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Ib puag ncig kev kho mob uas muaj kuab paug ua lub luag haujlwm tseem ceeb hauv kev sib kis ntawm cov kab mob uas tiv taus ntau yam tshuaj (MDR) thiab C. difficile. Lub hom phiaj ntawm txoj kev tshawb fawb no yog los ntsuam xyuas qhov cuam tshuam ntawm ozone uas tsim los ntawm lub tshuab hluav taws xob dielectric barrier discharge (DBD) plasma reactor rau kev ua haujlwm ntawm Enterococcus faecalis uas tiv taus vancomycin (VRE), Klebsiella pneumoniae uas tiv taus carbapenem (CRE), thiab carbapenem uas tiv taus Cov teebmeem tua kab mob ntawm ntau yam khoom uas muaj kuab paug nrog Pseudomonas spp. Pseudomonas aeruginosa (CRPA), Acinetobacter baumannii uas tiv taus carbapenem (CRAB) thiab Clostridium difficile spores. Ntau yam khoom uas muaj kuab paug nrog VRE, CRE, CRPA, CRAB thiab C. difficile spores tau kho nrog ozone ntawm ntau qhov concentration thiab lub sijhawm raug. Atomic force microscopy (AFM) tau qhia txog kev hloov pauv ntawm cov kab mob tom qab kev kho ozone. Thaum siv 500 ppm ozone rau VRE thiab CRAB li 15 feeb, pom tias muaj kev txo qis li ntawm 2 lossis ntau dua log10 hauv cov hlau tsis xeb, ntaub thiab ntoo, thiab pom tias muaj kev txo qis 1-2 log10 hauv iav thiab yas. Cov noob kab mob C. difficile tau pom tias tiv taus ozone ntau dua li lwm yam kab mob uas tau sim. Ntawm AFM, tom qab kho nrog ozone, cov kab mob cell tau o thiab deformed. Lub ozone uas tsim los ntawm DBD Plasma Reactor yog ib qho cuab yeej yooj yim thiab muaj txiaj ntsig rau kev tshem tawm cov kab mob MDRO thiab C. difficile, uas paub tias yog cov kab mob sib kis ntawm kev kis kab mob hauv kev kho mob.
Qhov tshwm sim ntawm cov kab mob uas tiv taus ntau yam tshuaj (MDR) yog tshwm sim los ntawm kev siv tshuaj tua kab mob tsis raug hauv tib neeg thiab tsiaj txhu thiab tau raug txheeb xyuas los ntawm Lub Koom Haum Kev Noj Qab Haus Huv Ntiaj Teb (WHO) ua qhov kev hem thawj loj rau kev noj qab haus huv pej xeem1. Tshwj xeeb, cov tsev kho mob tau ntsib ntau ntxiv nrog kev tshwm sim thiab kev sib kis ntawm MROs. Cov MROs tseem ceeb yog methicillin-resistant Staphylococcus aureus thiab vancomycin-resistant enterococcus (VRE), extended-spectrum beta-lactamase-producing enterobacteria (ESBL), multidrug-resistant Pseudomonas aeruginosa, multidrug-resistant Acinetobacter baumannii, thiab carbapenem-resistant Enterobacter (CRE). Tsis tas li ntawd, Clostridium difficile tus kab mob yog ib qho ua rau mob raws plab hauv kev kho mob, ua rau muaj kev nyuaj siab rau lub cev kho mob. MDRO thiab C. difficile kis tau los ntawm tes ntawm cov neeg ua haujlwm kho mob, cov chaw muaj kuab paug, lossis ncaj qha los ntawm ib tus neeg mus rau ib tus neeg. Cov kev tshawb fawb tsis ntev los no tau qhia tias cov chaw muaj kuab paug hauv cov chaw kho mob ua lub luag haujlwm tseem ceeb hauv kev sib kis ntawm MDRO thiab C. difficile thaum cov neeg ua haujlwm kho mob (HCWs) kov cov chaw muaj kuab paug lossis thaum cov neeg mob kov cov chaw muaj kuab paug 3,4. Cov chaw muaj kuab paug hauv cov chaw kho mob txo qhov tshwm sim ntawm kev kis tus kab mob MLRO thiab C. difficile lossis kev loj hlob5,6,7. Muab qhov kev txhawj xeeb thoob ntiaj teb txog kev nce ntawm kev tiv thaiv kab mob, nws yog qhov tseeb tias xav tau kev tshawb fawb ntxiv rau cov txheej txheem thiab cov txheej txheem rau kev tshem tawm cov kuab paug hauv cov chaw kho mob. Tsis ntev los no, cov txheej txheem ntxuav tsis sib cuag, tshwj xeeb tshaj yog cov khoom siv ultraviolet (UV) lossis cov tshuab hydrogen peroxide, tau raug lees paub tias yog cov txheej txheem zoo ntawm kev tshem tawm cov kuab paug. Txawm li cas los xij, cov khoom siv UV lossis hydrogen peroxide no tsis yog kim xwb, kev tua kab mob UV tsuas yog ua haujlwm tau zoo ntawm cov chaw raug, thaum kev tua kab mob hydrogen peroxide plasma xav tau lub sijhawm tshem tawm cov kuab paug ntev ua ntej lub voj voog tua kab mob tom ntej5.
Ozone muaj cov khoom tiv thaiv xeb thiab tuaj yeem tsim tau pheej yig8. Nws kuj paub tias yog lom rau tib neeg kev noj qab haus huv, tab sis tuaj yeem lwj sai sai rau hauv cov pa oxygen8. Dielectric barrier discharge (DBD) plasma reactors yog cov tshuab tsim ozone feem ntau9. Cov khoom siv DBD tso cai rau koj los tsim cov plasma kub qis hauv huab cua thiab tsim ozone. Txog rau tam sim no, kev siv ozone tau txwv rau kev tua kab mob ntawm cov dej pas dej ua ke, dej haus thiab dej phwj10. Ntau txoj kev tshawb fawb tau tshaj tawm nws siv hauv kev kho mob8,11.
Hauv kev tshawb fawb no, peb tau siv lub tshuab hluav taws xob me me DBD plasma ozone los qhia txog nws txoj kev ua haujlwm zoo hauv kev tshem tawm MDRO thiab C. difficile, txawm tias cov uas tau txhaj tshuaj rau ntawm ntau yam khoom siv uas feem ntau siv hauv kev kho mob. Tsis tas li ntawd, cov txheej txheem ozone sterilization tau piav qhia siv cov duab atomic force microscopy (AFM) ntawm cov hlwb kho ozone.
Cov kab mob tau txais los ntawm cov kab mob hauv tsev kho mob ntawm: VRE (SCH 479 thiab SCH 637), Klebsiella pneumoniae uas tiv taus carbapenem (CRE; SCH CRE-14 thiab DKA-1), Pseudomonas aeruginosa uas tiv taus carbapenem (CRPA; 54 thiab 83) thiab cov kab mob uas tiv taus carbapenem. cov kab mob Pseudomonas aeruginosa (CRPA; 54 thiab 83). Acinetobacter baumannii uas tiv taus (CRAB; F2487 thiab SCH-511). C. difficile tau txais los ntawm National Pathogen Culture Collection (NCCP 11840) ntawm Korea Agency for Disease Control and Prevention. Nws tau rho tawm los ntawm tus neeg mob hauv South Kauslim xyoo 2019 thiab pom tias yog ST15 siv ntau qhov kev ntaus ntawv sib lawv liag. Cov kua txiv hmab txiv ntoo Brain Heart Infusion (BHI) (BD, Sparks, MD, USA) uas tau txhaj tshuaj nrog VRE, CRE, CRPA thiab CRAB tau sib xyaw zoo thiab muab tso rau ntawm 37° C. rau 24 teev.
C. difficile tau raug tso rau hauv cov ntshav agar rau 48 teev. Tom qab ntawd, ntau pawg kab mob tau ntxiv rau 5 ml ntawm cov kua zaub hlwb thiab muab tso rau hauv cov xwm txheej anaerobic rau 48 teev. Tom qab ntawd, cov kab lis kev cai tau co, ntxiv 5 ml ntawm 95% ethanol, co dua thiab tso rau hauv chav sov rau 30 feeb. Tom qab centrifugation ntawm 3000 g rau 20 feeb, pov tseg cov supernatant thiab dai cov pellet uas muaj cov noob thiab tua cov kab mob hauv 0.3 ml dej. Cov hlwb muaj sia nyob tau suav los ntawm kev cog cov noob kab mob rau ntawm cov phaj ntshav agar tom qab dilution kom raug. Gram staining lees paub tias 85% txog 90% ntawm cov qauv kab mob yog cov noob.
Cov kev tshawb fawb hauv qab no tau ua los tshawb nrhiav cov teebmeem ntawm ozone ua cov tshuaj tua kab mob rau ntau qhov chaw uas muaj cov noob MDRO thiab C. difficile, uas paub tias ua rau muaj kev kis kab mob hauv kev kho mob. Npaj cov qauv ntawm cov hlau tsis xeb, ntaub (paj rwb), iav, yas (acrylic), thiab ntoo (ntoo thuv) ntsuas ib centimeter los ntawm ib centimeter. Tua kab mob ua ntej siv. Tag nrho cov qauv tau sterilized los ntawm autoclaving ua ntej kis kab mob nrog cov kab mob.
Hauv kev tshawb fawb no, cov kab mob cell tau kis mus rau ntau qhov chaw ntawm cov substrate thiab ntawm cov phaj agar. Cov vaj huam sib luag tom qab ntawd raug sterilized los ntawm kev muab lawv rau ozone rau ib lub sijhawm thiab ntawm qee qhov concentration hauv ib lub chamber kaw. Ntawm daim duab 1 yog daim duab ntawm cov khoom siv ozone sterilization. DBD plasma reactors tau tsim los ntawm kev txuas cov perforated thiab cov hlau stainless hlau electrodes rau pem hauv ntej thiab tom qab ntawm 1 hli tuab alumina (dielectric) phaj. Rau cov electrodes perforated, qhov aperture thiab qhov cheeb tsam yog 3 hli thiab 0.33 hli, feem. Txhua lub electrode muaj ib lub voj voog nrog lub cheeb ntawm 43 hli. Lub zog hluav taws xob siab zaus siab (GBS Elektronik GmbH Minipuls 2.2) tau siv los siv lub zog sinusoidal ntawm kwv yees li 8 kV ncov mus rau ncov ntawm zaus ntawm 12.5 kHz rau cov electrodes perforated los tsim plasma ntawm ntug ntawm cov electrodes. perforated electrodes. Vim tias cov thev naus laus zis yog txoj kev siv roj sterilization, sterilization yog ua tiav hauv ib lub chamber faib los ntawm ntim rau hauv cov chav sab saud thiab qis dua, uas muaj cov qauv kab mob thiab cov plasma generators, raws li. Lub chav sab saud muaj ob lub qhov rooj valve kom tshem tawm thiab tso pa tawm cov ozone seem. Ua ntej siv hauv kev sim, qhov kev hloov pauv ntawm lub sijhawm ntawm ozone concentration hauv chav tom qab tig rau ntawm lub plasma installation tau ntsuas raws li qhov nqus spectrum ntawm kab spectral ntawm 253.65 nm ntawm lub teeb mercury.
(a) Daim phiaj xwm ntawm kev teeb tsa sim rau kev tua cov kab mob ntawm ntau yam khoom siv siv ozone tsim nyob rau hauv DBD plasma reactor, thiab (b) ozone concentration thiab plasma generation lub sijhawm hauv chav tua kab mob. Daim duab tau ua los ntawm kev siv OriginPro version 9.0 (OriginPro software, Northampton, MA, USA; https://www.originlab.com).
Ua ntej, los ntawm kev tua cov kab mob uas muab tso rau ntawm cov phaj agar nrog ozone, thaum hloov qhov concentration ozone thiab lub sijhawm kho, qhov concentration ozone thiab lub sijhawm kho kom zoo rau kev tshem tawm cov kab mob MDRO thiab C. difficile tau txiav txim siab. Thaum lub sijhawm ua kom tsis muaj kab mob, lub chamber raug ntxuav nrog huab cua ib puag ncig thiab tom qab ntawd puv nrog ozone los ntawm kev tig rau ntawm lub plasma unit. Tom qab cov qauv tau kho nrog ozone rau lub sijhawm teem tseg, lub twj tso kua mis diaphragm siv los tshem tawm cov ozone seem. Cov kev ntsuas siv cov qauv ntawm 24-teev kab lis kev cai tiav (~ 108 CFU / ml). Cov qauv ntawm cov kab mob cell (20 μl) tau raug diluted kaum zaug nrog sterile saline, thiab tom qab ntawd cov qauv no tau muab faib rau ntawm cov phaj agar uas tau tua kab mob nrog ozone hauv lub chamber. Tom qab ntawd, cov qauv rov ua dua, suav nrog cov qauv raug thiab tsis raug ozone, tau incubated ntawm 37 ° C rau 24 teev thiab suav cov colonies los ntsuas qhov ua tau zoo ntawm kev tua kab mob.
Ntxiv mus, raws li cov xwm txheej sterilization txhais hauv kev tshawb fawb saum toj no, qhov cuam tshuam ntawm kev tshem tawm cov pa phem ntawm cov thev naus laus zis no rau MDRO thiab C. difficile tau soj ntsuam siv cov daim coupon ntawm ntau yam khoom siv (hlau tsis xeb, ntaub, iav, yas thiab ntoo daim coupon) uas feem ntau siv hauv cov tsev kho mob. Ua tiav 24 teev kab lis kev cai (~ 108 cfu / ml) tau siv. Cov qauv ntawm cov kab mob cell suspension (20 μl) tau diluted kaum zaug nrog sterile saline, thiab tom qab ntawd cov daim coupon tau immersed hauv cov kua zaub diluted no los ntsuas kev ua qias tuaj. Cov qauv tshem tawm tom qab immersion hauv cov kua zaub dilution tau muab tso rau hauv cov tais Petri sterile thiab ziab ntawm chav sov rau 24 teev. Muab lub hau tais petri rau ntawm cov qauv thiab ua tib zoo muab tso rau hauv chav kuaj. Tshem lub hau ntawm lub tais Petri thiab tso cov qauv rau 500 ppm ozone rau 15 feeb. Cov qauv tswj tau muab tso rau hauv lub txee kev nyab xeeb ntawm cov kab mob thiab tsis raug rau ozone. Tam sim ntawd tom qab raug rau ozone, cov qauv thiab cov qauv tsis raug irradiated (piv txwv li cov tswj) tau sib xyaw nrog sterile saline siv lub vortex mixer los cais cov kab mob ntawm qhov chaw. Cov tshuaj uas tau yaj lawm tau raug diluted 10 zaug nrog cov dej ntsev sterile, tom qab ntawd tus naj npawb ntawm cov kab mob diluted tau txiav txim siab ntawm cov phaj ntshav agar (rau cov kab mob aerobic) lossis cov phaj ntshav aerobic rau Brucella (rau Clostridium difficile) thiab incubated ntawm 37 ° C rau 24 teev. lossis nyob rau hauv cov xwm txheej anaerobic rau 48 teev ntawm 37 ° C hauv ob zaug los txiav txim siab qhov concentration pib ntawm cov tshuaj tua kab mob. Qhov sib txawv ntawm cov kab mob suav ntawm cov kev tswj tsis tau pom thiab cov qauv raug tau suav los muab qhov kev txo qis ntawm cov kab mob suav (piv txwv li, kev ua haujlwm ntawm kev tua kab mob) nyob rau hauv cov xwm txheej sim.
Cov hlwb ntawm lub cev yuav tsum tau immobilized rau ntawm lub phaj AFM imaging; yog li ntawd, ib lub disk mica tiaj tus thiab sib npaug nrog qhov roughness scale me dua qhov loj ntawm lub hlwb yog siv ua lub substrate. Lub txoj kab uas hla thiab tuab ntawm cov disks yog 20 hli thiab 0.21 hli, raws li. Txhawm rau kom cov hlwb ruaj khov rau ntawm qhov chaw, qhov chaw ntawm mica yog coated nrog poly-L-lysine (200 µl), ua rau nws them zoo thiab lub cell membrane them tsis zoo. Tom qab coated nrog poly-L-lysine, cov disks mica tau ntxuav 3 zaug nrog 1 ml deionized (DI) dej thiab cua qhuav ib hmos. Tom qab ntawd, cov hlwb kab mob tau siv rau ntawm qhov chaw mica coated nrog poly-L-lysine los ntawm kev siv cov tshuaj bacterial dilute, sab laug rau 30 feeb, thiab tom qab ntawd qhov chaw mica tau ntxuav nrog 1 ml ntawm dej deionized.
Ib nrab ntawm cov qauv tau kho nrog ozone thiab qhov morphology ntawm cov phaj mica uas muaj VRE, CRAB thiab C. difficile spores tau pom siv AFM (XE-7, park systems). Hom kev ua haujlwm AFM tau teeb tsa rau hom tapping, uas yog ib txoj kev siv rau kev thaij duab cov hlwb biological. Hauv kev sim, microcantilever tsim rau hom tsis sib cuag (OMCL-AC160TS, OLYMPUS Microscopy) tau siv. Cov duab AFM tau kaw raws li tus nqi probe scan ntawm 0.5 Hz ua rau cov duab daws teeb meem ntawm 2048 × 2048 pixels.
Txhawm rau txiav txim siab txog cov xwm txheej uas cov tshuab hluav taws xob DBD plasma ua haujlwm tau zoo rau kev tua kab mob, peb tau ua ntau qhov kev sim siv ob qho tib si MDRO (VRE, CRE, CRPA, thiab CRAB) thiab C. difficile los hloov pauv qhov concentration ntawm ozone thiab lub sijhawm raug. Ntawm daim duab 1b qhia txog qhov nkhaus ntawm lub sijhawm concentration ntawm ozone rau txhua qhov xwm txheej sim tom qab tig rau ntawm lub cuab yeej plasma. Qhov concentration nce ntxiv logarithmically, ncav cuag 300 thiab 500 ppm tom qab 1.5 thiab 2.5 feeb, raws li. Kev sim ua ntej nrog VRE tau qhia tias qhov tsawg kawg nkaus uas xav tau los tua cov kab mob kom zoo yog 300 ppm ozone rau 10 feeb. Yog li, hauv cov kev sim hauv qab no, MDRO thiab C. difficile tau raug rau ozone ntawm ob qhov concentration sib txawv (300 thiab 500 ppm) thiab ntawm ob lub sijhawm raug sib txawv (10 thiab 15 feeb). Kev ua haujlwm ntawm kev tua kab mob rau txhua qhov koob tshuaj ozone thiab lub sijhawm teeb tsa tau suav thiab qhia hauv Rooj 1. Kev raug rau 300 lossis 500 ppm ozone rau 10-15 feeb ua rau VRE txo qis tag nrho ntawm 2 lossis ntau dua log10. Qib siab ntawm kev tua kab mob nrog CRE tau ua tiav nrog 15 feeb ntawm kev raug rau 300 lossis 500 ppm ozone. Kev txo qis ntawm CRPA (> 7 log10) tau ua tiav nrog kev raug rau 500 ppm ntawm ozone rau 15 feeb. Kev txo qis ntawm CRPA (> 7 log10) tau ua tiav nrog kev raug rau 500 ppm ntawm ozone rau 15 feeb. Высокое снижение CRPA (> 7 log10) было достигнуто при воздействии 500 частей на миллион озона в течение 15 . Kev txo qis ntawm CRPA (> 7 log10) tau ua tiav nrog kev raug rau 500 ppm ozone rau 15 feeb.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. Kev txo qis ntawm CRPA (> 7 log10) tom qab 15 feeb raug rau 500 ppm ozone.Kev tua cov kab mob CRAB tsis tseem ceeb ntawm 300 ppm ozone; txawm li cas los xij, ntawm 500 ppm ozone, muaj > 1.5 log10 txo. txawm li cas los xij, ntawm 500 ppm ozone, muaj > 1.5 log10 txo. однако при концентрации озона 500 частей на миллион наблюдалось снижение > 1,5 log10. txawm li cas los xij, ntawm qhov concentration ntawm ozone ntawm 500 ppm, qhov kev txo qis ntawm >1.5 log10 tau pom.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. Txawm li cas los xij, ntawm qhov concentration ntawm ozone ntawm 500 ppm, qhov kev txo qis ntawm >1.5 log10 tau pom. Kev raug cov noob kab mob C. difficile rau 300 lossis 500 ppm ozone ua rau muaj kev txo qis > 2.5 log10. Kev raug cov noob kab mob C. difficile rau 300 lossis 500 ppm ozone ua rau muaj kev txo qis > 2.5 log10. Воздействие на споры C. difficile озона с концентрацией 300 или 500 частей на миллион приводило к снижению 10 , . Kev raug cov noob kab mob C. difficile rau 300 lossis 500 ppm ozone ua rau muaj kev txo qis ntau dua 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 сни5жению > 2. Kev raug cov noob kab mob C. difficile rau 300 lossis 500 ppm ozone ua rau muaj kev txo qis ntau dua 2.5 log10.
Raws li cov kev sim saum toj no, pom tias muaj qhov yuav tsum tau ua kom cov kab mob tsis ua haujlwm ntawm 500 ppm ozone rau 15 feeb. VRE, CRAB thiab C. difficile spores tau raug sim rau cov nyhuv tua kab mob ntawm ozone rau ntau yam khoom siv suav nrog stainless hlau, ntaub, iav, yas thiab ntoo uas feem ntau siv hauv tsev kho mob. Lawv cov txiaj ntsig tua kab mob tau pom hauv Rooj 2. Cov kab mob sim tau raug soj ntsuam ob zaug. Hauv VRE thiab CRAB, ozone tsis zoo rau ntawm cov iav thiab yas, txawm hais tias muaj kev txo qis log10 ntawm kwv yees li ntawm 2 lossis ntau dua ntawm cov hlau stainless hlau, ntaub thiab ntoo. C. difficile spores tau pom tias tiv taus kev kho ozone ntau dua li lwm cov kab mob sim. Txhawm rau kawm txog kev suav lej ntawm ozone rau kev tua cov nyhuv ntawm cov khoom sib txawv tawm tsam VRE, CRAB, thiab C. difficile, t-tests tau siv los sib piv qhov sib txawv ntawm tus lej ntawm CFU ib milliliter hauv pawg tswj thiab pawg sim ntawm cov khoom sib txawv (Daim Duab 2). cov hom kab mob tau qhia txog qhov sib txawv tseem ceeb, tab sis pom muaj qhov sib txawv ntau dua rau VRE thiab CRAB spores dua li rau C. difficile spores.
Daim duab qhia txog cov teebmeem ntawm ozone rau kev tua cov kab mob ntawm ntau yam khoom (a) VRE, (b) CRAB, thiab (c) C. difficile.
Daim duab AFM tau ua rau cov noob VRE, CRAB, thiab C. difficile uas tau kho thiab tsis tau kho los kawm txog cov txheej txheem ozone sterilization kom ntxaws. Hauv daim duab 3a, c thiab e qhia cov duab AFM ntawm cov noob VRE, CRAB thiab C. difficile uas tsis tau kho, raws li. Raws li pom hauv cov duab 3D, cov cell du thiab zoo. Daim duab 3b, d thiab f qhia cov noob VRE, CRAB thiab C. difficile tom qab kho ozone. Tsis yog lawv tsuas yog txo qis hauv qhov loj me rau txhua lub cell uas tau kuaj xwb, tab sis lawv qhov chaw tau dhau los ua qhov ntxhib dua tom qab raug ozone.
Cov duab AFM ntawm cov noob VRE, MRAB thiab C. difficile uas tsis tau kho (a, c, e) thiab (b, d, f) kho nrog 500 ppm ozone rau 15 feeb. Cov duab tau kos los ntawm kev siv Park Systems XEI version 5.1.6 (XEI Software, Suwon, Kauslim Teb; https://www.parksystems.com/102-products/park-xe-bio).
Peb txoj kev tshawb fawb qhia tau hais tias cov ozone uas tsim los ntawm cov khoom siv DBD plasma qhia tau tias muaj peev xwm tshem tawm cov kab mob MDRO thiab C. difficile, uas paub tias yog cov ua rau muaj kev kis kab mob hauv kev kho mob. Tsis tas li ntawd xwb, hauv peb txoj kev tshawb fawb, vim tias kev kis kab mob ib puag ncig nrog MDRO thiab C. difficile spores tuaj yeem ua rau muaj kev kis kab mob hauv kev kho mob, cov nyhuv tua kab mob ntawm ozone tau pom tias ua tiav rau cov ntaub ntawv siv hauv tsev kho mob. Kev ntsuam xyuas kev tshem tawm tau ua tiav siv cov khoom siv DBD plasma tom qab kev kis kab mob ntawm cov ntaub ntawv xws li hlau tsis xeb, ntaub, iav, yas thiab ntoo nrog MDRO thiab C. difficile spores. Yog li ntawd, txawm hais tias qhov cuam tshuam kev tshem tawm sib txawv nyob ntawm cov khoom siv, lub peev xwm tshem tawm ntawm ozone yog qhov zoo kawg nkaus.
Cov khoom uas raug kov ntau zaus hauv chav kho mob xav tau kev tua kab mob tsis tu ncua, qib qis. Txoj kev txheem rau kev tshem tawm cov khoom no yog kev ntxuav tes nrog cov tshuaj tua kab mob kua xws li quaternary ammonium compound 13. Txawm tias ua raws li cov lus qhia rau kev siv cov tshuaj tua kab mob, MPO nyuaj rau tshem tawm los ntawm kev ntxuav ib puag ncig ib txwm muaj (feem ntau yog kev ntxuav tes)14. Yog li ntawd, xav tau cov thev naus laus zis tshiab, xws li cov txheej txheem tsis sib cuag. Yog li ntawd, muaj kev txaus siab rau cov tshuaj tua kab mob roj, suav nrog hydrogen peroxide thiab ozone10. Qhov zoo ntawm cov tshuaj tua kab mob roj yog tias lawv tuaj yeem ncav cuag cov chaw thiab cov khoom uas cov txheej txheem ib txwm muaj tsis tuaj yeem ncav cuag. Hydrogen peroxide nyuam qhuav tau siv hauv cov chaw kho mob, txawm li cas los xij hydrogen peroxide nws tus kheej yog lom thiab yuav tsum tau ua raws li cov txheej txheem tuav nruj. Plasma sterilization nrog hydrogen peroxide xav tau lub sijhawm ntxuav ntev ua ntej lub voj voog sterilization tom ntej. Qhov sib piv, ozone ua haujlwm ua tus neeg sawv cev antibacterial dav dav, ua haujlwm zoo tiv thaiv cov kab mob thiab cov kab mob uas tiv taus lwm cov tshuaj tua kab mob8,11,15. Ntxiv mus, ozone tuaj yeem tsim tau pheej yig los ntawm huab cua thiab tsis xav tau cov tshuaj lom ntxiv uas tuaj yeem tawm hauv qhov chaw tsis zoo hauv ib puag ncig, vim tias thaum kawg nws tawg ua pa oxygen. Txawm li cas los xij, qhov laj thawj vim li cas ozone tsis siv dav ua tshuaj tua kab mob yog raws li nram no. Ozone yog lom rau tib neeg kev noj qab haus huv, yog li nws qhov concentration tsis tshaj 0.07 ppm qhov nruab nrab rau ntau dua 8 teev16, yog li ozone sterilizers tau tsim thiab muab tso rau hauv kev ua lag luam, feem ntau yog rau kev ntxuav cov pa tso pa tawm. Nws kuj tseem ua tau kom nqus pa roj thiab tsim cov ntxhiab tsw tsis zoo tom qab tshem tawm5,8. Ozone tsis tau siv nquag hauv cov tsev kho mob. Txawm li cas los xij, ozone tuaj yeem siv tau zoo hauv cov chav ua kom tsis muaj kab mob thiab nrog cov txheej txheem cua kom zoo, thiab nws txoj kev tshem tawm tuaj yeem ua kom nrawm dua los ntawm kev siv lub tshuab hloov pauv catalytic. Hauv kev tshawb fawb no, peb qhia tau tias plasma ozone sterilizers tuaj yeem siv rau kev tua kab mob hauv cov chaw kho mob. Peb tau tsim ib lub cuab yeej nrog lub peev xwm ua kom tsis muaj kab mob siab, kev ua haujlwm yooj yim thiab kev pabcuam sai rau cov neeg mob hauv tsev kho mob. Tsis tas li ntawd, peb tau tsim ib chav ua kom tsis muaj kab mob yooj yim uas siv huab cua ib puag ncig yam tsis muaj nqi ntxiv. Txog niaj hnub no, tsis muaj cov ntaub ntawv txaus txog qhov yuav tsum tau ua ozone tsawg kawg nkaus rau MDRO inactivation. Cov khoom siv siv hauv peb txoj kev tshawb fawb yooj yim teeb tsa thiab siv sijhawm luv luv thiab xav tias yuav muaj txiaj ntsig zoo rau kev tua kab mob ntawm cov khoom siv ntau zaus.
Lub tshuab ua haujlwm ntawm kev tua kab mob ntawm ozone tsis meej kiag li. Muaj ntau txoj kev tshawb fawb tau qhia tias ozone ua rau cov hlwb ntawm cov kab mob puas tsuaj, ua rau muaj kev xau hauv hlwb thiab thaum kawg cell lysis17,18. Ozone tuaj yeem cuam tshuam nrog kev ua haujlwm enzymatic ntawm cellular los ntawm kev cuam tshuam nrog cov pab pawg thiol thiab tuaj yeem hloov kho purine thiab pyrimidine hauv nucleic acids. Txoj kev tshawb fawb no tau pom cov morphology ntawm VRE, CRAB, thiab C. difficile spores ua ntej thiab tom qab kev kho ozone thiab pom tias tsis yog lawv tsuas yog txo qis me me xwb, tab sis lawv kuj tau dhau los ua qhov ntxhib dua ntawm qhov chaw, qhia txog kev puas tsuaj lossis xeb ntawm daim nyias nyias sab nraud. thiab cov ntaub ntawv sab hauv vim yog roj ozone muaj peev xwm oxidizing muaj zog. Qhov kev puas tsuaj no tuaj yeem ua rau cell tsis ua haujlwm, nyob ntawm qhov hnyav ntawm kev hloov pauv cellular.
Cov noob kab mob C. difficile nyuaj rau tshem tawm ntawm chav tsev kho mob. Cov noob kab mob tseem nyob hauv qhov chaw uas lawv poob 10,20. Ntxiv rau, hauv txoj kev tshawb fawb no, txawm hais tias qhov siab tshaj plaws logarithmic 10-zaug txo qis hauv tus naj npawb ntawm cov kab mob ntawm cov phaj agar ntawm 500 ppm ozone rau 15 feeb yog 2.73, cov nyhuv bactericidal ntawm ozone rau ntau yam khoom siv uas muaj C spores .difficile tau raug txo qis. Yog li ntawd, ntau txoj hauv kev tuaj yeem txiav txim siab los txo cov kab mob C. difficile hauv cov chaw kho mob. Rau kev siv hauv cov chav cais C. difficile xwb, nws kuj tseem yuav pab tau los kho lub sijhawm raug thiab qhov muaj zog ntawm kev kho ozone. Ntxiv rau, peb yuav tsum nco ntsoov tias txoj kev tshem tawm ozone tsis tuaj yeem hloov pauv kev ntxuav tes nrog cov tshuaj tua kab mob thiab cov tswv yim antimicrobial, thiab kuj tseem tuaj yeem ua tau zoo heev hauv kev tswj C. difficile 5. Hauv txoj kev tshawb fawb no, qhov ua tau zoo ntawm ozone ua tshuaj tua kab mob sib txawv rau ntau hom MPO. Kev ua tau zoo yuav nyob ntawm ntau yam xws li theem kev loj hlob, phab ntsa cell, thiab kev ua tau zoo ntawm cov txheej txheem kho 21,22. Qhov laj thawj rau qhov sib txawv ntawm cov nyhuv sterilizing ntawm ozone ntawm qhov chaw ntawm txhua yam khoom siv yuav yog vim muaj kev tsim ntawm biofilm. Cov kev tshawb fawb yav dhau los tau qhia tias E. faecium thiab E. faecium ua rau muaj kev tiv thaiv ib puag ncig thaum muaj nyob rau hauv biofilms23, 24, 25. Txawm li cas los xij, kev tshawb fawb no qhia tau hais tias ozone muaj cov nyhuv bactericidal tseem ceeb rau MDRO thiab C. difficile spores.
Ib qho kev txwv ntawm peb txoj kev tshawb fawb yog tias peb tau soj ntsuam qhov cuam tshuam ntawm kev khaws cia ozone tom qab kev kho dua tshiab. Qhov no tuaj yeem ua rau muaj kev kwv yees ntau dhau ntawm tus lej ntawm cov kab mob uas muaj sia nyob.
Txawm hais tias txoj kev tshawb fawb no tau ua los ntsuam xyuas qhov ua tau zoo ntawm ozone ua cov tshuaj tua kab mob hauv tsev kho mob, nws nyuaj rau kev piav qhia peb cov txiaj ntsig rau txhua qhov chaw hauv tsev kho mob. Yog li, xav tau kev tshawb fawb ntxiv los tshawb xyuas qhov siv tau thiab kev sib raug zoo ntawm DBD ozone sterilizer no hauv ib puag ncig tsev kho mob tiag tiag.
Cov ozone uas tsim los ntawm DBD plasma reactors tuaj yeem yog ib qho yooj yim thiab muaj txiaj ntsig zoo rau kev tshem tawm cov pa phem rau MDRO thiab C. difficile. Yog li, kev kho ozone tuaj yeem suav hais tias yog lwm txoj hauv kev zoo rau kev tua kab mob hauv tsev kho mob.
Cov ntaub ntawv siv thiab/lossis tshuaj xyuas hauv kev tshawb fawb tam sim no muaj los ntawm cov kws sau ntawv raws li qhov kev thov tsim nyog.
WHO txoj kev npaj thoob ntiaj teb los tswj kev tiv thaiv kab mob. https://www.who.int/drugresistance/WHO_Global_Strategy.htm/en/ Muaj.
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