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He kuleana koʻikoʻi ko kahi ʻano mālama ola kino haumia i ka laha ʻana o nā meaola multidrug-resistant (MDR) a me C. difficile. ʻO ke kumu o kēia noiʻi, ʻo ia ke loiloi i ka hopena o ka ozone i hana ʻia e kahi reactor plasma dielectric barrier discharge (DBD) ma ka hana o ka vancomycin-resistant Enterococcus faecalis (VRE), carbapenem-resistant Klebsiella pneumoniae (CRE), carbapenem-resistant Antibacterial effects o nā mea like ʻole i haumia ʻia me Pseudomonas spp. Pseudomonas aeruginosa (CRPA), carbapenem-resistant Acinetobacter baumannii (CRAB) a me Clostridium difficile spores. Ua mālama ʻia nā mea like ʻole i haumia ʻia me VRE, CRE, CRPA, CRAB a me C. difficile spores me ka ozone ma nā ʻano like ʻole a me nā manawa hōʻike. Ua hōʻike ka microscopy ikaika atomika (AFM) i ka hoʻololi ʻana o ka ʻili o ka bacteria ma hope o ka mālama ʻana i ka ozone. I ka wā i hoʻopili ʻia ai kahi mahele o 500 ppm ozone iā VRE a me CRAB no 15 mau minuke, ua ʻike ʻia ka emi ʻana o kahi 2 a ʻoi aku paha log10 i ke kila kila, ka lole a me ka lāʻau, a ua ʻike ʻia ka emi ʻana o 1-2 log10 i ke aniani a me ka plastic. Ua ʻike ʻia nā spores C. difficile e kūʻē i ka ozone ma mua o nā meaola ʻē aʻe i hoʻāʻo ʻia. Ma AFM, ma hope o ka mālama ʻana me ka ozone, ua pehu a hoʻololi ʻia nā cell bacteria. ʻO ka ozone i hana ʻia e ka DBD Plasma Reactor he mea hana decontamination maʻalahi a waiwai nui no nā spores MDRO a me C. difficile, i ʻike ʻia he mau pathogens maʻamau o nā maʻi e pili ana i ka mālama ola.
ʻO ka puka ʻana mai o nā meaola multidrug-resistant (MDR) i hana ʻia e ka hoʻohana pono ʻole ʻana i nā antibiotics i loko o nā kānaka a me nā holoholona a ua ʻike ʻia e ka World Health Organization (WHO) he hoʻoweliweli nui i ke olakino lehulehu1. Ma ke ʻano kūikawā, ke kū nei nā ʻoihana mālama ola i ka puka ʻana mai a me ka laha ʻana o nā MRO. ʻO nā MRO nui he methicillin-resistant Staphylococcus aureus a me vancomycin-resistant enterococcus (VRE), extended-spectrum beta-lactamase-producing enterobacteria (ESBL), multidrug-resistant Pseudomonas aeruginosa, multidrug-resistant Acinetobacter baumannii, a me carbapenem-resistant Enterobacter (CRE). Eia kekahi, ʻo ka maʻi Clostridium difficile kekahi kumu nui o ka maʻi diarrhea e pili ana i ka mālama ola, e kau ana i kahi kaumaha nui ma ka ʻōnaehana mālama ola. Hoʻolaha ʻia ka MDRO a me C. difficile ma o nā lima o nā limahana mālama ola, nā wahi haumia, a i ʻole pololei mai ke kanaka a i ke kanaka. Ua hōʻike ʻia nā haʻawina hou e pili ana nā wahi haumia i nā wahi mālama ola kino i ka hoʻoili ʻana o MDRO a me C. difficile i ka wā e launa pū ai nā limahana olakino (HCW) me nā ʻili haumia a i ʻole ke launa pololei nā mea maʻi me nā ʻili haumia 3,4. hoʻemi nā wahi haumia i nā wahi mālama ola kino i ka nui o ka maʻi MLRO a me C. difficile a i ʻole ka colonization5,6,7. Ma muli o ka hopohopo honua e pili ana i ka piʻi ʻana o ke kūʻē antimicrobial, ua maopopo he pono hou aku ka noiʻi ʻana i nā ʻano hana a me nā kaʻina hana no ka decontamination i nā wahi mālama ola kino. I kēia manawa, ua ʻike ʻia nā ʻano hoʻomaʻemaʻe terminal non-contact, ʻoiai nā lako ultraviolet (UV) a i ʻole nā ​​​​ʻōnaehana hydrogen peroxide, he mau ʻano hoʻohiki no ka decontamination. Eia nō naʻe, ʻaʻole wale ke kumukūʻai o kēia mau mea UV a hydrogen peroxide i loaʻa ma ke kālepa, he pono wale nō ka disinfection UV ma nā ʻili i hōʻike ʻia, ʻoiai ʻo ka disinfection plasma hydrogen peroxide e koi ana i kahi manawa decontamination lōʻihi ma mua o ke kaʻina hana disinfection aʻe5.
Ua ʻike ʻia ka Ozone i nā waiwai anti-corrosion a hiki ke hana ʻia me ke kumu kūʻai ʻole8. Ua ʻike ʻia hoʻi he mea ʻawahia i ke olakino kanaka, akā hiki ke palaho koke i ka oxygen 8. ʻO nā reactors plasma dielectric barrier discharge (DBD) nā mea hana ozone maʻamau loa9. Hiki i nā lako DBD ke hana i ka plasma haʻahaʻa haʻahaʻa i ka lewa a hana i ka ozone. A hiki i kēia manawa, ua kaupalena ʻia ka hoʻohana pono ʻana o ka ozone i ka disinfection o ka wai ʻauʻau, ka wai inu a me ka wai ʻino10. Ua hōʻike ʻia kekahi mau noiʻi i kona hoʻohana ʻana i nā wahi mālama ola8,11.
Ma kēia haʻawina, ua hoʻohana mākou i kahi mea hana ozone plasma DBD compact e hōʻike i kona pono i ka hoʻomaʻemaʻe ʻana i ka MDRO a me C. difficile, ʻoiai nā mea i hoʻokomo ʻia ma nā mea like ʻole i hoʻohana pinepine ʻia i nā wahi lapaʻau. Eia kekahi, ua wehewehe ʻia ke kaʻina hana sterilization ozone me ka hoʻohana ʻana i nā kiʻi microscopy ikaika atomika (AFM) o nā cell i mālama ʻia me ka ozone.
Ua loaʻa nā ʻano mai nā isolates lapaʻau o: VRE (SCH 479 a me SCH 637), Klebsiella pneumoniae kūpaʻa carbapenem (CRE; SCH CRE-14 a me DKA-1), Pseudomonas aeruginosa kūpaʻa carbapenem (CRPA; 54 a me 83) a me nā bacteria kūpaʻa carbapenem. bacteria Pseudomonas aeruginosa (CRPA; 54 a me 83). Acinetobacter baumannii kūpaʻa (CRAB; F2487 a me SCH-511). Ua loaʻa ʻo C. difficile mai ka National Pathogen Culture Collection (NCCP 11840) o ka Korea Agency for Disease Control and Prevention. Ua hoʻokaʻawale ʻia mai kahi maʻi ma Korea Hema i ka makahiki 2019 a ua ʻike ʻia he pili ia iā ST15 me ka hoʻohana ʻana i ke ʻano o ka moʻo multilocus. Ua hui maikaʻi ʻia ka Brain Heart Infusion (BHI) Broth (BD, Sparks, MD, USA) i hoʻokomo ʻia me VRE, CRE, CRPA a me CRAB a ua hoʻomoʻa ʻia ma 37° C. no 24 mau hola.
Ua hoʻoheheʻe ʻia ʻo C. difficile ma ke ʻano anaerobic ma luna o ka agar koko no 48 mau hola. A laila ua hoʻohui ʻia kekahi mau kolone i 5 ml o ka hupa puʻuwai lolo a hoʻomoʻa ʻia ma lalo o nā kūlana anaerobic no 48 mau hola. Ma hope o kēlā, ua lulu ʻia ka moʻomeheu, ua hoʻohui ʻia he 5 ml o 95% ethanol, lulu hou ʻia a waiho ʻia ma ka mahana o ka lumi no 30 mau minuke. Ma hope o ka centrifugation ma 3000 g no 20 mau minuke, e hoʻolei i ka supernatant a hoʻokuʻu i ka pellet i loaʻa nā spores a me nā bacteria i pepehi ʻia i loko o 0.3 ml o ka wai. Ua helu ʻia nā cell ola ma o ka lūlū ʻana i ka spiral o ka hoʻokuʻu ʻana o nā cell bacteria ma luna o nā papa agar koko ma hope o ka dilution kūpono. Ua hōʻoia ka Gram staining he 85% a 90% o nā ʻano bacteria he spores.
Ua mālama ʻia ke aʻo ʻana ma lalo nei e noiʻi i nā hopena o ka ozone ma ke ʻano he disinfectant ma nā ʻili like ʻole i haumia ʻia me MDRO a me C. difficile spores, kahi i ʻike ʻia e hoʻoulu ai i nā maʻi e pili ana i ka mālama ola. E hoʻomākaukau i nā laʻana o ke kila kila, ka lole (pulupulu), ke aniani, ka plastic (acrylic), a me ka lāʻau (pine) e ana ana i hoʻokahi kenimika ma hoʻokahi kenimika. E hoʻomaʻemaʻe i nā coupons ma mua o ka hoʻohana ʻana. Ua hoʻomaʻemaʻe ʻia nā laʻana āpau e ka autoclaving ma mua o ka maʻi ʻana me ka bacteria.
Ma kēia haʻawina, ua hoʻolaha ʻia nā ʻāpana bacteria ma nā ʻili substrate like ʻole a me nā papa agar. A laila hoʻomaʻemaʻe ʻia nā panela ma ka hōʻike ʻana iā lākou i ka ozone no kekahi manawa a ma kahi kikoʻī i loko o kahi keʻena i hoʻopaʻa ʻia. Ma ke kiʻi 1 he kiʻi o nā lako hana hoʻomaʻemaʻe ozone. Ua hana ʻia nā reactors plasma DBD ma ka hoʻopili ʻana i nā electrodes kila kila perforated a hōʻike ʻia i mua a me hope o nā papa alumina (dielectric) 1 mm mānoanoa. No nā electrodes perforated, ʻo ka puka a me ka ʻāpana puka he 3 mm a me 0.33 mm, kēlā me kēia. He ʻano poepoe kēlā me kēia electrode me ke anawaena o 43 mm. Ua hoʻohana ʻia kahi mana uila kiʻekiʻe kiʻekiʻe (GBS Elektronik GmbH Minipuls 2.2) e hoʻopili i kahi uila sinusoidal o kahi o 8 kV peak to peak ma ke alapine o 12.5 kHz i nā electrodes perforated e hana i ka plasma ma nā kihi o nā electrodes. ʻOiai ʻo ka ʻenehana he ʻano hoʻomaʻemaʻe kinoea, hana ʻia ka sterilization i loko o kahi keʻena i puʻunaue ʻia e ka nui i nā keʻena o luna a me lalo, kahi i loaʻa ai nā laʻana i haumia ʻia e ka bacteria a me nā mea hana plasma. Loaʻa i ka keʻena o luna ʻelua mau puka valve e wehe a hoʻokuʻu i ke koena ozone. Ma mua o ka hoʻohana ʻana i ka hoʻokolohua, ua ana ʻia ka loli o ka manawa o ka nui o ka ozone i loko o ka lumi ma hope o ka hoʻā ʻana i ka hoʻonohonoho plasma e like me ka spectrum absorption o ka laina spectral o 253.65 nm o ke kukui mercury.
(a) Ka hoʻolālā o kahi hoʻonohonoho hoʻokolohua no ka sterilization o nā bacteria ma nā mea like ʻole e hoʻohana ana i ka ozone i hana ʻia i loko o ka reactor plasma DBD, a me (b) ka nui o ka ozone a me ka manawa hana plasma i loko o ke keʻena sterilization. Ua hana ʻia ke kiʻi me ka hoʻohana ʻana i ka mana OriginPro 9.0 (polokalamu OriginPro, Northampton, MA, USA; https://www.originlab.com).
ʻO ka mea mua, ma ka hoʻomaʻemaʻe ʻana i nā cell bacteria i kau ʻia ma nā papa agar me ka ozone, me ka hoʻololi ʻana i ka nui o ka ozone a me ka manawa mālama, ua hoʻoholo ʻia ka nui o ka ozone kūpono a me ka manawa mālama no ka decontamination o MDRO a me C. difficile. I ka wā o ke kaʻina hana sterilization, hoʻomaʻemaʻe mua ʻia ke keʻena me ka ea ambient a laila hoʻopiha ʻia me ka ozone ma ka hoʻohuli ʻana i ka ʻāpana plasma. Ma hope o ka mālama ʻia ʻana o nā laʻana me ka ozone no kahi manawa i hoʻoholo mua ʻia, hoʻohana ʻia kahi pamu diaphragm e wehe i ke koena o ka ozone. Ua hoʻohana nā ana i kahi laʻana o kahi moʻomeheu piha 24-hola (~ 108 CFU/ml). Ua hoʻoheheʻe mua ʻia nā laʻana o nā hoʻokuʻu ʻana o nā cell bacteria (20 μl) i nā manawa he ʻumi me ka saline sterile, a laila ua hoʻolaha ʻia kēia mau laʻana ma nā papa agar i sterilized me ka ozone i loko o ke keʻena. Ma hope o kēlā, ua hoʻoulu ʻia nā laʻana i hana hou ʻia, nona nā laʻana i hōʻike ʻia a ʻaʻole i hōʻike ʻia i ka ozone, ma 37°C no 24 mau hola a helu ʻia nā kolone e loiloi i ka pono o ka sterilization.
Eia kekahi, e like me nā kūlana sterilization i wehewehe ʻia ma ke aʻo ʻana ma luna, ua loiloi ʻia ka hopena decontamination o kēia ʻenehana ma MDRO a me C. difficile me ka hoʻohana ʻana i nā coupons o nā mea like ʻole (kila kila, lole, aniani, plastic a me nā coupons lāʻau) i hoʻohana pinepine ʻia i nā ʻoihana lapaʻau. Ua hoʻohana ʻia nā moʻomeheu piha 24 hola (~108 cfu/ml). Ua hoʻoheheʻe ʻia nā laʻana o ka hoʻokuʻu ʻana o nā cell bacteria (20 μl) i nā manawa he ʻumi me ka saline sterile, a laila ua hoʻokomo ʻia nā coupons i loko o kēia mau wai hoʻoheheʻe ʻia e loiloi i ka haumia. Ua waiho ʻia nā laʻana i lawe ʻia ma hope o ka hoʻokomo ʻana i loko o ka wai hoʻoheheʻe ʻia i loko o nā kīʻaha Petri sterile a hoʻomaloʻo ʻia i ka mahana o ka lumi no 24 mau hola. E kau i ka uhi o ka pā petri ma luna o ka laʻana a waiho pono i loko o ke keʻena hoʻāʻo. Wehe i ke poʻi mai ka pā Petri a hōʻike i ka laʻana i ka ozone 500 ppm no 15 mau minuke. Ua waiho ʻia nā laʻana kaohi i loko o kahi keʻena palekana biological a ʻaʻole i hōʻike ʻia i ka ozone. Ma hope koke iho o ka hōʻike ʻana i ka ozone, ua hui pū ʻia nā laʻana a me nā laʻana i hoʻomālamalama ʻole ʻia (ʻo ia hoʻi nā kaohi) me ka saline sterile me ka hoʻohana ʻana i ka mixer vortex e hoʻokaʻawale i ka bacteria mai ka ʻili. Ua hoʻokahe ʻia ka wai hoʻokahe ʻia he 10 mau manawa me ka saline sterile, ma hope iho ua hoʻoholo ʻia ka nui o nā bacteria i hoʻokahe ʻia ma nā papa agar koko (no nā bacteria aerobic) a i ʻole nā ​​papa agar koko anaerobic no Brucella (no Clostridium difficile) a hoʻomoʻa ʻia ma 37°C no 24 mau hola. a i ʻole ma lalo o nā kūlana anaerobic no 48 mau hola ma 37°C ma ka pālua e hoʻoholo ai i ka nui mua o ka inoculum. Ua helu ʻia ka ʻokoʻa o ka helu bacteria ma waena o nā kaohi i hōʻike ʻole ʻia a me nā laʻana i hōʻike ʻia e hāʻawi i kahi hōʻemi log i ka helu bacteria (ʻo ia hoʻi, ka pono sterilization) ma lalo o nā kūlana hoʻāʻo.
Pono e hoʻopaʻa ʻia nā cell biological ma kahi papa kiʻi AFM; no laila, hoʻohana ʻia kahi disk mica pālahalaha a ʻano like me ka unahi ʻoʻoleʻa me kahi pae ʻoʻoleʻa liʻiliʻi ma mua o ka nui o ke kelepona ma ke ʻano he substrate. ʻO ke anawaena a me ka mānoanoa o nā disks he 20 mm a me 0.21 mm, kēlā me kēia. No ka hoʻopaʻa paʻa ʻana i nā cell i ka ʻili, ua uhi ʻia ka ʻili o ka mica me ka poly-L-lysine (200 µl), e hoʻopiha maikaʻi ʻia a hoʻopiha maikaʻi ʻole ʻia ka membrane cell. Ma hope o ka uhi ʻana me ka poly-L-lysine, ua holoi ʻia nā disks mica i 3 mau manawa me ka wai 1 ml deionized (DI) a maloʻo i ka ea i ka pō. A laila, ua hoʻopili ʻia nā cell bacteria i ka ʻili mica i uhi ʻia me ka poly-L-lysine ma ka hoʻohui ʻana i kahi hopena bacteria dilute, waiho ʻia no 30 min, a laila ua holoi ʻia ka ʻili mica me 1 ml o ka wai deionized.
Ua mālama ʻia ka hapalua o nā laʻana me ka ozone a ua ʻike ʻia ke ʻano o ka ʻili o nā papa mica i hoʻouka ʻia me VRE, CRAB a me nā spores C. difficile me ka hoʻohana ʻana iā AFM (XE-7, nā ʻōnaehana paka). Ua hoʻonohonoho ʻia ke ʻano hana AFM i ke ʻano tapping, ʻo ia ke ʻano maʻamau no ke kiʻi ʻana i nā cell biological. I nā hoʻokolohua, ua hoʻohana ʻia kahi microcantilever i hoʻolālā ʻia no ke ʻano non-contact (OMCL-AC160TS, OLYMPUS Microscopy). Ua hoʻopaʻa ʻia nā kiʻi AFM ma muli o ka wikiwiki scan probe o 0.5 Hz e hopena ana i kahi hoʻonā kiʻi o 2048 × 2048 mau pikela.
No ka hoʻoholo ʻana i nā kūlana ma lalo o ka pono o nā reactors plasma DBD no ka sterilization, ua hana mākou i kahi moʻo o nā hoʻokolohua e hoʻohana ana iā MDRO (VRE, CRE, CRPA, a me CRAB) a me C. difficile e hoʻololi i ka nui o ka ozone a me ka manawa hōʻike. Ma ke kiʻi. Hōʻike ʻo 1b i ka piʻo manawa o ka nui o ka ozone no kēlā me kēia kūlana hoʻāʻo ma hope o ka hoʻohuli ʻana i ka hāmeʻa plasma. Ua piʻi ka nui ma ke ʻano logarithmically, hiki i ka 300 a me 500 ppm ma hope o 1.5 a me 2.5 mau minuke, kēlā me kēia. Ua hōʻike nā hoʻokolohua mua me VRE ʻo ka palena iki e pono ai e hoʻomaʻemaʻe pono i ka bacteria he 300 ppm ozone no 10 mau minuke. No laila, ma nā hoʻokolohua ma hope, ua hōʻike ʻia ʻo MDRO a me C. difficile i ka ozone ma ʻelua mau ʻano like ʻole (300 a me 500 ppm) a ma ʻelua mau manawa hōʻike like ʻole (10 a me 15 mau minuke). Ua helu ʻia ka pono o ka sterilization no kēlā me kēia mahele ozone a me ka hoʻonohonoho manawa hōʻike a ua hōʻike ʻia ma ka Papa 1. ʻO ka hōʻike ʻana i ka 300 a i ʻole 500 ppm ozone no 10-15 mau minuke ua hopena i ka emi ʻana o ka VRE o 2 a ʻoi aku paha log10. Ua hoʻokō ʻia kēia pae kiʻekiʻe o ka pepehi bacteria me CRE me 15 mau minuke o ka hōʻike ʻana i ka 300 a i ʻole 500 ppm ozone. Ua hoʻokō ʻia ka hōʻemi kiʻekiʻe ma CRPA (> 7 log10) me ka hoʻolaha ʻana i 500 ppm o ka ozone no 15 min. Ua hoʻokō ʻia ka hōʻemi kiʻekiʻe ma CRPA (> 7 log10) me ka hoʻolaha ʻana i 500 ppm o ka ozone no 15 min. Высокое снижение CRPA (> 7 log10) было достигнуто при воздействии 500 частей на миллион озона в течение 15 минут. Ua hoʻokō ʻia ka emi ʻana o ka CRPA (> 7 log10) me ka hoʻolaha ʻana i ka ozone 500 ppm no 15 mau minuke.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) mai 15-минутного воздействия озона с концентрацией 500 ppm. Ka emi nui ʻana o ka CRPA (> 7 log10) ma hope o 15 mau minuke o ka hoʻopili ʻia ʻana i ka ozone 500 ppm.Ka pepehi ʻana i ka bacteria CRAB ma 300 ppm ozone; eia naʻe, ma ka 500 ppm ozone, aia kahi hōʻemi > 1.5 log10. eia naʻe, ma ka 500 ppm ozone, aia kahi hōʻemi > 1.5 log10. однако при концентрации озона 500 частей на миллион наблюдалось снижение > 1,5 log10. akā naʻe, ma kahi nui o ka ozone o 500 ppm, ua ʻike ʻia ka emi ʻana o >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. Eia nō naʻe, ma kahi nui o ka ozone he 500 ppm, ua ʻike ʻia ka emi ʻana o >1.5 log10. ʻO ka hōʻike ʻana i nā spores C. difficile i ka ozone 300 a i ʻole 500 ppm i hopena i ka emi ʻana > 2.5 log10. ʻO ka hōʻike ʻana i nā spores C. difficile i ka ozone 300 a i ʻole 500 ppm i hopena i ka emi ʻana > 2.5 log10. Воздействие на споры C. difficile озона с концентрацией 300 или 500 частей на миллион приводило к снижению > 2,5 log10. ʻO ka hōʻike ʻana o nā spores C. difficile i ka ozone 300 a i ʻole 500 ppm i hopena i ka hōʻemi ʻana ma mua o 2.5 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 log10. ʻO ka hōʻike ʻana o nā spores C. difficile i ka ozone 300 a i ʻole 500 ppm i hopena i ka hōʻemi ʻana ma mua o 2.5 log10.
Ma muli o nā hoʻokolohua ma luna, ua ʻike ʻia kahi koi lawa e hoʻopau i ka bacteria ma kahi mahele o 500 ppm ozone no 15 mau minuke. Ua hoʻāʻo ʻia nā spores VRE, CRAB a me C. difficile no ka hopena germicidal o ka ozone ma nā ʻano mea like ʻole me ke kila kila, ka lole, ke aniani, ka plastic a me ka lāʻau i hoʻohana pinepine ʻia i nā haukapila. Hōʻike ʻia ko lākou pono sterilization ma ka Papa 2. Ua loiloi ʻia nā meaola hoʻāʻo i ʻelua manawa. Ma VRE a me CRAB, ʻaʻole i maikaʻi ka ozone ma nā ʻili aniani a me ka plastic, ʻoiai ua ʻike ʻia kahi hōʻemi log10 ma kahi o 2 a ʻoi aku paha ma nā ʻili kila kila, ka lole a me ka lāʻau. Ua ʻike ʻia nā spores C. difficile ʻoi aku ka paʻakikī i ka mālama ʻana i ka ozone ma mua o nā meaola ʻē aʻe i hoʻāʻo ʻia. No ke aʻo ʻana i ka hopena o ka ozone ma ka hopena pepehi o nā mea like ʻole e kūʻē iā VRE, CRAB, a me C. difficile, ua hoʻohana ʻia nā t-tests e hoʻohālikelike i nā ʻokoʻa ma waena o ka helu o CFU no ka milliliter ma nā hui kaohi a me nā hui hoʻokolohua ma nā mea like ʻole (Kiʻi 2). ua hōʻike nā ʻano ʻokoʻa koʻikoʻi i ka helu helu, akā ua ʻike ʻia nā ʻokoʻa koʻikoʻi no nā spores VRE a me CRAB ma mua o nā spores C. difficile.
Ka hoʻolaha ʻana o nā hopena o ka ozone ma ka pepehi ʻana i nā bacteria o nā mea like ʻole (a) VRE, (b) CRAB, a me (c) C. difficile.
Ua hana ʻia ke kiʻi ʻana o AFM ma nā spores VRE, CRAB, a me C. difficile i mālama ʻia me ka ozone a me ka mālama ʻole ʻia e aʻo pono i ke kaʻina hana sterilization kinoea ozone. Ma ke kiʻi 3a, c a me e hōʻike i nā kiʻi AFM o nā spores VRE, CRAB a me C. difficile i mālama ʻole ʻia, kēlā me kēia. E like me ka mea i ʻike ʻia ma nā kiʻi 3D, ua laumania a paʻa nā cell. Hōʻike nā Kiʻi 3b, d a me f i nā spores VRE, CRAB a me C. difficile ma hope o ka mālama ʻana i ka ozone. ʻAʻole wale lākou i emi iho i ka nui holoʻokoʻa no nā cell āpau i hoʻāʻo ʻia, akā ua ʻike ʻia ko lākou ʻili ma hope o ka hōʻike ʻana i ka ozone.
Nā kiʻi AFM o nā spores VRE, MRAB a me C. difficile i mālama ʻole ʻia (a, c, e) a me (b, d, f) i mālama ʻia me ka ozone 500 ppm no 15 min. Ua kaha kiʻi ʻia nā kiʻi me ka hoʻohana ʻana iā Park Systems XEI mana 5.1.6 (XEI Software, Suwon, Korea; https://www.parksystems.com/102-products/park-xe-bio).
Hōʻike kā mākou noiʻi ʻana ua hōʻike ka ozone i hana ʻia e nā lako plasma DBD i ka hiki ke hoʻomaʻemaʻe pono i nā spores MDRO a me C. difficile, kahi i ʻike ʻia he mau kumu nui o nā maʻi e pili ana i ka mālama ola. Eia kekahi, i kā mākou noiʻi ʻana, no ka mea hiki i ka haumia o ke kaiapuni me nā spores MDRO a me C. difficile ke lilo i kumu o nā maʻi e pili ana i ka mālama ola, ua ʻike ʻia ka hopena germicidal o ka ozone he holomua no nā mea i hoʻohana nui ʻia ma nā wahi haukapila. Ua hana ʻia nā hoʻāʻo decontamination me ka hoʻohana ʻana i nā lako plasma DBD ma hope o ka haumia artificial o nā mea e like me ke kila kila, ka lole, ke aniani, ka plastic a me ka lāʻau me nā spores MDRO a me C. difficile. ʻO ka hopena, ʻoiai ʻokoʻa ka hopena decontamination ma muli o ka mea, he mea kupaianaha ka hiki ke decontamination o ka ozone.
Pono nā mea i hoʻopā pinepine ʻia i loko o nā lumi haukapila i ka disinfection maʻamau a haʻahaʻa. ʻO ke ʻano maʻamau no ka hoʻomaʻemaʻe ʻana i kēlā mau mea, ʻo ia ka hoʻomaʻemaʻe lima me kahi disinfectant wai e like me ka hui ammonium quaternary 13. ʻOiai me ka mālama pono ʻana i nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana i nā disinfectants, paʻakikī ke wehe ʻana iā MPO e ka hoʻomaʻemaʻe kūlohelohe (ʻo ka hoʻomaʻemaʻe lima pinepine)14. No laila, pono nā ʻenehana hou, e like me nā ʻano pili ʻole. No laila, ua nui ka hoihoi i nā disinfectants gaseous, me ka hydrogen peroxide a me ka ozone10. ʻO ka pōmaikaʻi o nā disinfectants gaseous, hiki iā lākou ke hiki i nā wahi a me nā mea i hiki ʻole i nā ʻano hana lima kuʻuna ke hiki. Ua hoʻohana hou ʻia ka hydrogen peroxide i nā wahi lapaʻau, akā naʻe he mea ʻawahia ka hydrogen peroxide ponoʻī a pono e mālama ʻia e like me nā kaʻina hana lawelawe koʻikoʻi. Pono ka sterilization plasma me ka hydrogen peroxide i kahi manawa hoʻomaʻemaʻe lōʻihi ma mua o ke kaʻina hana sterilization aʻe. I ka hoʻohālikelike ʻana, hana ka ozone ma ke ʻano he mea antibacterial ākea, kūpono i ka bacteria a me nā virus i kūʻē i nā disinfectants ʻē aʻe8,11,15. Eia kekahi, hiki ke hana ʻia ka ozone me ke kumu kūʻai haʻahaʻa mai ka lewa lewa a ʻaʻole pono nā kemika ʻawaʻawa hou aʻe e hiki ke waiho i kahi kapuaʻi ʻino i ke kaiapuni, ʻoiai e haki ana i ka oxygen. Eia nō naʻe, ʻo ke kumu i hoʻohana nui ʻole ʻia ai ka ozone ma ke ʻano he disinfectant penei. He mea ʻawaʻawa ka Ozone i ke olakino kanaka, no laila ʻaʻole i ʻoi aku kona nui ma mua o 0.07 ppm ma ka awelika no nā hola he 8 a ʻoi aku, no laila ua hoʻomohala ʻia nā mea hoʻomaʻemaʻe ozone a kau ʻia ma ka mākeke, ʻo ia hoʻi no ka hoʻomaʻemaʻe ʻana i nā kinoea hoʻopau. Hiki nō hoʻi ke hanu i ke kinoea a hana i kahi ʻala ʻino ma hope o ka decontamination5,8. ʻAʻole i hoʻohana nui ʻia ka Ozone ma nā ʻoihana lapaʻau. Eia nō naʻe, hiki ke hoʻohana palekana ʻia ka ozone i loko o nā keʻena sterilization a me nā kaʻina hana ea kūpono, a hiki ke hoʻolalelale nui ʻia kona wehe ʻana ma ka hoʻohana ʻana i kahi mea hoʻololi catalytic. Ma kēia haʻawina, hōʻike mākou e hiki ke hoʻohana ʻia nā mea hoʻomaʻemaʻe ozone plasma no ka disinfection ma nā wahi mālama ola. Ua hoʻomohala mākou i kahi mea hana me nā hiki sterilization kiʻekiʻe, ka hana maʻalahi a me ka lawelawe wikiwiki no nā maʻi maʻi. Eia kekahi, ua hoʻomohala mākou i kahi ʻāpana sterilization maʻalahi e hoʻohana ana i ka ea ambient me ke kumu kūʻai ʻole. A hiki i kēia lā, ʻaʻohe ʻike lawa e pili ana i nā koi ozone liʻiliʻi no ka hoʻopau ʻana o MDRO. He maʻalahi ke hoʻonohonoho ʻana i nā lako i hoʻohana ʻia ma kā mākou noiʻi a he pōkole ka manawa holo a ua manaʻo ʻia he mea pono no ka hoʻomaʻemaʻe pinepine ʻana i nā lako.
ʻAʻole maopopo loa ke ʻano o ka hana bactericidal o ka ozone. Ua hōʻike ʻia kekahi mau noiʻi e hōʻino ana ka ozone i nā membrane cell bacteria, e alakaʻi ana i ka leakage intracellular a me ka lysis cell hope loa17,18. Hiki i ka Ozone ke hoʻopilikia i ka hana enzymatic cellular ma ka pane ʻana me nā hui thiol a hiki ke hoʻololi i nā kumu purine a me pyrimidine i loko o nā waikawa nucleic. Ua ʻike kēia haʻawina i ke ʻano o nā spores VRE, CRAB, a me C. difficile ma mua a ma hope o ka mālama ʻana i ka ozone a ua ʻike ʻia ʻaʻole wale lākou i emi iho i ka nui, akā ua lilo lākou i ʻoi aku ka paʻakikī ma ka ʻili, e hōʻike ana i ka hōʻino a i ʻole ka pala o ka membrane waho loa. a me nā mea kūloko ma muli o ke kinoea ozone he hiki ke oxidizing ikaika. Hiki i kēia hōʻino ke alakaʻi i ka inactivation cell, ma muli o ke koʻikoʻi o nā loli cellular.
He paʻakikī ke wehe ʻana i nā spores C. difficile mai nā lumi haukapila. Noho nā spores ma nā wahi i hoʻokahe ai lākou i 10,20. Eia kekahi, ma kēia haʻawina, ʻoiai ʻo ka nui o ka logarithmic 10-fold emi ʻana o ka helu o nā bacteria ma nā papa agar ma 500 ppm ozone no 15 mau minuke he 2.73, ua hoʻemi ʻia ka hopena bactericidal o ka ozone ma nā mea like ʻole e loaʻa ana nā spores C .difficile. No laila, hiki ke noʻonoʻo ʻia nā hoʻolālā like ʻole e hōʻemi i ka maʻi C. difficile i nā wahi mālama ola kino. No ka hoʻohana ʻana i nā keʻena C. difficile i hoʻokaʻawale ʻia wale nō, he mea pono paha ke hoʻoponopono i ka manawa hōʻike a me ka ikaika o ka mālama ʻana i ka ozone. Eia kekahi, pono mākou e hoʻomanaʻo ʻaʻole hiki i ke ʻano decontamination ozone ke pani piha i ka hoʻomaʻemaʻe lima maʻamau me nā disinfectants a me nā hoʻolālā antimicrobial, a hiki ke lilo i mea maikaʻi loa i ka kaohi ʻana iā C. difficile 5. Ma kēia haʻawina, ua ʻokoʻa ka pono o ka ozone ma ke ʻano he disinfectant no nā ʻano MPO like ʻole. Hiki ke hilinaʻi ka pono i kekahi mau mea e like me ke kahua ulu, ka paia cell, a me ka pono o nā ʻano hana hoʻoponopono21,22. ʻO ke kumu o ka hopena sterilizing ʻokoʻa o ka ozone ma luna o ka ʻili o kēlā me kēia mea ma muli paha o ka hoʻokumu ʻia ʻana o kahi biofilm. Ua hōʻike ʻia nā haʻawina mua e hoʻonui ana ʻo E. faecium lāua ʻo E. faecium i ke kū'ē ʻana i ke kaiapuni ke kū nei ma ke ʻano he biofilms23, 24, 25. Eia nō naʻe, hōʻike kēia haʻawina he hopena bactericidal koʻikoʻi ko ka ozone ma nā spores MDRO a me C. difficile.
ʻO kahi palena o kā mākou noiʻi ʻana, ʻo ia ka loiloi ʻana i ka hopena o ka paʻa ʻana o ka ozone ma hope o ka hoʻoponopono ʻana. Hiki i kēia ke alakaʻi i ka helu nui ʻana o ka nui o nā cell bacteria ola.
ʻOiai ua hana ʻia kēia noiʻi e loiloi i ka pono o ka ozone ma ke ʻano he disinfectant ma kahi haukapila, he paʻakikī ke hoʻolaha i kā mākou mau hopena i nā wahi haukapila āpau. No laila, pono ka noiʻi hou aku e noiʻi i ka hoʻohana a me ka kūlike o kēia DBD ozone sterilizer ma kahi haukapila maoli.
Hiki i ka ozone i hana ʻia e nā reactors plasma DBD ke lilo i mea hoʻomaʻemaʻe maʻalahi a waiwai nui no MDRO a me C. difficile. No laila, hiki ke noʻonoʻo ʻia ka mālama ʻana i ka ozone ma ke ʻano he koho kūpono no ka disinfection o ke kaiapuni haukapila.
Loaʻa nā ʻikepili i hoʻohana ʻia a/a i ʻole i kālailai ʻia i ke aʻo ʻana o kēia manawa mai nā mea kākau like ʻole ma ke noi kūpono.
Hoʻolālā honua o WHO e kāohi i ke kū'ē ʻana i nā antimicrobial. https://www.who.int/drugresistance/WHO_Global_Strategy.htm/en/ Loaʻa.
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