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He kuleana koʻikoʻi ke kaiapuni mālama ola kino i ka hoʻolaha ʻana o nā mea ola multidrug-resistant (MDR) a me C. difficile. ʻO ke kumu o kēia haʻawina ʻo ia ka loiloi i ka hopena o ka ozone i hana ʻia e ka dielectric barrier discharge (DBD) plasma reactor ma ka hana a vancomycin-resistant Enterococcus faecalis (VRE), carbapenem-resistant Klebsiella pneumoniae (CRE), carbapenem-resistant Antibacterial hopena o nā mea like ʻole i haumia me Pseudomonas spp. ʻO Pseudomonas aeruginosa (CRPA), ʻo Acinetobacter baumannii (CRAB) kūʻē i ka carbapenem a me Clostridium difficile spores. Ua mālama ʻia nā ʻano mea like ʻole me VRE, CRE, CRPA, CRAB a me C. difficile spores me ka ozone ma nā ʻano ʻokoʻa a me nā manawa hōʻike. Ua hōʻike ʻo Atomic force microscopy (AFM) i ka hoʻololi ʻana o ka ʻili o ka bacteria ma hope o ka mālama ʻana i ka ozone. I ka wā i hoʻohana ʻia ai kahi maʻi o 500 ppm ozone i VRE a me CRAB no 15 mau minuke, ua ʻike ʻia ka emi ʻana o ka 2 a ʻoi aku ka log10 i ke kila kila, ka lole a me ka lāʻau, a ʻike ʻia ka emi ʻana o 1-2 log10 i ke aniani a me ka plastic. Ua ʻike ʻia ʻo C. difficile spores ʻoi aku ke kūʻē i ka ozone ma mua o nā mea ola ʻē aʻe i hoʻāʻo ʻia. Ma ka AFM, ma hope o ka mālama ʻana me ka ozone, ua pehu a hoʻomāinoino nā cell bacteria. ʻO ka ozone i hanaʻia e ka DBD Plasma Reactor he mea hana hoʻopau maʻalahi a waiwai no nā spores MDRO a me C. difficile, iʻikeʻia he mau pathogens maʻamau o nā maʻi e pili ana i ke olakino.
ʻO ka puka ʻana mai o nā lāʻau multidrug-resistant (MDR) ma muli o ka hoʻohana hewa ʻana i nā lāʻau antibiotic i ke kanaka a me nā holoholona a ua ʻike ʻia e ka World Health Organization (WHO) he mea hoʻoweliweli nui i ke olakino lehulehu1. ʻO ka mea kūikawā, ke kū nei nā keʻena mālama olakino i ka puka ʻana a me ka hoʻolaha 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 ka carbapenem-resistant (C Enterobacterm). Eia kekahi, ʻo ka maʻi Clostridium difficile kahi kumu nui o ka maʻi maʻi e pili ana i ka mālama olakino, e kau ana i kahi kaumaha nui i ka ʻōnaehana mālama ola. Hoʻouna ʻia ʻo MDRO a me C. difficile ma o nā lima o nā limahana mālama ola, nā wahi i hoʻohaumia ʻia, a i ʻole mai ke kanaka a i ke kanaka. Ua hōʻike ʻia nā haʻawina hou i nā wahi i hoʻohaumia ʻia i nā wahi mālama olakino e hana nui i ka lawe ʻana i ka MDRO a me C. difficile i ka wā e hoʻopili ai nā limahana olakino (HCWs) i nā wahi i hoʻopōʻino ʻia a i ka wā e hele mai ai nā mea maʻi i ka hoʻopili pololei ʻana me nā wahi i hoʻohaumia ʻia 3,4. ʻO nā wahi i hoʻohaumia ʻia i nā wahi mālama olakino e hoʻemi i ka nui o ka maʻi MLRO a me C. difficile a i ʻole colonization5,6,7. Hāʻawi ʻia i ka hopohopo honua e pili ana i ka piʻi ʻana o ke kūʻē antimicrobial, ʻike maopopo ʻia ka nui o ka noiʻi ʻana e pili ana i nā ʻano a me nā kaʻina hana no ka decontamination i nā wahi mālama olakino. I kēia mau lā, ua ʻike ʻia nā ʻano hoʻomaʻemaʻe hoʻomaʻemaʻe ʻole, ʻoi aku ka ultraviolet (UV) a i ʻole nā ​​​​pūnaewele hydrogen peroxide. Eia nō naʻe, ʻaʻole kūʻai wale kēia mau mea uila UV a i ʻole hydrogen peroxide i kūʻai ʻia, ʻoi aku ka maikaʻi o ka disinfection UV ma nā ʻaoʻao i ʻike ʻia, aʻo ka hydrogen peroxide plasma disinfection e koi i kahi manawa decontamination lōʻihi ma mua o ke kaʻina disinfection e hiki mai ana5.
Ua ʻike ʻo Ozone i nā waiwai anti-corrosion a hiki ke hana ʻia me ke kumu kūʻai ʻole8. Ua ʻike ʻia he mea ʻawaʻawa i ke olakino kanaka, akā hiki ke hoʻoheheʻe koke ʻia i ka oxygen 8. ʻO nā reactors plasma dielectric barrier discharge (DBD) ka mea maʻamau o nā mea hana ozone9. 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 ʻino. Ua hōʻike ʻia kekahi mau haʻawina i kona hoʻohana ʻana i nā hoʻonohonoho mālama olakino8,11.
Ma kēia noiʻi ʻana, ua hoʻohana mākou i ka DBD plasma ozone generator e hōʻike i kona pono i ka hoʻomaʻemaʻe ʻana i ka MDRO a me C. difficile, ʻo ia hoʻi nā mea i hoʻopaʻa ʻia ma nā mea like ʻole i hoʻohana mau ʻia i nā ʻoihana olakino. Eia hou, ua wehewehe ʻia ke kaʻina hana sterilization ozone me ka hoʻohana ʻana i nā kiʻi atomic force microscopy (AFM) o nā cell i mālama ʻia i ka ozone.
Ua loaʻa nā ʻāʻī mai nā kaʻawale maʻi o: VRE (SCH 479 a me SCH 637), carbapenem-resistant Klebsiella pneumoniae (CRE; SCH CRE-14 a me DKA-1), carbapenem-resistant Pseudomonas aeruginosa (CRPA; 54 a me 83) a me ka carbapenem-resistant bacteria. bacteria Pseudomonas aeruginosa (CRPA; 54 a me 83). Acinetobacter baumannii (CRAB; F2487 a me SCH-511). Ua loaʻa iā C. difficile mai ka National Pathogen Culture Collection (NCCP 11840) o ka Korea Agency for Disease Control and Prevention. Ua hoʻokaʻawale ʻia mai kahi mea maʻi ma South Korea i ka makahiki 2019 a ua ʻike ʻia ʻo ST15 me ka hoʻohana ʻana i ke ʻano multilocus sequence type. ʻO ka Brain Heart Infusion (BHI) Broth (BD, Sparks, MD, USA) i hoʻopili ʻia me VRE, CRE, CRPA a me CRAB ua hui maikaʻi ʻia a hoʻokomo ʻia ma 37 ° C. no 24 mau hola.
C. difficile streaked anaerobic ma ke koko agar no 48 hola. Ua hoʻohui ʻia kekahi mau kolone i 5 ml o ka hupa puʻuwai o ka lolo a hoʻomoʻi ʻia ma lalo o nā kūlana anaerobic no 48 mau hola. Ma hope o kēlā, hoʻoluliluli ʻia ka moʻomeheu, 5 ml o 95% ethanol i hoʻohui ʻia, hoʻoluliluli hou a waiho ʻia i ka lumi wela 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 pepehi i ka bacteria i 0.3 ml o ka wai. Ua helu ʻia nā pūnaewele ola e ka hoʻoulu ʻia ʻana o ka hoʻokuʻu ʻia ʻana o ka cell bacteria ma luna o nā pā agara koko ma hope o ka hoʻoheheʻe ʻia ʻana. Ua hōʻoia ʻo Gram staining he 85% a i ka 90% o nā hale bacteria he spores.
Ua mālama ʻia kēia haʻawina e noiʻi i nā hopena o ka ozone ma ke ʻano he disinfectant ma luna o nā ʻāpana like ʻole i hoʻohaumia ʻia me MDRO a me C. difficile spores, i ʻike ʻia ke kumu o nā maʻi e pili ana i ka mālama olakino. E hoʻomākaukau i nā laʻana o ke kila kuhiliʻole, ka lole (ʻulaʻula), ke aniani, ka plastic (acrylic), a me ka lāʻau (pine) e ana ana i hoʻokahi kenimika me hoʻokahi kenimika. E hoʻomaʻemaʻe i nā coupons ma mua o ka hoʻohana ʻana. Hoʻopili ʻia nā laʻana a pau e ka autoclaving ma mua o ka loaʻa ʻana o ka maʻi bacteria.
I loko o kēia noiʻi ʻana, ua hoʻolaha ʻia nā cell bacteria ma nā ʻaoʻao substrate like ʻole me nā papa agar. Hoʻopili ʻia nā paneli ma ka hoʻolaha ʻana iā lākou i ka ozone no kekahi manawa a ma kahi ʻano i loko o kahi keʻena i hoʻopaʻa ʻia. Ma ka fig. He kiʻi ʻo 1 o nā mea hana hoʻomaʻemaʻe ozone. Ua hana ʻia nā mea hoʻoheheʻe plasma DBD ma o ka hoʻopili ʻana i nā electrodes kila stainless i ka mua a me hope o nā pā alumina (dielectric) mānoanoa 1 mm. No nā electrodes perforated, he 3 mm a me 0.33 mm ka puka a me ka lua. He ʻano poepoe kēlā me kēia electrode me ke anawaena o 43 mm. Ua hoʻohana ʻia kahi mana kiʻekiʻe kiʻekiʻe kiʻekiʻe (GBS Elektronik GmbH Minipuls 2.2) no ka hoʻopili ʻana i ka volta sinusoidal ma kahi o 8 kV peak a hiki i ka piko ma ke alapine o 12.5 kHz i nā electrodes perforated e hana i ka plasma ma nā kihi o nā electrodes. nā electrodes perforated. No ka mea he ʻenehana sterilization ka ʻenehana, lawe ʻia ka sterilization i loko o kahi keʻena i hoʻokaʻawale ʻia e ka leo i loko o nā ʻāpana o luna a me lalo, kahi i loaʻa i nā mea hoʻohālikelike bacteria a me nā mea hana plasma, kēlā me kēia. ʻO ke keʻena o luna he 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 hoʻololi ʻana i ka manawa o ka ozone i loko o ka lumi ma hope o ka hoʻohuli ʻana i ka hoʻonohonoho plasma e like me ka spectrum absorption o ka laina spectral o 253.65 nm o kahi kukui mercury.
(a) Hoʻolālā o kahi hoʻonohonoho hoʻokolohua no ka hoʻomaʻamaʻa ʻana i nā maʻi bacteria ma nā mea like ʻole me ka hoʻohana ʻana i ka ozone i hana ʻia i loko o ka DBD plasma reactor, a (b) ozone concentration a me ka manawa hana plasma i loko o ke keʻena sterilization. Ua hana ʻia ke kiʻi me ka OriginPro version 9.0 (OriginPro software, Northampton, MA, USA; https://www.originlab.com).
ʻO ka mea mua, ma ka sterilizing cell bacteria i kau ʻia ma luna o nā papa agar me ka ozone, ʻoiai e hoʻololi ana i ka ʻike ozone a me ka manawa lapaʻau, ua hoʻoholo ʻia ka manawa kūpono o ka ozone a me ka manawa mālama no ka decontamination o MDRO a me C. difficile. I ka wā o ka 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 koho mua ʻia, hoʻohana ʻia kahi pamu diaphragm e wehe i ke koena ozone. Ua hoʻohana nā ana i kahi laʻana o kahi moʻomeheu piha 24-hola (~ 108 CFU/ml). ʻO nā laʻana o ka hoʻokuʻu ʻana o nā pūnaewele bacteria (20 μl) i hoʻoheheʻe mua ʻia i nā manawa he ʻumi me ka saline sterile, a laila ua māhele ʻia kēia mau laʻana ma nā papa agar sterilized me ka ozone i loko o ke keʻena. Ma hope o kēlā, ua hoʻopili ʻia nā laʻana hou, ʻo ia hoʻi nā laʻana i hōʻike ʻia a ʻaʻole i ʻike ʻia i ka ozone, i hoʻomoʻa ʻia 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 ka noiʻi 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 (stainless steel, fabric, glass, plastic and wood coupons) i hoʻohana mau ʻia i nā keʻena olakino. Ua hoʻohana ʻia nā moʻomeheu piha 24 hola (~108 cfu/ml). ʻO nā laʻana o ka hoʻokuʻu ʻia ʻana o ka cell bacteria (20 μl) i hoʻoheheʻe ʻia he ʻumi mau manawa me ka saline sterile, a laila ua hoʻokomo ʻia nā coupons i loko o kēia mau broths i hoʻoheheʻe ʻia e nānā i ka haumia. ʻO nā laʻana i wehe ʻia ma hope o ka hoʻokomo ʻia ʻana i ka broth dilution i hoʻokomo ʻia i loko o nā kīʻaha Petri sterile a hoʻomaloʻo ʻia i ka lumi wela no 24 mau hola. E kau i ka poʻi ipu petri ma luna o ka laʻana a waiho pono i loko o ke keʻena hoʻāʻo. Wehe i ka poʻi mai ka ipu Petri a hōʻike i ka hāpana i 500 ppm ozone no 15 mau minuke. Hoʻokomo ʻia nā laʻana mana i loko o kahi keʻena palekana olaola a ʻaʻole i ʻike ʻia i ka ozone. Ma hope koke o ka ʻike ʻana i ka ozone, ua hui pū ʻia nā laʻana a me nā laʻana non-irradiated (ʻo ia hoʻi nā mana) me ka paʻakai sterile me ka hoʻohana ʻana i kahi hui vortex e hoʻokaʻawale i ka maʻi bacteria mai ka ʻili. Ua hoʻoheheʻe ʻia ka hoʻokuʻu ʻana i ka eluted he 10 mau manawa me ka saline sterile, a ma hope iho ua hoʻoholo ʻia ka helu o nā bacteria i hoʻoheheʻe ʻia ma nā pā koko koko (no ka bacteria aerobic) a i ʻole nā ​​​​palapala 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 ke ʻano pālua e hoʻoholo ai i ka neʻe mua o ka inoculum. Ua helu ʻia ka ʻokoʻa o ka helu bacterial ma waena o nā mana unexposed a me nā laʻana i hōʻike ʻia e hāʻawi i kahi hōʻemi log i nā helu bacteria (ʻo ia hoʻi, sterilization efficiency) ma lalo o nā kūlana hoʻāʻo.
Pono e hoʻokuʻu ʻia nā cell biological ma kahi pā kiʻi AFM; no laila, hoʻohana ʻia kahi pākī mica palahalaha a me ke ʻano like ʻole me ke ʻano ʻino i ʻoi aku ka liʻiliʻi ma mua o ka nui o ke kelepona ma ke ʻano he substrate. ʻO ke anawaena a me ka mānoanoa o nā diski he 20 mm a me 0.21 mm. No ka hoʻopaʻa paʻa ʻana i nā cell i ka ʻili, ua uhi ʻia ka ʻili o ka mika me ka poly-L-lysine (200 µl), e hoʻopiʻi maikaʻi ʻia a hoʻopiʻi maikaʻi ʻia ka membrane cell. Ma hope o ka uhi ʻana me ka poly-L-lysine, ua holoi ʻia nā disks mika i 3 mau manawa me ka wai deionized (DI) 1 ml a maloʻo ka ea i ka pō. A laila, hoʻopili ʻia nā cell bacteria i ka ʻili mika i uhi ʻia me ka poly-L-lysine ma ka hoʻohana ʻana i kahi hopena bacterial dilute, waiho ʻia no 30 min, a laila holoi ʻia ka ʻili mika me 1 ml o ka wai deionized.
Ua mālama ʻia ka hapalua o nā laʻana me ka ozone a ʻike ʻia ka morphology ili o nā papa mika i hoʻopiha ʻia me VRE, CRAB a me C. difficile spores me ka hoʻohana ʻana i ka AFM (XE-7, nā ʻōnaehana paka). Hoʻonohonoho ʻia ke ʻano hana AFM i ke ʻano paʻi, kahi ala 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 mode (OMCL-AC160TS, OLYMPUS Microscopy). Ua hoʻopaʻa ʻia nā kiʻi AFM ma muli o ka helu scan probe o 0.5 Hz me ka hopena o ka hoʻonā kiʻi o 2048 × 2048 pixels.
No ka hoʻoholo ʻana i nā kūlana ma lalo o ka DBD plasma reactors e pono ai no ka sterilization, ua hana mākou i kahi ʻano o nā hoʻokolohua me ka hoʻohana ʻana i ka MDRO (VRE, CRE, CRPA, a me CRAB) a me C. paʻakikī e hoʻololi i ka ʻike ozone a me ka manawa hōʻike. Ma ka fig. Hōʻike ka 1b i ka pihi manawa ozone no kēlā me kēia kūlana hoʻāʻo ma hope o ka hoʻohuli ʻana i ka hāmeʻa plasma. Ua hoʻonui ʻia ka manaʻo logarithmically, hiki i 300 a me 500 ppm ma hope o 1.5 a me 2.5 mau minuke. Ua hōʻike ʻia nā hoʻāʻo mua me VRE ʻo ka palena liʻiliʻi e pono ai e hoʻomaʻemaʻe maikaʻi i ka bacteria he 300 ppm ozone no 10 mau minuke. No laila, ma nā hoʻokolohua e hiki mai ana, ua hōʻike ʻia ʻo MDRO a me C. difficile i ka ozone ma nā ʻāpana ʻokoʻa ʻelua (300 a me 500 ppm) a i ʻelua mau manawa hoʻolaha like ʻole (10 a me 15 mau minuke). Ua helu ʻia ka maikaʻi o ka sterilization no kēlā me kēia ʻano ozone a me ka hoʻonohonoho manawa hoʻolaha a hōʻike ʻia ma ka Papa 1. ʻO ka hōʻike ʻana i 300 a i ʻole 500 ppm ozone no 10-15 mau minuke i hopena i ka hōʻemi holoʻokoʻa o VRE o 2 a ʻoi aku ka log10. Ua hoʻokō ʻia kēia pae kiʻekiʻe o ka pepehi maʻi bacteria me CRE me 15 mau minuke o ka ʻike ʻana i 300 a i ʻole 500 ppm ozone. Loaʻa ka hōʻemi kiʻekiʻe ma CRPA (> 7 log10) me ka ʻike ʻana i 500 ppm o ka ozone no 15 min. Loaʻa ka hōʻemi kiʻekiʻe ma CRPA (> 7 log10) me ka ʻike 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 loaʻa ka hōʻemi kiʻekiʻe o ka CRPA (> 7 log10) me ka ʻike ʻana i 500 ppm ozone 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. ʻO ka emi nui o ka CRPA (> 7 log10) ma hope o 15 mau minuke ka ʻike ʻana i 500 ppm ozone.ʻO ka pepehi ʻole ʻia o ka bacteria CRAB ma 300 ppm ozone; akā naʻe, ma ka 500 ppm ozone, aia kahi > 1.5 log10 hōʻemi. akā naʻe, ma ka 500 ppm ozone, aia kahi > 1.5 log10 hōʻemi. однако при концентрации озона 500 частей на миллион наблюдалось снижение > 1,5 log10. akā naʻe, ma kahi 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 naʻe, ma kahi ozone o 500 ppm, ua ʻike ʻia ka emi ʻana o >1.5 log10. ʻO ka hōʻike ʻana i nā spores C. difficile i 300 a i ʻole 500 ppm ozone i hopena i kahi > 2.5 log10 hōʻemi. ʻO ka hōʻike ʻana i nā spores C. difficile i 300 a i ʻole 500 ppm ozone i hopena i kahi > 2.5 log10 hōʻemi. 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 300 a i ʻole 500 ppm ozone ua hopena i> 2.5 log10 hōʻemi.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 300 a i ʻole 500 ppm ozone ua hopena i> 2.5 log10 hōʻemi.
Ma muli o nā hoʻokolohua ma luna, ua loaʻa kahi koi kūpono e hoʻopau i ka bacteria ma kahi ʻano o 500 ppm ozone no 15 mau minuke. Ua hoʻāʻo ʻia ʻo VRE, CRAB a me C. difficile spores 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 mau ʻia i nā haukapila. Hōʻike ʻia ka maikaʻi o kā lākou sterilization ma ka Papa 2. Ua loiloi ʻia nā mea ola hoʻāʻo ʻelua. Ma VRE a me CRAB, ʻaʻole maikaʻi ka ozone ma nā aniani a me nā ʻili plastik, ʻoiai ua ʻike ʻia ka hoʻemi ʻana o ka log10 ma kahi o 2 a ʻoi aʻe paha ma luna o ke kila kila, ka lole a me nā ʻili lāʻau. Ua ʻike ʻia ʻo C. difficile spores i ʻoi aku ke kūpaʻa i ka lāʻau ozone ma mua o nā mea ola ʻē aʻe i hoʻāʻo ʻia. No ke aʻoʻana i ka helu helu i ka hopena o ka ozone ma ka hopena pepehi o nā mea likeʻole e kū'ē i ka VRE, CRAB, a me C. difficile, ua hoʻohanaʻia nā ho'āʻo-t e hoʻohālikelike i nāʻokoʻa ma waena o ka helu o CFU no ka milliliter ma ka mana a me nā hui hoʻokolohua ma nā mea likeʻole (Fig. 2). Ua ʻike ʻia nā ʻokoʻa koʻikoʻi no ka VRE a me ka CRAB spores ma mua o ka C. difficile spores.
Hoʻopili i nā hopena o ka ozone i ka pepehi ʻana i nā mea bacteria o nā mea like ʻole (a) VRE, (b) CRAB, a me (c) C. difficile.
Ua hana ʻia ke kiʻi kiʻi AFM ma VRE, CRAB, a me C. difficile spores i mālama ʻia i ka ozone a i hoʻoponopono ʻole ʻia e aʻo i nā kikoʻī i ke kaʻina hana sterilization gas ozone. Ma ka fig. 3a, c a me e hōʻike i nā kiʻi AFM o VRE i mālama ʻole ʻia, CRAB a me C. difficile spores. E like me ka ʻike ʻia ma nā kiʻi 3D, ʻoluʻolu 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 hoʻemi i ka nui holoʻokoʻa no nā cell āpau i hoʻāʻo ʻia, akā ua ʻike ʻia ko lākou ʻili ma hope o ka ʻike ʻana i ka ozone.
ʻO nā kiʻi AFM o VRE, MRAB a me C. difficile spores (a, c, e) a me (b, d, f) i mālamaʻoleʻia me ka 500 ppm ozone no 15 min. Ua kaha ʻia nā kiʻi me ka hoʻohana ʻana iā Park Systems XEI version 5.1.6 (XEI Software, Suwon, Korea; https://www.parksystems.com/102-products/park-xe-bio).
Hōʻike kā mākou noiʻi i ka ozone i hana ʻia e nā mea plasma DBD e hōʻike ana i ka hiki ke hoʻokaʻawale maikaʻi i nā spores MDRO a me C. difficile, i ʻike ʻia he kumu nui o nā maʻi e pili ana i ke olakino. Eia hou, i loko o kā mākou noiʻi ʻana, hāʻawi ʻia ka hoʻohaumia ʻana o ke kaiapuni me MDRO a me C. difficile spores hiki ke lilo i kumu o nā maʻi e pili ana i ke olakino, ua ʻike ʻia ka hopena germicidal o ka ozone no nā mea i hoʻohana mua ʻia i nā hoʻonohonoho halemai. Hana ʻia nā hoʻāʻo decontamination me ka hoʻohana ʻana i nā lako plasma DBD ma hope o ka hoʻohaumia ʻana o nā mea e like me ke kila kila, ka lole, ke aniani, ka plastic a me ka lāʻau me MDRO a me C. difficile spores. ʻO ka hopena, ʻoiai ʻokoʻa ka hopena decontamination ma muli o ka mea, he mea kupaianaha ka hiki ke decontamination o ka ozone.
ʻO nā mea i hoʻopā pinepine ʻia i loko o nā keʻena haukapila e pono ai ka disinfection maʻamau, haʻahaʻa haʻahaʻa. ʻO ke ala maʻamau no ka hoʻomaʻemaʻe ʻana i ia mau mea, ʻo ia ka hoʻomaʻemaʻe lima me ka wai disinfectant e like me ka quaternary ammonium compound 13. ʻOiai me ka mālama pono ʻana i nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana i nā disinfectants, paʻakikī ʻo MPO e wehe ʻia e ka hoʻomaʻemaʻe kaiapuni kuʻuna (maʻamau ka hoʻomaʻemaʻe manual)14. No laila, koi ʻia nā ʻenehana hou, e like me nā ala pili ʻole. No laila, ua nui ka hoihoi i nā disinfectants kinoea, me ka hydrogen peroxide a me ka ozone10. ʻO ka pōmaikaʻi o nā disinfectants kinoea hiki iā lākou ke hōʻea i nā wahi a me nā mea i hiki ʻole ke kiʻi ʻia i nā hana manual. Ua hoʻohana ʻia ka hydrogen peroxide i nā lāʻau lapaʻau, akā ʻo ka hydrogen peroxide ponoʻī he mea ʻawaʻawa a pono e mālama ʻia e like me nā kaʻina hana koʻikoʻi. Pono ka sterilization plasma me ka hydrogen peroxide i kahi manawa hoʻomaʻemaʻe lōʻihi ma mua o ka pōʻai sterilization e hiki mai ana. ʻO ka ʻokoʻa, hana ka ozone ma ke ʻano he lāʻau antibacterial ākea ākea, maikaʻi e kūʻē i nā maʻi bacteria a me nā maʻi i kū i nā disinfectants8,11,15. Eia hou, hiki ke hana maʻalahi ka ozone mai ka ea lewa a ʻaʻole koi i nā kemika ʻona ʻē aʻe e hiki ke waiho i kahi kapuaʻi pōʻino i ke kaiapuni, no ka mea, ua haki ia i ka oxygen. Eia naʻe, ʻo ke kumu i hoʻohana ʻole ʻia ai ka ozone ma ke ʻano he disinfectant penei. He mea ʻawaʻawa ʻo Ozone i ke olakino kanaka, no laila ʻaʻole i ʻoi aku ka nui o kona neʻe ʻana ma mua o 0.07 ppm ma ka awelika no nā hola 816, no laila ua hoʻomohala ʻia nā sterilizers ozone a kau ʻia ma ka mākeke, no ka hoʻomaʻemaʻe ʻana i nā kinoea pau. Hiki nō hoʻi ke inhale i ke kinoea a hoʻopuka i kahi ʻala maikaʻi ʻole ma hope o ka decontamination5,8. ʻAʻole i hoʻohana ikaika ʻia ka Ozone i nā keʻena lapaʻau. Eia naʻe, hiki ke hoʻohana maluhia ʻia ka ozone i loko o nā keʻena sterilization a me nā kaʻina hana hoʻoheheʻe kūpono, a hiki ke hoʻonui nui ʻia kona wehe ʻana ma o ka hoʻohana ʻana i ka catalytic converter. Ma kēia haʻawina, hōʻike mākou e hiki ke hoʻohana ʻia nā sterilizer ozone plasma no ka disinfection i nā wahi mālama olakino. Ua hoʻomohala mākou i kahi mea hana me nā mana sterilization kiʻekiʻe, hana maʻalahi a me ka lawelawe wikiwiki no nā maʻi maʻi maʻi. Eia kekahi, ua hoʻomohala mākou i kahi ʻāpana sterilization maʻalahi e hoʻohana ana i ka ea ambient me ka uku ʻole. I kēia lā, ʻaʻole lawa ka ʻike e pili ana i nā koi ozone liʻiliʻi no ka hoʻopau ʻana o MDRO. ʻO nā mea hana i hoʻohana ʻia i kā mākou aʻo ʻana he maʻalahi ka hoʻonohonoho ʻana a he manawa holo pōkole a manaʻo ʻia e pono no ka sterilization lako pinepine.
ʻAʻole maopopo loa ke ʻano o ka hana bactericidal o ka ozone. Ua hōʻike ʻia kekahi mau haʻawina e hōʻino ana ka ozone i nā membrane cell bacteria, e alakaʻi ana i ka leakage intracellular a me ka lysis cell17,18. Hiki i ka Ozone ke hoʻopilikia i ka hana enzymatic cellular ma o ka hana ʻana me nā hui thiol a hiki ke hoʻololi i nā kumu purine a me pyrimidine i loko o nā waikawa nucleic. Ua ʻike ʻia kēia haʻawina i ka morphology o VRE, CRAB, a me C. difficile spores ma mua a ma hope o ka mālama ʻana i ka ozone a ʻike ʻia ʻaʻole i emi wale ka nui, akā ua lilo pū lākou i mea ʻino loa ma ka ʻili, e hōʻike ana i ka pōʻino a i ʻole ka corrosion o ka membrane o waho. a me nā mea i loko ma muli o ke kinoea ozone he mana oxidizing ikaika. Hiki i kēia pōʻino ke alakaʻi i ka hana ʻole o ke kelepona, ma muli o ke koʻikoʻi o nā loli kelepona.
He paʻakikī ka wehe ʻana o nā spores C. difficile mai nā keʻena haukapila. Noho nā spores ma nā wahi a lākou e hoʻokahe ai i ka 10,20. Eia kekahi, i loko o kēia haʻawina, ʻoiai ʻo ka nui o ka logarithmic 10-fold ka 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 i loaʻa nā C spores .difficile. No laila, hiki ke noʻonoʻo ʻia nā hoʻolālā like ʻole e hōʻemi i ka maʻi C. difficile ma nā wahi mālama olakino. No ka hoʻohana ʻana i nā keʻena kaʻawale C. difficile wale nō, pono paha e 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 hoʻololi loa i ka hoʻomaʻemaʻe manual maʻamau me nā disinfectants a me nā hoʻolālā antimicrobial, a hiki nō hoʻi ke hana maikaʻi loa i ka mālama ʻana iā C. difficile 5. Ma kēia haʻawina, ʻokoʻa ka hopena o ka ozone ma ke ʻano he disinfectant no nā ʻano MPO like ʻole. Hiki ke hilinaʻi ka maikaʻi ma nā kumu like ʻole e like me ka ulu ʻana, ka paia o ke kelepona, a me ka pono o nā mīkini hoʻoponopono21,22. ʻO ke kumu o ka hopena sterilizing ʻokoʻa o ka ozone ma ka ʻili o kēlā me kēia mea ma muli paha o ka hoʻokumu ʻana o kahi biofilm. Ua hōʻike mua nā haʻawina i ka hoʻonui ʻana o E. faecium a me E. faecium i ke kūʻokoʻa o ke kaiapuni i ka wā e loaʻa ai he biofilms23, 24, 25. Eia naʻe, hōʻike kēia haʻawina he hopena bactericidal koʻikoʻi ka ozone ma MDRO a me C. difficile spores.
ʻO kahi palena o kā mākou noiʻi ʻana ʻo ia kā mākou loiloi i ka hopena o ka paʻa ʻana o ka ozone ma hope o ka hoʻoponopono ʻana. Hiki i kēia ke alakaʻi i kahi overestimation o ka nui o nā cell bacteria ola.
ʻOiai ua hana ʻia kēia haʻawina no ka loiloi ʻana i ka pono o ka ozone ma ke ʻano he disinfectant i loko o kahi haukapila, paʻakikī ke hoʻonui i kā mākou hopena i nā ʻōnaehana haukapila āpau. No laila, ʻoi aku ka nui o ka noiʻi e noiʻi i ka hoʻopili a me ka hoʻohālikelike ʻana o kēia DBD ozone sterilizer i loko o kahi hale haukapila maoli.
ʻO ka ozone i hana ʻia e DBD plasma reactors he mea maʻalahi a waiwai nui no ka 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 o ka haukapila.
Loaʻa nā ʻikepili i hoʻohana ʻia a/a i ʻike ʻia i ka noiʻi o kēia manawa mai nā mea kākau ma muli o ke noi kūpono.
ʻO ka hoʻolālā honua ʻo WHO e loaʻa i ka pale antimicrobial. https://www.who.int/drugresistance/WHO_Global_Strategy.htm/en/ Loaʻa.
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