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He mea nui te taiao hauora poke i roto i te horapa o ngā rauropi ātete-maha-rongoā (MDR) me te C. difficile. Ko te whāinga o tēnei rangahau he aromatawai i te pānga o te ozone i hangaia e te tauhohenga plasma dielectric barrier discharge (DBD) ki te mahi a te Enterococcus faecalis ātete-vancomycin (VRE), te Klebsiella pneumoniae ātete-carbapenem (CRE), te ātete-carbapenem i ngā pānga paturopi o ngā rauemi rerekē kua pokehia e te Pseudomonas spp. Pseudomonas aeruginosa (CRPA), te Acinetobacter baumannii ātete-carbapenem (CRAB) me ngā pua Clostridium difficile. He maha ngā rauemi kua pokehia e te VRE, CRE, CRPA, CRAB me ngā pua C. difficile i tukinotia ki te ozone i ngā kukū me ngā wā whakaaturanga rerekē. I whakaatuhia e te karuārai kaha atomika (AFM) te whakarerekētanga o te mata o ngā huakita i muri i te maimoatanga ozone. I te whakamahinga o te horopeta o te ozone 500 ppm ki te VRE me te CRAB mō te 15 meneti, i kitea he hekenga tata ki te 2, neke atu rānei ngā log10 i roto i te maitai kore waikura, te papanga me te rakau, ā, i kitea he hekenga 1-2 log10 i roto i te karāhe me te kirihou. I kitea he ātete ake ngā pua C. difficile ki te ozone i ngā mea ora katoa i whakamatautauria. I runga i te AFM, i muri i te maimoatanga ki te ozone, ka pupuhi, ka rerekē te āhua o ngā pūtau huakita. Ko te ozone i hangaia e te DBD Plasma Reactor he taputapu horoi poke māmā, whai hua hoki mō ngā pua MDRO me te C. difficile, e mōhiotia ana he pathogens noa o ngā mate e pā ana ki te hauora.
Ko te putanga mai o ngā rauropi ātete-maha-rongoā (MDR) i puta mai i te whakamahinga hē o ngā paturopi i roto i te tangata me ngā kararehe, ā, kua tautuhia e te World Health Organization (WHO) hei tūmomo mōrearea nui ki te hauora tūmatanui1. Ina koa, kei te tūtaki ngā whare hauora ki te putanga mai me te horapa o ngā MRO. Ko ngā MRO matua ko te Staphylococcus aureus ātete-methicillin me te enterococcus ātete-vancomycin (VRE), te enterobacteria whakaputa beta-lactamase whānui-whānui (ESBL), te Pseudomonas aeruginosa ātete-maha-rongoā, te Acinetobacter baumannii ātete-maha-rongoā, me te Enterobacter ātete-carbapenem (CRE). Hei tāpiri, ko te mate Clostridium difficile tetahi o ngā tino take o te mate korere e pā ana ki te hauora, e whakararuraru ana i te pūnaha hauora. Ka horahia te MDRO me te C. difficile mā roto i ngā ringa o ngā kaimahi hauora, ngā taiao poke, mā roto rānei i te tangata ki te tangata. Kua whakaatuhia e ngā rangahau hou he mea nui te wāhi o ngā taiao poke i roto i ngā wāhi tiaki hauora ki te horapa o te MDRO me te C. difficile ina pa atu ngā kaimahi hauora (HCW) ki ngā mata poke, ina pa atu rānei ngā tūroro ki ngā mata poke 3,4. ka whakaitihia e ngā taiao poke i roto i ngā wāhi tiaki hauora te maha o ngā mate MLRO me te C. difficile, te noho rānei ki te whenua5,6,7. I runga i te āwangawanga o te ao mō te pikinga ake o te ātete ki ngā huakita, e mārama ana me nui ake ngā rangahau mō ngā tikanga me ngā tukanga mō te whakakorenga poke i roto i ngā wāhi tiaki hauora. Nō nā tata nei, kua mōhiotia ngā tikanga horoi mutunga kore-pā, inā koa ngā taputapu ultraviolet (UV) me ngā pūnaha hauwai waikura, hei tikanga whakakorenga poke whai hua. Heoi, ehara i te mea he utu nui noa iho ēnei taputapu UV, hauwai waikura rānei e wātea ana i te hokohoko, he whai hua anake te patu huakita UV ki ngā mata e kitea ana, ko te patu huakita plasma hauwai waikura me roa te wā whakakorenga poke i mua i te huringa patu huakita e whai ake nei5.
E mōhiotia ana he āhuatanga ārai-waikura te ozone, ā, he iti te utu ka taea te hanga.8. E mōhiotia ana hoki he paitini ki te hauora o te tangata, engari ka tere te pirau hei hāora.8. Ko ngā tauhohenga plasma dielectric barrier discharge (DBD) ngā mea whakaputa ozone tino noa9. Mā ngā taputapu DBD ka taea e koe te hanga plasma pāmahana-iti i te rangi me te whakaputa ozone. Tae noa ki tēnei wā, ko te whakamahinga mahi o te ozone kua whakawhāitihia ki te patu huakita i te wai puna kaukau, te wai inu me te paru10. He maha ngā rangahau kua pūrongo i tōna whakamahinga i roto i ngā wāhi tiaki hauora8,11.
I roto i tēnei rangahau, i whakamahia e mātou he pūwhakaputa ozone plasma DBD kiato hei whakaatu i tōna whai huatanga ki te whakakore i te MDRO me te C. difficile, tae atu ki ērā i werohia ki ngā rauemi maha e whakamahia whānuitia ana i roto i ngā wāhi hauora. Hei tāpiri, kua whakamāramahia te tukanga whakahoromata ozone mā te whakamahi i ngā whakaahua karuārai kaha atomika (AFM) o ngā pūtau i rongoatia ki te ozone.
I tangohia ngā momo mai i ngā momo motuhake haumanu o: VRE (SCH 479 me SCH 637), Klebsiella pneumoniae ātete-carbapenem (CRE; SCH CRE-14 me DKA-1), Pseudomonas aeruginosa ātete-carbapenem (CRPA; 54 me 83) me ngā huakita ātete-carbapenem. huakita Pseudomonas aeruginosa (CRPA; 54 me 83). Acinetobacter baumannii ātete (CRAB; F2487 me SCH-511). I tangohia mai a C. difficile i te National Pathogen Culture Collection (NCCP 11840) o te Korea Agency for Disease Control and Prevention. I tangohia mai i tētahi tūroro i Kōrea ki te Tonga i te tau 2019, ā, i kitea nō ST15 mā te whakamahi i te momo raupapatanga maha-locus. I konatunatua pai te hupa Brain Heart Infusion (BHI) (BD, Sparks, MD, USA) i werohia ki te VRE, CRE, CRPA me te CRAB, ā, i whaowhia ki te 37° C mō ngā haora 24.
I whakatōngia te C. difficile kia kore e ora i runga i te agar toto mō ngā hāora 48. Kātahi ka tāpirihia ētahi koroni ki te 5 ml o te hupa ngākau roro, ā, ka whakatōkia i raro i ngā āhuatanga kore ora mō ngā hāora 48. Whai muri i tēnā, ka rūrūtia te ahurea, ka tāpirihia he 5 ml o te 95% etanoru, ka rūrūtia anō, ā, ka waiho ki te pāmahana rūma mō ngā meneti 30. Whai muri i te whakatōtō i te 3000 karamu mō ngā meneti 20, maka atu te wai i roto i te ipu, ka whakatarewahia te pirepire kei roto ngā pua me ngā huakita i mate ki roto i te 0.3 ml o te wai. I tatauhia ngā pūtau ora mā te whakatō i te whakatārewatanga o ngā pūtau huakita ki runga i ngā pereti agar toto i muri i te whakaranu tika. I whakaūtia e te tae Gram he pua te 85% ki te 90% o ngā hanganga huakita.
I whakahaerehia te rangahau e whai ake nei hei tirotiro i ngā pānga o te ozone hei patu huakita ki ngā mata kua poke i te MDRO me ngā pua C. difficile, e mōhiotia ana ka puta he mate e pā ana ki te hauora. Whakaritea ngā tauira o te maitai kore waikura, te papanga (miro), te karāhe, te kirihou (kiririka), me te rakau (paina) he kotahi henimita te whānui, kotahi henimita te whānui. Patupatua ngā tīkitipati i mua i te whakamahinga. I whakahoromatahia ngā tauira katoa mā te autoclaving i mua i te pangia e te huakita.
I roto i tēnei rangahau, i horahia ngā pūtau huakita ki runga i ngā mata o te papa me ngā pereti agar. Kātahi ka whakahoromatatia ngā panera mā te whakaatu ki te ozone mō tētahi wā, me te kukū motuhake i roto i tētahi rūma hiri. Kei te pikitia 1 tētahi whakaahua o ngā taputapu whakahoromata ozone. I hangaia ngā tauhohenga plasma DBD mā te tāpiri i ngā irahiko maitai kore waikura kua pokaia, kua whakaaturia ki mua me muri o ngā pereti alumina (dielectric) 1 mm te matotoru. Mō ngā irahiko pokaia, ko te āputa me te horahanga kōhao he 3 mm me te 0.33 mm, ia. He āhua porowhita ia irahiko me te diameter o te 43 mm. I whakamahia he pūhiko hiko auau teitei ngaohiko teitei (GBS Elektronik GmbH Minipuls 2.2) hei tono i te ngaohiko sinusoidal o te 8 kV peak to peak i te auau o te 12.5 kHz ki ngā irahiko pokaia hei whakaputa i te plasma i ngā taha o ngā irahiko. ngā irahiko pokaia. Nā te mea he tikanga whakahoromata hau te hangarau nei, ka mahia te whakahoromata i roto i tētahi rūma kua wehea e te rōrahi ki ngā wāhanga o runga me raro, kei roto ngā tauira kua poke i te huakita me ngā kaihanga plasma. E rua ngā putanga takirere o te wāhanga o runga hei tango me te whakaputa i te toenga ozone. I mua i te whakamahinga i roto i te whakamātautau, i inehia te huringa o te wā o te kukū ozone i roto i te rūma i muri i te tahuritanga o te tāutanga plasma i runga i te whānuitanga mimiti o te rārangi whānuitanga o te 253.65 nm o te rama mercury.
(a) Kaupapa o tētahi whakatakotoranga whakamātautau mō te whakahoromata i ngā huakita i runga i ngā rauemi rerekē mā te whakamahi i te ozone i hangaia i roto i te tauhohenga plasma DBD, me (b) te kukū ozone me te wā whakaputa plasma i roto i te rūma whakahoromata. I hangaia te ahua mā te whakamahi i te OriginPro putanga 9.0 (pūmanawa OriginPro, Northampton, MA, USA; https://www.originlab.com).
Tuatahi, mā te whakahoromata i ngā pūtau huakita kua whakatakotoria ki runga i ngā pereti agar me te ozone, me te whakarerekē i te kukū ozone me te wā maimoatanga, i whakatauhia te kukū ozone me te wā maimoatanga e tika ana mō te whakakorenga i te MDRO me te C. difficile. I te wā o te tukanga whakahoromata, ka horoia tuatahitia te rūma ki te hau taiao, kātahi ka whakakīia ki te ozone mā te tahuri i te waeine plasma. I muri i te maimoatanga o ngā tauira ki te ozone mō tētahi wā kua whakaritea, ka whakamahia he papu diaphragm hei tango i te ozone e toe ana. I whakamahia e ngā inenga he tauira o tētahi ahurea 24-hāora katoa (~ 108 CFU/ml). Ko ngā tauira o ngā whakatārewatanga o ngā pūtau huakita (20 μl) i whakaranua tuatahitia kia tekau ngā wā ki te tote whakahoromata, kātahi ka tohatohahia ēnei tauira ki runga i ngā pereti agar kua whakahoromatahia ki te ozone i roto i te rūma. Whai muri i tēnā, ka whakatōkia ngā tauira kua tāruatia, arā, ko ngā tauira kua whakaatuhia me ngā tauira kāore i whakaatuhia ki te ozone, ki te 37°C mō ngā hāora 24, ā, ka tatauhia ngā koroni hei aromatawai i te whai huatanga o te whakahoromata.
I tua atu, e ai ki ngā tikanga whakahoromata kua tautuhia i roto i te rangahau i runga ake nei, i aromatawaihia te pānga whakahoromata o tēnei hangarau ki te MDRO me te C. difficile mā te whakamahi i ngā tīkitipati o ngā rauemi rerekē (he kowiri tira, he papanga, he karāhe, he kirihou me he tīkitipati rakau) e whakamahia whānuitia ana i roto i ngā whare hauora. I whakamahia ngā ahurea 24 hāora katoa (~108 cfu/ml). Ko ngā tauira o te whakatārewatanga pūtau kitakita (20 μl) i whakaranua kia tekau ngā wā ki te tote parakore, kātahi ka rumakina ngā tīkitipati ki roto i ēnei hupa kua whakaranua hei aromatawai i te poke. Ko ngā tauira i tangohia i muri i te rumakina ki te hupa whakahoromata i whakanohoia ki roto i ngā rihi Petri parakore, ā, i whakamaroketia ki te pāmahana rūma mō ngā hāora 24. Whakatakotoria te taupoki rihi petri ki runga i te tauira, ā, ata whakanohoia ki roto i te rūma whakamātautau. Tangohia te taupoki mai i te rihi Petri, ā, whakaaturia te tauira ki te ozone 500 ppm mō ngā meneti 15. I whakanohoia ngā tauira whakahaere ki roto i tētahi kāpata haumaru koiora, ā, kāore i whakaaturia ki te ozone. I muri tonu i te whakaaturanga ki te ozone, i konatunatua ngā tauira me ngā tauira kāore i whakahoromatahia (arā, ngā mana whakahaere) ki te tote parakore mā te whakamahi i tētahi mīhini whakaranu vortex hei wehe i ngā kitakita mai i te mata. I whakaranua te wai whakatārewatanga i whakawāteatia kia 10 ngā wā ki te tote parakore, ā, i muri iho ka whakatauhia te maha o ngā huakita kua whakaranua ki runga i ngā pereti agar toto (mō ngā huakita aerobic) me ngā pereti agar toto anaerobic rānei mō Brucella (mō Clostridium difficile) ā, ka whaowhia ki te 37°C mō ngā hāora 24. i raro rānei i ngā āhuatanga anaerobic mō ngā hāora 48 i te 37°C kia rua ngā wā hei whakatau i te kukū tuatahi o te inokulum. I tatauhia te rerekētanga o te maha o ngā huakita i waenga i ngā mana whakahaere kāore i kitea me ngā tauira i kitea kia puta ai he whakahekenga taki i roto i te maha o ngā huakita (arā, te whai huatanga o te whakawātea) i raro i ngā āhuatanga whakamātautau.
Me whakapūmau ngā pūtau koiora ki runga i tētahi pereti whakaahua AFM; nō reira, ka whakamahia he kōpae mika papatahi, taratara hoki, he iti iho i te rahi o te pūtau hei papa. Ko te whānui me te matotoru o ngā kōpae he 20 mm me te 0.21 mm, ia. Hei whakau pūmau i ngā pūtau ki te mata, ka pania te mata o te mika ki te poly-L-lysine (200 µl), ka utua pai, ka utua kino hoki te kiriuhi pūtau. I muri i te paninga ki te poly-L-lysine, ka horoia ngā kōpae mika e 3 ngā wā ki te 1 ml wai whakakore iona (DI) ka whakamarokehia ki te hau i te pō. Kātahi ka pania ngā pūtau huakita ki te mata mika kua pania ki te poly-L-lysine mā te tāpiri i tētahi otinga huakita waimeha, ka waiho mō te 30 meneti, kātahi ka horoia te mata mika ki te 1 ml wai whakakore iona.
I rongoatia te haurua o ngā tauira ki te ozone, ā, i tirohia te āhua o te mata o ngā pereti mika kua utaina ki ngā pua VRE, CRAB me C. difficile mā te whakamahi i te AFM (XE-7, pūnaha pāka). Kua whakatakotoria te aratau mahi AFM ki te aratau patopato, he tikanga noa mō te whakaahua i ngā pūtau koiora. I roto i ngā whakamātautau, i whakamahia he microcantilever i hangaia mō te aratau kore-pa (OMCL-AC160TS, OLYMPUS Microscopy). I tuhia ngā whakaahua AFM i runga i te tere matawai tirotiro o te 0.5 Hz, ā, i hua ake he taumira whakaahua o te 2048 × 2048 pika.
Hei whakatau i ngā āhuatanga e whai hua ai ngā tauhohenga plasma DBD mō te whakahoromata, i whakahaerehia e mātou he raupapa whakamātautau mā te whakamahi i te MDRO (VRE, CRE, CRPA, me te CRAB) me te C. difficile hei whakarerekē i te kukū ozone me te wā whakaaturanga. Kei te pikitia 1b e whakaatu ana i te pihi wā kukū ozone mō ia āhuatanga whakamātautau i muri i te tahuritanga o te taputapu plasma. I piki ake te kukū i te logarithm, tae atu ki te 300 me te 500 ppm i muri i te 1.5 me te 2.5 meneti. Kua whakaatuhia e ngā whakamātautau tuatahi me te VRE ko te iti rawa e hiahiatia ana hei whakakore pai i ngā huakita ko te 300 ppm ozone mō te 10 meneti. Nō reira, i roto i ngā whakamātautau e whai ake nei, i whakaatuhia te MDRO me te C. difficile ki te ozone i ngā kukū rerekē e rua (300 me te 500 ppm) me ngā wā whakaaturanga rerekē e rua (10 me te 15 meneti). I tatauhia te whai huatanga o te whakahoromata mō ia horopeta ozone me te tautuhinga wā whakaaturanga, ā, i whakaaturia ki te Ripanga 1. Nā te whakaaturanga ki te ozone 300, 500 ppm rānei mō te 10–15 meneti i hua ake ai te whakahekenga whānui o te VRE o te 2, neke atu rānei log10. I tutuki tēnei taumata teitei o te whakamate huakita me te CRE me te whakaaturanga 15 meneti ki te ozone 300, 500 ppm rānei. I tutuki te whakahekenga nui o te CRPA (> 7 log10) mā te whakamahi i te 500 ppm o te ozone mō te 15 meneti. I tutuki te whakahekenga nui o te CRPA (> 7 log10) mā te whakamahi i te 500 ppm o te ozone mō te 15 meneti. Высокое снижение CRPA (> 7 log10) было достигнуто при воздействии 500 частей на миллион озона в течение 15 min. I tutuki te whakahekenga nui o te CRPA (> 7 log10) mā te pānga ki te ozone 500 ppm mō te 15 meneti.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. He hekenga nui i roto i te CRPA (> 7 log10) i muri i te 15 meneti o te pānga ki te ozone 500 ppm.Te whakamatenga iti noa o ngā huakita CRAB i te 300 ppm ozone; heoi, i te 500 ppm ozone, i kitea he whakahekenga > 1.5 log10. heoi, i te 500 ppm ozone, i kitea he whakahekenga > 1.5 log10. однако при концентрации озона 500 частей на миллион наблюдалось снижение > 1,5 log10. heoi, i te kukū o te ozone o te 500 ppm, i kitea he hekenga 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. Heoi, i te kukū o te ozone o te 500 ppm, i kitea he hekenga o >1.5 log10. Nā te whakaaturanga o ngā pua o te C. difficile ki te ozone 300, 500 ppm rānei, i heke ai te nui o te > 2.5 log10. Nā te whakaaturanga o ngā pua o te C. difficile ki te ozone 300, 500 ppm rānei, i heke ai te nui o te > 2.5 log10. Воздействие на споры C. difficile озона с концентрацией 300 ranei 500 частей на миллион приводило к снижению > 2,5 log10. Nā te pānga o ngā pua C. difficile ki te ozone 300, 500 ppm rānei, i heke ai te nui o te >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 ranei 500 частей на миллион приводило к снижению >2,5 log10. Nā te pānga o ngā pua C. difficile ki te ozone 300, 500 ppm rānei, i heke ai te nui o te >2.5 log10.
I runga i ngā whakamātautau i runga ake nei, i kitea he whakaritenga e ranea ana hei whakakore i ngā huakita i te horopeta o te 500 ppm ozone mō te 15 meneti. Kua whakamatautauria ngā pua VRE, CRAB me C. difficile mō te pānga patu huakita o te ozone ki ngā momo rauemi tae atu ki te maitai kore waikura, te kakahu, te karāhe, te kirihou me te rakau e whakamahia whānuitia ana i roto i ngā hōhipera. Kei te Ripanga 2 te whakaaturanga o tō rātou whai huatanga whakamate ira. E rua ngā aromatawai i ngā rauropi whakamātautau. I roto i te VRE me te CRAB, he iti ake te whai huatanga o te ozone ki ngā mata karāhe me te kirihou, ahakoa i kitea he whakahekenga log10 tata ki te 2, neke atu rānei, i runga i te maitai kore waikura, te kakahu me te rakau. I kitea he ātete ake ngā pua C. difficile ki te maimoatanga ozone i ngā rauropi katoa i whakamatautauria. Hei ako tatauranga i te pānga o te ozone ki te pānga whakamate o ngā rauemi rerekē ki a VRE, CRAB, me C. difficile, i whakamahia ngā whakamātautau-t hei whakataurite i ngā rerekētanga i waenga i te maha o te CFU ia miririta i roto i ngā rōpū mana whakahaere me ngā rōpū whakamātautau i runga i ngā rauemi rerekē (Pikitia 2). i whakaatu ngā momo rerekētanga nui ā-tatauranga, engari he nui ake ngā rerekētanga nui i kitea mō ngā pua VRE me CRAB i ngā pua C. difficile.
Kauwhata marara o ngā pānga o te ozone ki te whakamate i ngā huakita o ngā momo rauemi (a) VRE, (b) CRAB, me (c) C. difficile.
I whakahaerehia te whakaahua AFM ki runga i ngā pua VRE, CRAB, me C. difficile i maimoatia ki te ozone me ngā mea kāore i maimoatia hei ako taipitopito i te tukanga whakahoromata hau ozone. I te pikitia 3a, c me te e whakaatuhia ana ngā whakaahua AFM o ngā pua VRE, CRAB me C. difficile kāore i maimoatia. E kitea ana i roto i ngā whakaahua 3D, he maeneene, he ora tonu ngā pūtau. E whakaatu ana ngā pikitia 3b, d me te f i ngā pua VRE, CRAB me C. difficile i muri i te maimoatanga ozone. Kāore i te iti noa te rahi whānui mō ngā pūtau katoa i whakamatautauria, engari i kitea te taratara o te mata i muri i te pānga ki te ozone.
Ngā whakaahua AFM o ngā pua VRE, MRAB me C. difficile kāore i rongoātia (a, c, e) me (b, d, f) i rongoātia ki te ozone 500 ppm mō te 15 meneti. I tuhia ngā whakaahua mā te whakamahi i te Park Systems XEI putanga 5.1.6 (XEI Software, Suwon, Korea; https://www.parksystems.com/102-products/park-xe-bio).
E whakaatu ana tā mātou rangahau ko te ozone i hangaia e ngā taputapu plasma DBD e whakaatu ana i te kaha ki te whakakore i ngā poke MDRO me ngā pua C. difficile, e mōhiotia ana ko ngā tino take o ngā mate e pā ana ki te hauora. Hei tāpiri, i roto i tā mātou rangahau, i te mea ko te poke taiao me ngā pua MDRO me ngā pua C. difficile ka taea te waiho hei pūtake o ngā mate e pā ana ki te hauora, i kitea he angitu te pānga patu huakita o te ozone mō ngā rauemi e whakamahia ana i ngā wāhi hōhipera. I whakahaerehia ngā whakamātautau whakakore poke mā te whakamahi i ngā taputapu plasma DBD i muri i te poke horihori o ngā rauemi pēnei i te maitai kore waikura, te kakahu, te karāhe, te kirihou me te rakau me ngā pua MDRO me ngā pua C. difficile. Nō reira, ahakoa he rerekē te pānga whakakore poke i runga i te rauemi, he mea whakamiharo te kaha whakakore poke o te ozone.
Ko ngā mea e pāngia pinepinetia ana i roto i ngā rūma hōhipera me patu huakita auau, iti te taumata. Ko te tikanga paerewa mō te patu huakita ko te horoi ā-ringa me te patu huakita wai pērā i te pūhui ammonium quaternary 13. Ahakoa te piripono ki ngā taunakitanga mō te whakamahinga o ngā patu huakita, he uaua ki te tango i te MPO mā te horoi taiao tuku iho (te nuinga o te horoi ā-ringa)14. Nō reira, me whai hangarau hou, pērā i ngā tikanga kore-pā. Nō reira, kua piki ake te hiahia ki ngā patu huakita hau, tae atu ki te hauwai peroxide me te ozone10. Ko te painga o ngā patu huakita hau ko te taea e rātou te tae atu ki ngā wāhi me ngā mea e kore e taea e ngā tikanga ā-ringa tuku iho te tae atu. Kua whakamahia te hauwai peroxide i ngā wāhi hauora i ēnei wā tata nei, heoi, he paitini te hauwai peroxide, ā, me whakahaere kia rite ki ngā tikanga whakahaere tino pakari. Ko te patu huakita plasma me te hauwai peroxide me whai wā horoi roa i mua i te huringa patu huakita e whai ake nei. He rerekē, ko te ozone he kaihoko patu huakita whānui-whānui, he whai hua ki ngā huakita me ngā huaketo e ātete ana ki ētahi atu patu huakita8,11,15. Hei tāpiritanga, ka taea te whakaputa i te ozone i te iti o te utu mai i te hau o te āhuarangi, ā, kāore e hiahiatia he matū paitini tāpiri ka waiho he tapuwae kino ki te taiao, nā te mea ka pakaru hei hāora. Heoi, ko te take kāore te ozone i te whakamahia whānuitia hei patu huakita koia tēnei. He paitini te ozone ki te hauora o te tangata, nō reira kāore tōna kukū e neke ake i te 0.07 ppm i te toharite mō te neke atu i te 8 hāora16, nō reira kua whakawhanakehia ngā taputapu whakamate ozone, ā, kua tukuna ki te mākete, ko te nuinga hei horoi i ngā hau putanga. Ka taea hoki te hongi i te hau me te whakaputa i te kakara kino i muri i te horoinga5,8. Kāore i whakamahia te ozone i roto i ngā whare hauora. Heoi, ka taea te whakamahi haumaru i te ozone i roto i ngā rūma whakamate me ngā tikanga hauhautanga tika, ā, ka taea te tere ake te tango mā te whakamahi i te kaitahuri catalytic. I roto i tēnei rangahau, e whakaatu ana mātou ka taea te whakamahi i ngā taputapu whakamate ozone plasma mō te patu huakita i roto i ngā wāhi tiaki hauora. Kua whakawhanakehia e mātou he taputapu me ngā kaha whakamate teitei, he ngāwari te whakahaere me te ratonga tere mō ngā tūroro i te hōhipera. Hei tāpiritanga, kua whakawhanakehia e mātou he waeine whakamate ngawari e whakamahi ana i te hau taiao me te kore utu tāpiri. Tae noa ki tēnei wā, kāore i te rawaka ngā mōhiohio mō ngā whakaritenga ozone iti rawa mō te whakakorenga MDRO. He ngāwari te whakatū i ngā taputapu i whakamahia i roto i tā mātou rangahau, ā, he poto te wā e whakamahia ana, ā, e tika ana kia whai hua mō te whakahoromata pinepine i ngā taputapu.
Kāore i te tino mārama te tikanga o te mahi patu huakita o te ozone. He maha ngā rangahau kua whakaatu ka pakaru te ozone i ngā kiriuhi pūtau huakita, ka puta te turuturu o roto, ā, ka mutu, ka pakaru te pūtau17,18. Ka taea e te ozone te whakararuraru i te mahi whākōkī pūtau mā te tauhohe ki ngā rōpū thiol, ā, ka taea te whakarerekē i ngā turanga purine me te pyrimidine i roto i ngā waikawa karihi. I whakaatuhia e tēnei rangahau te āhua o ngā pua VRE, CRAB, me te C. difficile i mua atu, i muri mai hoki i te maimoatanga ozone, ā, i kitea kāore i te iti noa te rahi, engari i tino pakari ake te mata, e tohu ana i te kino, i te waikura rānei o te kiriuhi o waho rawa. ā, he kaha te kaha o ngā rauemi o roto nā te hau ozone ki te whakapūngao. Ka taea e tēnei kino te arahi ki te whakakorenga o te pūtau, i runga i te kaha o ngā huringa pūtau.
He uaua te tango i ngā pua C. difficile mai i ngā rūma hōhipera. Ka noho tonu ngā pua ki ngā wāhi i tukuna ai e rātou te 10,20. Hei tāpiri, i roto i tēnei rangahau, ahakoa ko te whakahekenga nui rawa atu o te maha o ngā huakita i runga i ngā pereti agar i te 500 ppm ozone mō te 15 meneti he 2.73, kua whakaitihia te pānga patu huakita o te ozone ki ngā rauemi kei roto ngā pua C .difficile. Nō reira, ka taea te whakaaro ki ngā rautaki maha hei whakaiti i te mate C. difficile i roto i ngā wāhi tiaki hauora. Mō te whakamahi i roto i ngā rūma motuhake o C. difficile anake, tera pea he pai ki te whakarerekē i te roa o te whakaaturanga me te kaha o te maimoatanga ozone. Hei tāpiri, me mahara tātou kāore e taea e te tikanga whakakore poke ozone te whakakapi katoa i te horoi ā-ringa tuku iho me ngā patu huakita me ngā rautaki patu huakita, ā, ka tino whai hua hoki ki te whakahaere i te C. difficile 5. I roto i tēnei rangahau, he rerekē te whai huatanga o te ozone hei patu huakita mō ngā momo MPO rerekē. Ka whakawhirinaki pea te whai huatanga ki ētahi āhuatanga pēnei i te wāhanga tipu, te pakitara pūtau, me te whai huatanga o ngā tikanga whakatika21,22. Ko te take o te rerekētanga o te pānga whakahoromata o te ozone ki te mata o ia rauemi, tērā pea nā te hanganga o te kiriata koiora. Kua whakaatuhia e ngā rangahau o mua ka whakanui ake a E. faecium me E. faecium i te ātete taiao ina puta mai hei kiriata koiora23, 24, 25. Heoi, e whakaatu ana tēnei rangahau he pānga patu huakita nui tō te ozone ki ngā pua MDRO me C. difficile.
Ko tētahi herenga o tā mātou rangahau ko tā mātou aromatawai i te pānga o te pupuri ozone i muri i te whakaora. Ka taea e tēnei te arahi ki te whakatau tata rawa i te maha o ngā pūtau huakita ora.
Ahakoa i whakahaerehia tēnei rangahau hei aromatawai i te whai huatanga o te ozone hei patu huakita i roto i te hōhipera, he uaua ki te whakawhanui i ā mātou hua ki ngā hōhipera katoa. Nō reira, me nui ake ngā rangahau hei tirotiro i te whaihua me te hototahitanga o tēnei taputapu whakamate huakita DBD i roto i te hōhipera tūturu.
He māmā noa iho, he whai hua hoki te whakamahi i te ozone i hangaia e ngā tauhohenga plasma DBD hei whakamaroke i te MDRO me te C. difficile. Nō reira, ka taea te whakaaro ko te maimoatanga ozone he huarahi whai hua hei whakakapi i te patu huakita i te taiao hōhipera.
Kei te wātea mai ngā huinga raraunga i whakamahia, i tātarihia rānei i roto i te rangahau o nāianei i ngā kaituhi e pā ana ki te tono tika.
Rautaki ā-ao a te WHO hei pehi i te ātete ki ngā huakita. https://www.who.int/drugresistance/WHO_Global_Strategy.htm/en/ Kei te wātea.
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