ƙarancin zafi a cikin iska da kuma samar da ozone. Har zuwa yanzu, amfani da ozone a aikace ya takaita ne kawai ga tsaftace ruwan wanka, ruwan sha da najasa10. Bincike da yawa sun ba da rahoton amfani da shi a wuraren kiwon lafiya8,11.
A cikin wannan binciken, mun yi amfani da ƙaramin injin samar da ozone na DBD na plasma don nuna ingancinsa wajen share MDRO da C. difficile, har ma da waɗanda aka yi wa allurar rigakafi a kan kayayyaki daban-daban da aka saba amfani da su a wuraren kiwon lafiya. Bugu da ƙari, an fayyace tsarin sterilization na ozone ta amfani da hotunan ƙwayoyin da aka yi wa ozone magani ta hanyar amfani da na'urar hangen nesa ta atomic force microscopy (AFM).
An samo nau'ikan daga ƙwayoyin cuta na asibiti kamar: VRE (SCH 479 da SCH 637), Klebsiella pneumoniae mai jure wa carbapenem (CRE; SCH CRE-14 da DKA-1), Pseudomonas aeruginosa mai jure wa carbapenem (CRPA; 54 da 83) da ƙwayoyin cuta masu jure wa carbapenem. ƙwayoyin cuta Pseudomonas aeruginosa (CRPA; 54 da 83). Acinetobacter baumannii mai jure wa (CRAB; F2487 da SCH-511). An samo C. difficile daga Ƙungiyar Al'adu ta Ƙasa (NCCP 11840) ta Hukumar Kula da Cututtuka da Rigakafin Koriya. An ware shi daga wani majiyyaci a Koriya ta Kudu a shekarar 2019 kuma an gano cewa yana cikin ST15 ta amfani da nau'in jerin abubuwa masu yawa. An gauraya ruwan miyar da aka yi wa allurar VRE, CRE, CRPA da CRAB sosai sannan aka saka a zafin jiki na 37°C na tsawon awanni 24.
An shafa C. difficile a kan agar jini na tsawon awanni 48. Daga nan aka ƙara wasu ƙwayoyin cuta a cikin ruwan zuciya na 5 ml sannan aka saka shi a cikin yanayin rashin lafiyar jiki na tsawon awanni 48. Bayan haka, an girgiza al'adar, an ƙara ethanol 5 ml na 95%, an sake girgiza shi sannan aka bar shi a zafin ɗaki na minti 30. Bayan an saka shi a 3000 g na minti 20, a jefar da ruwan da ke cikinsa sannan a daka shi a cikin 0.3 ml na ruwa. An ƙirga ƙwayoyin da ke rayuwa ta hanyar shuka ƙwayoyin cuta a kan faranti na agar jini bayan an narkar da su yadda ya kamata. Tabon gram ya tabbatar da cewa kashi 85% zuwa 90% na tsarin ƙwayoyin cuta spores ne.
An gudanar da wannan bincike ne don bincika tasirin ozone a matsayin maganin kashe ƙwayoyin cuta a wurare daban-daban da suka gurɓata da ƙwayoyin cuta na MDRO da C. masu wahala, waɗanda aka san suna haifar da cututtuka masu alaƙa da kiwon lafiya. Shirya samfuran ƙarfe mai bakin ƙarfe, yadi (auduga), gilashi, filastik (acrylic), da itace (pine) waɗanda suke auna santimita ɗaya da santimita ɗaya. Ana kashe takardun kashe ƙwayoyin cuta kafin amfani. An tsaftace duk samfuran ta hanyar amfani da autoclave kafin kamuwa da ƙwayoyin cuta.
A cikin wannan binciken, an bazu ƙwayoyin cuta a saman substrate daban-daban da kuma a kan faranti na agar. Sannan ana tsaftace bangarorin ta hanyar fallasa su ga ozone na wani lokaci kuma a wani yanki mai rufewa. A hoto na 1 akwai hoton kayan aikin tsarkake ozone. An ƙera reactors na DBD plasma ta hanyar haɗa electrodes ɗin bakin ƙarfe da aka huda da kuma waɗanda aka fallasa zuwa gaba da bayan faranti na alumina (dielectric) mai kauri mm 1. Ga electrodes ɗin da aka huda, yankin buɗewa da ramin sun kasance mm 3 da 0.33 mm, bi da bi. Kowace electrode tana da siffar zagaye mai diamita na mm 43. An yi amfani da wutar lantarki mai yawan ƙarfin lantarki mai yawa (GBS Elektronik GmbH Minipuls 2.2) don amfani da ƙarfin sinusoidal na kusan 8 kV kololuwa zuwa kololuwa a mita na 12.5 kHz zuwa ga electrodes ɗin da aka huda don samar da plasma a gefunan electrodes ɗin. electrodes ɗin da aka huda. Tunda fasahar hanyar tace iskar gas ce, ana yin tacewa a cikin ɗaki da aka raba ta da girma zuwa manyan sassa na sama da ƙasa, waɗanda ke ɗauke da samfuran da suka gurɓata ƙwayoyin cuta da kuma janareto na plasma, bi da bi. Sashen sama yana da tashoshin bawul guda biyu don cirewa da kuma fitar da iskar ozone da ya rage. Kafin amfani da shi a cikin gwajin, an auna canjin lokacin yawan ozone a cikin ɗakin bayan kunna shigarwar plasma bisa ga yanayin sha na layin spectral na 253.65 nm na fitilar mercury.
(a) Tsarin gwajin da aka yi don tsaftace ƙwayoyin cuta a kan kayayyaki daban-daban ta amfani da ozone da aka samar a cikin reactor na jini na DBD, da kuma (b) yawan ozone da lokacin samar da plasma a cikin ɗakin tsaftacewa. An yi hoton ta amfani da OriginPro version 9.0 (software na OriginPro, Northampton, MA, Amurka; https://www.originlab.com).
Da farko, ta hanyar tsaftace ƙwayoyin cuta da aka sanya a kan faranti na agar da ozone, yayin da ake canza yawan ozone da lokacin magani, an tantance yawan ozone da lokacin magani don kawar da gurɓataccen MDRO da C. difficile. A lokacin aikin tsaftacewa, ana fara tsaftace ɗakin da iska mai kewaye sannan a cika shi da ozone ta hanyar kunna na'urar plasma. Bayan an yi wa samfuran magani da ozone na wani lokaci da aka ƙayyade, ana amfani da famfon diaphragm don cire sauran ozone. Ma'aunin ya yi amfani da samfurin cikakken al'ada na awanni 24 (~ 108 CFU/ml). Da farko an narkar da samfuran dakatarwar ƙwayoyin cuta (20 μl) sau goma a jere da saline mai tsafta, sannan aka rarraba waɗannan samfuran a kan faranti na agar da aka yi wa wanka da ozone a cikin ɗakin. Bayan haka, an sake sanya samfuran, waɗanda suka ƙunshi samfuran da aka fallasa kuma ba a fallasa su da ozone ba, a cikin zafin jiki na awanni 24 kuma an ƙirga ƙwayoyin cuta don tantance ingancin tsaftacewa.
Bugu da ƙari, bisa ga yanayin tsaftacewa da aka bayyana a cikin binciken da ke sama, an kimanta tasirin tsarkakewar wannan fasaha akan MDRO da C. difficile ta amfani da takardun shaida na kayan aiki daban-daban (bakin ƙarfe, yadi, gilashi, filastik da takardun katako) waɗanda aka saba amfani da su a cibiyoyin kiwon lafiya. An yi amfani da cikakkun al'adun awanni 24 (~108 cfu/ml). An narkar da samfuran dakatarwar ƙwayoyin cuta (20 μl) a jere sau goma da ruwan gishiri mai tsafta, sannan aka nutsar da takardun shaida a cikin waɗannan ruwan magani mai narkewa don tantance gurɓatawa. An sanya samfuran da aka cire bayan nutsewa cikin ruwan magani mai narkewa a cikin kwano na Petri mai tsafta kuma an busar da su a zafin ɗaki na tsawon awanni 24. Sanya murfin kwano na Petri akan samfurin kuma a hankali a sanya shi a cikin ɗakin gwaji. Cire murfin daga kwano na Petri kuma a fallasa samfurin zuwa ozone na 500 ppm na mintuna 15. An sanya samfuran sarrafawa a cikin kabad na aminci na halitta kuma ba a fallasa su ga ozone ba. Nan da nan bayan fallasa su ga ozone, an haɗa samfuran da samfuran da ba a ba da hasken rana ba (watau sarrafawa) da ruwan gishiri mai tsafta ta amfani da mahaɗin vortex don ware ƙwayoyin cuta daga saman. An narkar da maganin da aka cire sau 10 a jere da ruwan gishiri mai tsafta, bayan haka aka tantance adadin ƙwayoyin cuta da aka narkar a kan faranti na agar na jini (ga ƙwayoyin cuta masu saurin kamuwa da cuta) ko faranti na agar na jini na Brucella (ga Clostridium difficile) sannan aka sanya shi a zafin jiki na 37°C na tsawon awanni 24. ko kuma a ƙarƙashin yanayin anaerobic na tsawon awanni 48 a zafin jiki na 37°C a kwafi don tantance yawan farko na inoculum. An ƙididdige bambancin adadin ƙwayoyin cuta tsakanin sarrafawar da ba a fallasa ba da samfuran da aka fallasa don ba da raguwar adadin ƙwayoyin cuta (watau, ingancin tsaftacewa) a ƙarƙashin yanayin gwaji.
Dole ne a sanya ƙwayoyin halitta a kan farantin hoton AFM; saboda haka, ana amfani da faifan mica mai faɗi da kauri iri ɗaya tare da sikelin kauri ƙasa da girman tantanin halitta a matsayin substrate. Diamita da kauri na faifan sun kasance 20 mm da 0.21 mm, bi da bi. Don ɗaure ƙwayoyin zuwa saman, an shafa saman mica da poly-L-lysine (200 µl), wanda hakan ya sa ya yi caji mai kyau kuma membrane ɗin tantanin halitta ya yi caji mara kyau. Bayan an shafa poly-L-lysine, an wanke faifan mica sau 3 da ruwan deionized (DI) 1 ml sannan aka busar da iska cikin dare ɗaya. Sannan, an shafa ƙwayoyin cuta a saman mica da aka shafa da poly-L-lysine ta hanyar shan maganin ƙwayoyin cuta mai narkewa, an bar shi na tsawon minti 30, sannan aka wanke saman mica da 1 ml na ruwan deionized.
An yi wa rabin samfuran magani da ozone kuma an nuna yanayin saman farantin mica da aka ɗora da VRE, CRAB da C. difficile spores ta amfani da AFM (XE-7, tsarin wurin shakatawa). An saita yanayin aikin AFM zuwa yanayin taɓawa, wanda hanya ce ta gama gari don ɗaukar hotunan ƙwayoyin halitta. A cikin gwaje-gwajen, an yi amfani da microcantilever wanda aka tsara don yanayin da ba a taɓawa ba (OMCL-AC160TS, OLYMPUS Microscopy). An yi rikodin hotunan AFM bisa ga ƙimar binciken bincike na 0.5 Hz wanda ya haifar da ƙudurin hoto na 2048 × 2048 pixels.
Domin tantance yanayin da na'urorin DBD na plasma ke da tasiri wajen tsaftace jiki, mun gudanar da gwaje-gwaje da dama ta amfani da MDRO (VRE, CRE, CRPA, da CRAB) da kuma C. waɗanda ke da wahalar bambanta yawan ozone da lokacin fallasa. A hoto na 1b, an nuna lanƙwasa lokacin tattara ozone ga kowane yanayin gwaji bayan kunna na'urar plasma. Yawan ya karu ta hanyar logarithm, inda ya kai 300 da 500 ppm bayan mintuna 1.5 da 2.5, bi da bi. Gwaje-gwajen farko tare da VRE sun nuna cewa mafi ƙarancin da ake buƙata don kawar da ƙwayoyin cuta ta hanyar da ta dace shine 300 ppm ozone na mintuna 10. Don haka, a cikin gwaje-gwajen da ke gaba, MDRO da C. difficile sun fallasa ozone a cikin yawan daban-daban guda biyu (300 da 500 ppm) da kuma a lokutan fallasa guda biyu daban-daban (minti 10 da 15). An ƙididdige ingancin tsaftacewa ga kowane adadin ozone da lokacin fallasa kuma an nuna shi a cikin Tebur 1. Fuskantar ozone 300 ko 500 ppm na tsawon mintuna 10-15 ya haifar da raguwar VRE gaba ɗaya na log10 2 ko fiye. An cimma wannan babban matakin kashe ƙwayoyin cuta tare da CRE da mintuna 15 na fallasa ga ozone 300 ko 500 ppm. An samu raguwar CRPA sosai (> 7 log10) tare da fallasa ga 500 ppm na ozone na tsawon minti 15. An samu raguwar CRPA sosai (> 7 log10) tare da fallasa ga 500 ppm na ozone na tsawon minti 15. Высокое снижение CRPA (> 7 log10) было достигнуто при воздействии 500 частей на миллион озона в течение 15. An samu raguwar CRPA sosai (> 7 log10) ta hanyar fallasa shi ga ozone na 500 ppm na tsawon mintuna 15.暴露于500 ppm 的臭氧15 分钟后，可大幅降低CRPA (> 7 log10)。暴露于500 ppm 的臭氧15 分钟后，可大幅降低CRPA (> 7 log10)。 Существенное снижение CRPA (> 7 log10) после 15-минутного воздействия озона с концентрацией 500 ppm. Babban raguwa a cikin CRPA (> 7 log10) bayan mintuna 15 da aka fallasa ga ozone 500 ppm.Kashe ƙwayoyin cuta na CRAB a 300 ppm ozone; duk da haka, a 500 ppm ozone, an sami raguwar > 1.5 log10. duk da haka, a 500 ppm ozone, an sami raguwar > 1.5 log10. однако при концентрации озона 500 частей на миллион наблюдалось снижение > 1,5 log10. duk da haka, a yawan sinadarin ozone na ppm 500, an lura da raguwar >1.5 log10.然而，在500 ppm 臭氧下，减少了> 1.5 log10.然而，在500 ppm 臭氧下，减少了> 1.5 log10. Однако при концентрации озона 500 частей на миллион наблюдалось снижение >1,5 log10. Duk da haka, a lokacin da aka samu yawan sinadarin ozone na ppm 500, an lura da raguwar >1.5 log10. Bayyana ƙwayoyin C. masu wahala ga ozone 300 ko 500 ppm ya haifar da raguwar fiye da 2.5 log10. Bayyana ƙwayoyin C. masu wahala ga ozone 300 ko 500 ppm ya haifar da raguwar fiye da 2.5 log10. Воздействие на споры C. difficile озона с концентрацией 300 или 500 частей на миллион приводило к снижению > 2,5. Fuskantar ƙwayoyin C. masu wahala ga ozone mai ƙarfin 300 ko 500 ppm ya haifar da raguwar fiye da log10.将艰难梭菌孢子暴露于300 或500 ppm 的臭氧中导致> 2.5 log10 减少。 300 或500 ppm 的臭氧中导致> 2.5 log10 减少。 Воздействие на споры C. difficile озона с концентрацией 300 или 500 частей на миллион приводило к снижению >2,5. Fuskantar ƙwayoyin C. masu wahala ga ozone mai ƙarfin 300 ko 500 ppm ya haifar da raguwar fiye da log10.
Bisa ga gwaje-gwajen da aka yi a sama, an gano isasshen buƙata don hana ƙwayoyin cuta aiki a cikin adadin ozone na 500 ppm na tsawon mintuna 15. An gwada ƙwayoyin VRE, CRAB da C. masu wahala don tasirin ozone akan ƙwayoyin cuta daban-daban, gami da bakin ƙarfe, yadi, gilashi, filastik da itace da aka saba amfani da su a asibitoci. An nuna ingancin hana su a cikin Jadawali na 2. An kimanta ƙwayoyin cuta sau biyu. A cikin VRE da CRAB, ozone bai yi tasiri sosai akan saman gilashi da filastik ba, kodayake an lura da raguwar log10 na kusan kashi 2 ko fiye akan saman bakin ƙarfe, yadi da itace. An gano cewa ƙwayoyin C. masu wahala sun fi jure wa maganin ozone fiye da duk sauran halittu da aka gwada. Don yin nazarin kididdigar tasirin ozone akan tasirin kashe kayan daban-daban akan VRE, CRAB, da C. masu wahala, an yi amfani da gwaje-gwajen t don kwatanta bambance-bambance tsakanin adadin CFU a kowace millilita a cikin ƙungiyoyin sarrafawa da gwaji akan kayan daban-daban (Hoto na 2). nau'ikan sun nuna bambance-bambance masu mahimmanci a kididdiga, amma an lura da bambance-bambance masu mahimmanci ga ƙwayoyin VRE da CRAB fiye da na ƙwayoyin C. masu wahala.
Takaitaccen bayani game da tasirin ozone akan kashe ƙwayoyin cuta na abubuwa daban-daban (a) VRE, (b) CRAB, da (c) C. wahala.
An yi hoton AFM akan ƙwayoyin VRE, CRAB, da C. masu wahalar samu don yin nazari dalla-dalla kan tsarin tsaftace iskar ozone. A hoto na 3a, c da e sun nuna hotunan AFM na ƙwayoyin VRE, CRAB da C. masu wahalar samu, bi da bi. Kamar yadda aka gani a hotunan 3D, ƙwayoyin suna da santsi kuma ba su da matsala. Hotuna na 3b, d da f sun nuna ƙwayoyin VRE, CRAB da C. masu wahalar samu bayan maganin ozone. Ba wai kawai sun ragu a girman dukkan ƙwayoyin da aka gwada ba, har ma saman su ya yi tsauri sosai bayan fallasa su ga ozone.
Hotunan AFM na ƙwayoyin VRE, MRAB da C. masu wahala waɗanda ba a yi musu magani ba (a, c, e) da (b, d, f) waɗanda aka yi musu magani da ozone na 500 ppm na tsawon minti 15. An zana hotunan ta amfani da sigar Park Systems XEI 5.1.6 (XEI Software, Suwon, Korea; https://www.parksystems.com/102-products/park-xe-bio).
Bincikenmu ya nuna cewa sinadarin ozone da kayan aikin plasma na DBD ke samarwa yana nuna ikon kawar da ƙwayoyin MDRO da C. masu wahala yadda ya kamata, waɗanda aka san su ne manyan abubuwan da ke haifar da cututtuka masu alaƙa da kiwon lafiya. Bugu da ƙari, a cikin bincikenmu, ganin cewa gurɓatar muhalli tare da ƙwayoyin MDRO da C. masu wahala na iya zama tushen kamuwa da cuta da ke da alaƙa da kiwon lafiya, an gano cewa tasirin kashe ƙwayoyin cuta na ozone ya yi nasara ga kayan da ake amfani da su galibi a asibitoci. An gudanar da gwaje-gwajen kawar da ƙwayoyin cuta ta amfani da kayan aikin plasma na DBD bayan gurɓatar kayan aiki kamar bakin ƙarfe, zane, gilashi, filastik da itace tare da ƙwayoyin MDRO da C. masu wahala. Sakamakon haka, kodayake tasirin kawar da ƙwayoyin cuta ya bambanta dangane da kayan, ikon kawar da ƙwayoyin ozone abin mamaki ne.
Abubuwan da ake taɓawa akai-akai a ɗakunan asibiti suna buƙatar tsaftacewa ta yau da kullun, mai ƙarancin matakin tsaftacewa. Hanyar da aka saba amfani da ita don kawar da irin waɗannan abubuwa ita ce tsaftace hannu da maganin kashe ƙwayoyin cuta kamar quaternary ammonium compound 13. Ko da tare da bin shawarwarin amfani da magungunan kashe ƙwayoyin cuta, MPO yana da wahalar cirewa ta hanyar tsaftace muhalli na gargajiya (yawanci tsaftacewa da hannu)14. Saboda haka, ana buƙatar sabbin fasahohi, kamar hanyoyin da ba sa taɓawa. Saboda haka, an sami sha'awar magungunan kashe ƙwayoyin cuta na iska, gami da hydrogen peroxide da ozone10. Fa'idar magungunan kashe ƙwayoyin cuta na iskar gas ita ce suna iya isa wurare da abubuwan da hanyoyin hannu ba za su iya isa ba. An fara amfani da hydrogen peroxide kwanan nan a wuraren kiwon lafiya, duk da haka hydrogen peroxide da kansa yana da guba kuma dole ne a sarrafa shi bisa ga tsauraran hanyoyin sarrafawa. Yin amfani da sinadarin plasma tare da hydrogen peroxide yana buƙatar lokaci mai tsawo kafin zagayowar tsaftacewa ta gaba. Sabanin haka, ozone yana aiki azaman maganin kashe ƙwayoyin cuta mai faɗi, mai tasiri akan ƙwayoyin cuta da ƙwayoyin cuta waɗanda ke jure wa sauran magungunan kashe ƙwayoyin cuta8,11,15. Bugu da ƙari, ana iya samar da ozone cikin rahusa daga iskar yanayi kuma baya buƙatar ƙarin sinadarai masu guba waɗanda za su iya barin mummunan tasiri a cikin muhalli, tunda daga ƙarshe yana wargajewa zuwa iskar oxygen. Duk da haka, dalilin da ya sa ba a amfani da ozone sosai a matsayin maganin kashe ƙwayoyin cuta shine kamar haka. Ozone yana da guba ga lafiyar ɗan adam, don haka yawansa bai wuce 0.07 ppm a matsakaici na fiye da awanni 816, don haka an ƙirƙiri masu hana ozone kuma an sanya shi a kasuwa, galibi don tsaftace iskar gas. Hakanan yana yiwuwa a shaƙa iskar gas da samar da ƙamshi mara daɗi bayan an share gurɓata 5,8. Ba a yi amfani da ozone sosai a cibiyoyin kiwon lafiya ba. Duk da haka, ana iya amfani da ozone lafiya a cikin ɗakunan tsaftacewa da kuma hanyoyin samun iska mai kyau, kuma ana iya hanzarta cire shi ta hanyar amfani da mai canza catalytic. A cikin wannan binciken, mun nuna cewa ana iya amfani da masu hana ozone na plasma don kashe ƙwayoyin cuta a wuraren kiwon lafiya. Mun ƙirƙiro na'ura mai ƙarfin tsaftacewa, sauƙin aiki da kuma sabis mai sauri ga marasa lafiya da ke asibiti. Bugu da ƙari, mun ƙirƙiro na'urar tsaftacewa mai sauƙi wacce ke amfani da iskar yanayi ba tare da ƙarin kuɗi ba. Zuwa yanzu, babu isasshen bayani game da mafi ƙarancin buƙatun ozone don hana aikin MDRO. Kayan aikin da aka yi amfani da su a bincikenmu suna da sauƙin saitawa kuma suna da ɗan gajeren lokaci kuma ana sa ran za su kasance masu amfani don yawan tsaftace kayan aiki.
Tsarin aikin kashe ƙwayoyin cuta na ozone ba a fayyace shi gaba ɗaya ba. Nazari da dama sun nuna cewa ozone yana lalata membranes na ƙwayoyin cuta, wanda ke haifar da zubewar ƙwayoyin halitta da kuma lysis na ƙwayoyin halitta17,18. Ozone na iya tsoma baki ga ayyukan enzymatic na ƙwayoyin halitta ta hanyar amsawa da ƙungiyoyin thiol kuma yana iya canza tushen purine da pyrimidine a cikin nucleic acid. Wannan binciken ya hango yanayin ƙwayoyin VRE, CRAB, da C. masu wahala kafin da kuma bayan maganin ozone kuma ya gano cewa ba wai kawai sun ragu a girma ba, har ma sun zama masu ƙarfi a saman, suna nuna lalacewa ko tsatsa na membrane mafi tsayi. Kuma kayan ciki saboda iskar ozone yana da ƙarfin oxidizing. Wannan lalacewa na iya haifar da rashin aiki na ƙwayoyin halitta, ya danganta da tsananin canje-canjen ƙwayoyin halitta.
C. ƙwayoyin cuta masu wahala suna da wahalar cirewa daga ɗakunan asibiti. Kwayoyin cuta suna nan a wuraren da suke zubar da 10,20. Bugu da ƙari, a cikin wannan binciken, kodayake raguwar adadin ƙwayoyin cuta na logarithmic sau 10 a cikin adadin ƙwayoyin cuta akan faranti na agar a 500 ppm ozone na tsawon mintuna 15 ya kai 2.73, an rage tasirin ƙwayoyin cuta na ozone akan kayan da ke ɗauke da ƙwayoyin cuta na C spores .difficile. Saboda haka, ana iya la'akari da dabaru daban-daban don rage kamuwa da cutar C. mai wahala a wuraren kiwon lafiya. Don amfani a cikin ɗakunan da aka keɓe na C. mai wahala kawai, yana iya zama da amfani a daidaita lokacin fallasa da ƙarfin maganin ozone. Bugu da ƙari, dole ne mu tuna cewa hanyar kawar da gurɓataccen ozone ba za ta iya maye gurbin tsaftacewa ta hannu gaba ɗaya da magungunan kashe ƙwayoyin cuta da dabarun kashe ƙwayoyin cuta ba, kuma yana iya zama mai tasiri sosai wajen sarrafa C. mai wahala 5. A cikin wannan binciken, ingancin ozone a matsayin maganin kashe ƙwayoyin cuta ya bambanta ga nau'ikan MPO daban-daban. Ingancinsa na iya dogara ne akan abubuwa da dama kamar matakin girma, bangon tantanin halitta, da ingancin hanyoyin gyara21,22. Dalilin bambancin tasirin tsarkakewar ozone akan saman kowane abu na iya zama saboda samuwar biofilm. Nazarin da aka yi a baya ya nuna cewa E. faecium da E. faecium suna ƙara juriya ga muhalli idan aka gabatar da su a matsayin biofilms23, 24, 25. Duk da haka, wannan binciken ya nuna cewa ozone yana da tasirin kashe ƙwayoyin cuta mai mahimmanci akan ƙwayoyin cuta na MDRO da C. masu wahala.
Iyakar bincikenmu shine mun tantance tasirin riƙewar ozone bayan an gyara shi. Wannan na iya haifar da ƙiyasin adadin ƙwayoyin cuta masu rai.
Duk da cewa an gudanar da wannan binciken ne don tantance ingancin sinadarin ozone a matsayin maganin kashe ƙwayoyin cuta a asibiti, yana da wuya a fayyace sakamakonmu ga dukkan wuraren asibiti. Don haka, ana buƙatar ƙarin bincike don bincika dacewa da dacewa da wannan sinadarin ozone na DBD a cikin yanayin asibiti na gaske.
Ozone da na'urorin samar da iskar oxygen na DBD ke samarwa na iya zama wakili mai sauƙi kuma mai mahimmanci na kawar da gurɓataccen iska ga MDRO da C. difficile. Don haka, ana iya ɗaukar maganin ozone a matsayin madadin maganin kashe ƙwayoyin cuta na asibiti.
Bayanan da aka yi amfani da su da/ko aka yi nazari a kansu a cikin binciken na yanzu suna samuwa daga marubutan da suka dace idan aka buƙata.
Tsarin duniya na WHO don rage juriya ga ƙwayoyin cuta. https://www.who.int/drugresistance/WHO_Global_Strategy.htm/en/ Akwai.
Dubberke, ER & Olsen, MA. Nauyin Clostridium difficile kan tsarin kiwon lafiya. Dubberke, ER & Olsen, MA. Nauyin Clostridium difficile kan tsarin kiwon lafiya.Dubberke, ER da Olsen, MA. Matsala ta Clostridium difficile a tsarin kiwon lafiya. Dubberke, ER & Olsen, MA 艰难梭菌对医疗保健系统的负担。 Dubberke, ER & Olsen, MADubberke, ER da Olsen, MA Nauyin Clostridium difficile akan tsarin kula da lafiya.asibiti. Kamuwa. Dis. https://doi.org/10.1093/cid/cis335 (2012).
Boyce, JM Gurɓatar muhalli tana da tasiri mai yawa ga cututtukan da ke kama da na mata. J. Asibitin. Infect. 65 (Annex 2), 50-54. https://doi.org/10.1016/s0195-6701(07)60015-2 (2007).
Kim, YA, Lee, H. & K L.,. Kim, YA, Lee, H. & K L.,.Kim, YA, Lee, H. da KL,. Kim, YA, Lee, H. & K L.,. Kim, YA, Lee, H. & K L.,.Kim, YA, Lee, H. da KL,.Gurɓatawa da kuma kula da kamuwa da cuta a muhallin asibiti ta hanyar ƙwayoyin cuta masu cutarwa [J. Korea J. Hospital Infection Control. 20(1), 1-6 (2015).
Dancer, SJ Yaƙi da cututtukan da ke kama da na nosocomial: kulawa ga rawar da muhalli ke takawa da sabbin fasahohin kashe ƙwayoyin cuta. asibiti. ƙwayoyin cuta. buɗe 27(4), 665–690. https://doi.org/10.1128/cmr.00020-14 (2014).
Weber, DJ da sauransu. Ingancin na'urorin UV da tsarin hydrogen peroxide don kawar da gurɓataccen wurare: mai da hankali kan gwaje-gwajen asibiti. Ee. J. Kula da kamuwa da cuta. 44 (ƙari 5), e77-84. https://doi.org/10.1016/j.ajic.2015.11.015 (2016).
Siani, H. & Maillard, JY Mafi kyawun aikin kawar da gurɓataccen muhalli a fannin kiwon lafiya. Siani, H. & Maillard, JY Mafi kyawun aikin kawar da gurɓataccen muhalli a fannin kiwon lafiya. Siani, H. & Maillard, JY Передовая практика дезактивации Siani, H. & Maillard, JY Kyakkyawan aiki wajen kawar da gurɓataccen muhallin kiwon lafiya. Siani, H. & Maillard, JY 医疗环境净化的最佳实践。 Siani, H. & Maillard, JY Mafi kyawun aikin tsarkake muhallin likita. Siani, H. & Maillard, JY Передовой опыт обеззараживания Siani, H. & Maillard, JY Mafi kyawun aikin tsarkake gurɓataccen wuraren kiwon lafiya.EURO. J. Clin. ƙwayoyin cuta Don kamuwa da cuta ta Dis. 34(1), 1-11. https://doi.org/10.1007/s10096-014-2205-9 (2015).
Sharma, M. & Hudson, JB Ozone gas wani abu ne mai tasiri kuma mai amfani wajen kashe ƙwayoyin cuta. Sharma, M. & Hudson, JB Ozone gas wani abu ne mai tasiri kuma mai amfani wajen kashe ƙwayoyin cuta.Sharma, M. da Hudson, JB Gaseous ozone wakili ne mai tasiri kuma mai amfani da ƙwayoyin cuta. Sharma, M. & Hudson, JB 臭氧气体是一种有效且实用的抗菌剂。 Sharma, M. & Hudson, JBSharma, M. da Hudson, JB Gaseous ozone wakili ne mai tasiri kuma mai amfani da ƙwayoyin cuta.Eh. J. Kamuwa da cuta. iko. 36(8), 559-563. https://doi.org/10.1016/j.ajic.2007.10.021 (2008).
Seung-Lok Pak, J.-DM, Lee, S.-H. & Shin, S.-Y. & Shin, S.-Y.da Shin, S.-Yu. & Shin, S.-Y. & Shin, S.-Y.da Shin, S.-Yu.Ana samar da sinadarin ozone yadda ya kamata ta amfani da na'urorin lantarki na farantin grid a cikin janareta mai nau'in fitarwa ta ozone tare da shingen dielectric. J. Electrostatics. 64(5), 275-282. https://doi.org/10.1016/j.elstat.2005.06.007 (2006).
Moat, J., Cargill, J., Shone, J. & Upton, M. Amfani da sabon tsarin kawar da gurɓatawa ta amfani da iskar gas mai iskar ozone. Moat, J., Cargill, J., Shone, J. & Upton, M. Amfani da sabon tsarin kawar da gurɓatawa ta amfani da iskar gas mai iskar ozone.Moat J., Cargill J., Sean J. da Upton M. Amfani da sabon tsarin kawar da gurɓatawa ta amfani da iskar gas ta ozone. Moat, J., Cargill, J., Shone, J. & Upton, M. 使用气态臭氧的新型净化工艺的应用。 Moat, J., Cargill, J., Shone, J. & Upton, M.Moat J., Cargill J., Sean J. da Upton M. Aiwatar da sabon tsarin tsarkakewa ta amfani da iskar ozone.Can. J. Ƙananan halittu. 55(8), 928–933. https://doi.org/10.1139/w09-046 (2009).
Zoutman, D., Shannon, M. & Mandel, A. Ingancin sabon tsarin da aka yi amfani da shi a ozone don hanzarta tsaftace wurare da saman kiwon lafiya. Zoutman, D., Shannon, M. & Mandel, A. Ingancin sabon tsarin da aka yi amfani da shi a ozone don hanzarta tsaftace wurare da saman kiwon lafiya.Zutman, D., Shannon, M. da Mandel, A. Ingancin sabon tsarin da aka yi amfani da shi a ozone don tsaftace muhalli da saman lafiya cikin sauri da inganci. Zoutman, D., Shannon, M. & Mandel, A. Zoutman, D., Shannon, M. da Mandel, A.Zutman, D., Shannon, M. da Mandel, A. Ingancin sabon tsarin ozone don hanzarta tsaftacewa da kuma tsaftace muhallin likitanci da saman sa.Eh. J. Kula da kamuwa da cuta. 39(10), 873-879. https://doi.org/10.1016/j.ajic.2011.01.012 (2011).
Wullt, M., Odenholt, I. & Walder, M. Ayyukan magungunan kashe ƙwayoyin cuta guda uku da kuma nitrite mai acidified akan ƙwayoyin Clostridium difficile. Wullt, M., Odenholt, I. & Walder, M. Ayyukan magungunan kashe ƙwayoyin cuta guda uku da kuma nitrite mai acidified akan ƙwayoyin Clostridium difficile.Woollt, M., Odenholt, I. da Walder, M. Ayyukan magungunan kashe ƙwayoyin cuta guda uku da kuma nitrite mai acidified akan ƙwayoyin Clostridium masu wahala.Vullt M, Odenholt I da Walder M. Ayyukan magungunan kashe ƙwayoyin cuta guda uku da kuma nitrites masu ɗauke da sinadarin acid a kan ƙwayoyin cuta masu wahalar kamuwa da cuta na Clostridium. Asibitin Kula da Kamuwa da Cututtuka. Epidemiology. 24(10), 765-768. https://doi.org/10.1086/502129 (2003).
Ray, A. da sauransu. Rufe gurɓataccen hydrogen peroxide da aka yi da tururi yayin barkewar cutar Acinetobacter baumannii mai jure wa magunguna da yawa a asibiti na dogon lokaci. Asibitin Kula da Kamuwa da Cututtuka. Epidemiology. 31(12), 1236-1241. https://doi.org/10.1086/657139 (2010).
Ekshtein, BK da sauransu. Rage gurɓatar saman muhalli ta hanyar amfani da Clostridium difficile da enterococci mai jure wa vancomycin bayan ɗaukar matakan inganta hanyoyin tsaftacewa. Cutar da ke yaɗuwa ta Rundunar Sojan Ruwa. 7, 61. https://doi.org/10.1186/1471-2334-7-61 (2007).
Martinelli, M., Giovannangeli, F., Rotunno, S., Trombetta, CM & Montomoli, E. Maganin ruwa da iska na ozone a matsayin wata hanyar tsaftace muhalli. Martinelli, M., Giovannangeli, F., Rotunno, S., Trombetta, CM & Montomoli, E. Maganin ruwa da iska na ozone a matsayin wata hanyar tsaftace muhalli.Martinelli, M., Giovannangeli, F., Rotunno, S., Trombetta, KM da Montomoli, E. Maganin ruwa da iska na Ozone a matsayin madadin fasahar tsafta. Martinelli, M., Giovannangeli, F., Rotunno, S., Trombetta, CM & Montomoli, E. 水和空气臭氧处理作为替代消毒技术。 Martinelli, M., Giovannangeli, F., Rotunno, S., Trombetta, CM & Montomoli, E.Martinelli M, Giovannangeli F, Rotunno S, Trombetta SM da Montomoli E. Maganin Ozone na ruwa da iska a madadin hanyar kashe ƙwayoyin cuta.J. Shafin da ya gabata. magani. Hagrid. 58(1), E48-e52 (2017).
Ma'aikatar Muhalli ta Koriya. https://www.me.go.kr/mamo/web/index.do?menuId=586 (2022). Tun daga ranar 12 ga Janairu, 2022
Thanomsub, B. da sauransu. Tasirin maganin ozone akan haɓakar ƙwayoyin cuta da canje-canje a tsarin jiki. Karin Bayani J. Gen. ƙwayoyin cuta. 48(4), 193-199. https://doi.org/10.2323/jgam.48.193 (2002).
Zhang, YQ, Wu, QP, Zhang, JM & Yang, XH Tasirin ozone akan permeability na membrane da ultrastructure a cikin Pseudomonas aeruginosa. Zhang, YQ, Wu, QP, Zhang, JM & Yang, XH Tasirin ozone akan permeability na membrane da ultrastructure a cikin Pseudomonas aeruginosa. Zhang, YQ, Wu, QP, Zhang, JM & Yang, XH Влияние озона на проницаемость мембран da ультраструктуру Pseudomonas aeruginosa. Zhang, YQ, Wu, QP, Zhang, JM & Yang, XH Tasirin ozone akan permeability na membrane da ultrastructure na Pseudomonas aeruginosa. Zhang, YQ, Wu, QP, Zhang, JM & Yang, XH 臭氧对铜绿假单胞菌膜通透性和超微结构的影响。 Zhang, YQ, Wu, QP, Zhang, JM & Yang, XH Zhang, YQ, Wu, QP, Zhang, JM & Yang, XH Влияние озона на проницаемость мембран da ультраструктуру Pseudomonas aeruginosa. Zhang, YQ, Wu, QP, Zhang, JM & Yang, XH Tasirin ozone akan permeability na membrane da ultrastructure na Pseudomonas aeruginosa.J. Aikace-aikace. ƙwayoyin cuta. 111(4), 1006-1015. https://doi.org/10.1111/j.1365-2672.2011.05113.x (2011).
Russell, AD Kamanceceniya da bambance-bambance a cikin martanin ƙwayoyin cuta ga magungunan kashe ƙwayoyin cuta. J. Magungunan rigakafi. chemotherapy. 52(5), 750-763. https://doi.org/10.1093/jac/dkg422 (2003).
Whitaker, J., Brown, BS, Vidal, S. & Calcaterra, M. Tsarin yarjejeniya da za ta kawar da wahalar Clostridium: Haɗin gwiwa. Whitaker, J., Brown, BS, Vidal, S. & Calcaterra, M. Tsarin yarjejeniya da za ta kawar da wahalar Clostridium: Haɗin gwiwa.Whitaker J, Brown BS, Vidal S da Calcaterra M. Ƙirƙirar yarjejeniya don kawar da Clostridium difficile: haɗin gwiwa. Whitaker, J., Brown, BS, Vidal, S. & Calcaterra, M. 设计一种消除艰难梭菌的方案：合作企业。 Whitaker, J., Brown, BS, Vidal, S. & Calcaterra, M.Whitaker, J., Brown, BS, Vidal, S. da Calcaterra, M. Ƙirƙirar yarjejeniya don kawar da wahalar Clostridium: haɗin gwiwa.Eh. J. Kula da kamuwa da cuta. 35(5), 310-314. https://doi.org/10.1016/j.ajic.2006.08.010 (2007).
Broadwater, WT, Hoehn, RC & King, PH. Jin daɗin nau'ikan ƙwayoyin cuta guda uku da aka zaɓa zuwa ga ozone. Broadwater, WT, Hoehn, RC & King, PH. Jin daɗin nau'ikan ƙwayoyin cuta guda uku da aka zaɓa zuwa ga ozone. Broadwater, WT, Hoehn, RC & King, PH Чувствительность. Broadwater, WT, Hoehn, RC & King, PH Ra'ayin Ozone na nau'ikan ƙwayoyin cuta guda uku da aka zaɓa. Broadwater, WT, Hoehn, RC & King, PH 三种选定细菌对臭氧的敏感性。 Broadwater, WT, Hoehn, RC & King, PH Broadwater, WT, Hoehn, RC & King, PH Чувствительность. Broadwater, WT, Hoehn, RC & King, PH. Ra'ayin ƙwayoyin cuta guda uku da aka zaɓa.sanarwa. ƙwayoyin cuta. 26(3), 391–393. https://doi.org/10.1128/am.26.3.391-393.1973 (1973).
Patil, S., Valdramidis, VP, Karatzas, KA, Cullen, PJ & Bourke, P. Kimanta tsarin damuwa na ƙwayoyin cuta na maganin ozone ta hanyar martanin masu maye gurbin Escherichia coli. Patil, S., Valdramidis, VP, Karatzas, KA, Cullen, PJ & Bourke, P. Kimanta tsarin damuwa na ƙwayoyin cuta na maganin ozone ta hanyar martanin masu maye gurbin Escherichia coli.Patil, S., Valdramidis, VP, Karatzas, KA, Cullen, PJ da Burk, P. Kimanta Tsarin Damuwa Mai Sauƙi ta Kwayoyin cuta ta Maganin Ozone daga Escherichia coli Mutant Reactions. Patil, S., Valdramidis, VP, Karatzas, KA, Cullen, PJ & Bourke, P. 通过大肠杆菌五变体 Patil, S., Valdramidis, VP, Karatzas, KA, Cullen, PJ & Bourke, P.Patil, S., Valdramidis, VP, Karatsas, KA, Cullen, PJ da Bourque, P. Kimanta hanyoyin da ke haifar da damuwa ta oxidative a cikin maganin ozone ta hanyar halayen maye gurbin Escherichia coli.J. Aikace-aikace. ƙwayoyin cuta. 111(1), 136-144. https://doi.org/10.1111/j.1365-2672.2011.05021.x (2011).
Greene, C., Wu, J., Rickard, AH & Xi, C. Kimanta ikon Acinetobacter baumannii na samar da fina-finan biofilms akan wurare shida daban-daban na likitanci. Greene, C., Wu, J., Rickard, AH & Xi, C. Kimanta ikon Acinetobacter baumannii na samar da fina-finan biofilms akan wurare shida daban-daban na likitanci.Green, K., Wu, J., Rickard, A. Kh. da Si, K. Kimanta ikon Acinetobacter baumannii na samar da fina-finan halittu a wurare shida daban-daban masu dacewa da ilimin halitta. Greene, C., Wu, J., Rickard, AH & Xi, C. 评估鲍曼不动杆菌在六种不同生物医学相关表面上圢成行面上圢成视面上圢成视生。 Greene, C., Wu, J., Rickard, AH & Xi, C. Ƙimar ikon 鲍曼不动天生在六种 don samar da biofilm a kan sassa daban-daban na biomedical masu dacewa.Green, K., Wu, J., Rickard, A. Kh. da Si, K. Kimanta ikon Acinetobacter baumannii na samar da fina-finan halittu a wurare shida daban-daban masu dacewa da ilimin halitta.Wright. ƙwayoyin cuta masu amfani 63(4), 233-239. https://doi.org/10.1111/lam.12627 (2016).