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Malo otetezedwa azaumoyo amakhala ndi gawo lofunika kwambiri pakufalikira kwa zamoyo zosagonjetsedwa ndi mankhwala ambiri (MDR) ndi C. difficile. Cholinga cha kafukufukuyu chinali kuwunika momwe ozone yopangidwa ndi dielectric barrier discharge (DBD) plasma reactor imakhudzira ntchito ya vancomycin-resistant Enterococcus faecalis (VRE), carbapenem-resistant Klebsiella pneumoniae (CRE), carbapenem-resistant Antibacterial effects of different spores defied with Pseudomonas spp. Pseudomonas aeruginosa (CRPA), carbapenem-resistant Acinetobacter baumannii (CRAB) ndi Clostridium difficile spores. Zipangizo zosiyanasiyana zoipitsidwa ndi VRE, CRE, CRPA, CRAB ndi C. difficile spores zinachiritsidwa ndi ozone pamlingo wosiyanasiyana komanso nthawi zosiyanasiyana. Atomic force microscopy (AFM) inasonyeza kusintha kwa pamwamba pa mabakiteriya pambuyo pa chithandizo cha ozone. Pamene mlingo wa ozone wa 500 ppm unagwiritsidwa ntchito pa VRE ndi CRAB kwa mphindi 15, kuchepa kwa log10 pafupifupi 2 kapena kuposerapo kunawonedwa mu chitsulo chosapanga dzimbiri, nsalu ndi matabwa, ndipo kuchepa kwa log10 1-2 kunawonedwa mu galasi ndi pulasitiki. Ma spores a C. difficile adapezeka kuti ndi olimbana kwambiri ndi ozone kuposa zamoyo zina zonse zomwe zinayesedwa. Pa AFM, atalandira chithandizo ndi ozone, maselo a bakiteriya adatupa ndikuwonongeka. Ozone yopangidwa ndi DBD Plasma Reactor ndi chida chosavuta komanso chamtengo wapatali chochotsera kuipitsidwa kwa spores za MDRO ndi C. difficile, zomwe zimadziwika kuti ndi tizilombo toyambitsa matenda tomwe timayambitsa matenda okhudzana ndi thanzi.
Kupezeka kwa tizilombo toyambitsa matenda tosagwira mankhwala ambiri (MDR) kumachitika chifukwa cha kugwiritsa ntchito mankhwala opha tizilombo molakwika mwa anthu ndi nyama ndipo bungwe la World Health Organization (WHO) lazindikira kuti ndi chiwopsezo chachikulu pa thanzi la anthu. Makamaka, mabungwe azaumoyo akukumana ndi kufalikira ndi kufalikira kwa ma MRO. Ma MRO akuluakulu ndi Staphylococcus aureus yosagwirizana ndi methicillin ndi enterococcus yosagwirizana ndi vancomycin (VRE), enterobacteria yopangidwa ndi extended-spectrum beta-lactamase (ESBL), Pseudomonas aeruginosa yosagwirizana ndi mankhwala ambiri, Acinetobacter baumannii yosagwirizana ndi mankhwala ambiri, ndi Enterobacter yosagwirizana ndi carbapenem (CRE). Kuphatikiza apo, matenda a Clostridium difficile ndi omwe amachititsa kutsegula m'mimba komwe kumayenderana ndi chisamaliro chaumoyo, zomwe zimaika vuto lalikulu pa dongosolo lazaumoyo. MDRO ndi C. difficile zimafalikira kudzera m'manja mwa ogwira ntchito zachipatala, malo oipitsidwa, kapena mwachindunji kuchokera kwa munthu wina kupita kwa wina. Kafukufuku waposachedwapa wasonyeza kuti malo oipitsidwa m'malo azaumoyo amachita gawo lofunika kwambiri pakufalitsa matenda a MDRO ndi C. difficile pamene ogwira ntchito zachipatala (HCWs) akumana ndi malo oipitsidwa kapena pamene odwala akhudzana mwachindunji ndi malo oipitsidwa 3,4. malo oipitsidwa m'malo azaumoyo amachepetsa kuchuluka kwa matenda a MLRO ndi C. difficile kapena kulowa m'malo oipitsidwa 5,6,7. Popeza nkhawa yapadziko lonse lapansi yokhudza kukwera kwa kukana maantibayotiki, n'zoonekeratu kuti kafukufuku wowonjezereka akufunika pa njira ndi njira zochotsera mabakiteriya m'malo azaumoyo. Posachedwapa, njira zotsukira zosakhudzana ndi malo opumira, makamaka zida za ultraviolet (UV) kapena makina a hydrogen peroxide, zadziwika kuti ndi njira zabwino zochotsera mabakiteriya. Komabe, zida za UV kapena hydrogen peroxide zomwe zimapezeka m'masitolo sizimangokwera mtengo, kuchotsera mabakiteriya a UV kumagwira ntchito pamalo owonekera, pomwe kuchotsera mabakiteriya a hydrogen peroxide m'magazi kumafuna nthawi yayitali yochotsera mabakiteriya asanayambe kufalitsa mabakiteriya 5.
Ozone ili ndi mphamvu zodziwika bwino zotsutsana ndi dzimbiri ndipo imatha kupangidwa motchipa8. Imadziwikanso kuti ndi poizoni ku thanzi la anthu, koma imatha kuwola mwachangu kukhala mpweya 8. Ma dielectric barrier discharge (DBD) plasma reactors ndi omwe amagwiritsa ntchito kwambiri ozone 9. Zipangizo za DBD zimakulolani kupanga plasma yotsika kutentha mumlengalenga ndikupanga ozone. Mpaka pano, kugwiritsa ntchito ozone kwakhala kokha pakuchotsa madzi m'madzi osambira, madzi akumwa ndi zimbudzi10. Kafukufuku angapo wanena kuti imagwiritsidwa ntchito m'malo azaumoyo8,11.
Mu kafukufukuyu, tinagwiritsa ntchito jenereta ya ozone ya DBD plasma kuti tisonyeze kuti imagwira ntchito bwino pochotsa MDRO ndi C. difficile, ngakhale zomwe zimayikidwa pazipangizo zosiyanasiyana zomwe zimagwiritsidwa ntchito kwambiri m'malo azachipatala. Kuphatikiza apo, njira yoyeretsera ozone yafotokozedwa bwino pogwiritsa ntchito zithunzi za atomic force microscopy (AFM) za maselo ochiritsidwa ndi ozone.
Matendawa adapezeka kuchokera ku majeremusi opangidwa ndi: VRE (SCH 479 ndi SCH 637), Klebsiella pneumoniae yokana carbapenem (CRE; SCH CRE-14 ndi DKA-1), Pseudomonas aeruginosa yokana carbapenem (CRPA; 54 ndi 83) ndi majeremusi okana carbapenem. Majeremusi Pseudomonas aeruginosa (CRPA; 54 ndi 83). Acinetobacter baumannii yokana (CRAB; F2487 ndi SCH-511). C. difficile idapezeka kuchokera ku National Pathogen Culture Collection (NCCP 11840) ya Korea Agency for Disease Control and Prevention. Idapezeka kuchokera kwa wodwala ku South Korea mu 2019 ndipo idapezeka kuti ndi ya ST15 pogwiritsa ntchito multilocus sequence typing. Msuzi wa Brain Heart Infusion (BHI) (BD, Sparks, MD, USA) wothiridwa ndi VRE, CRE, CRPA ndi CRAB unasakanizidwa bwino ndikuyikidwa pa 37°C. kwa maola 24.
C. difficile inayikidwa mu agar yamagazi mopanda mpweya kwa maola 48. Kenako madera angapo anawonjezeredwa ku 5 ml ya msuzi wa mtima wa ubongo ndikuyikidwa mu incubation pansi pa anaerobic kwa maola 48. Pambuyo pake, chomeracho chinagwedezeka, 5 ml ya 95% ethanol inawonjezedwa, kugwedezekanso ndikusiyidwa kutentha kwa chipinda kwa mphindi 30. Pambuyo poika centrifugation pa 3000 g kwa mphindi 20, taya supernatant ndikuyimitsa pellet yokhala ndi spores ndikupha mabakiteriya mu 0.3 ml ya madzi. Maselo okhazikika anawerengedwa poika mbewu ya bacterial cell suspension pa blood agar plates pambuyo pochepetsa koyenera. Gram staining inatsimikizira kuti 85% mpaka 90% ya kapangidwe ka bakiteriya kanali spores.
Kafukufuku wotsatira adachitika kuti afufuze zotsatira za ozone ngati mankhwala ophera tizilombo toyambitsa matenda pamalo osiyanasiyana omwe ali ndi spores za MDRO ndi C. difficile, zomwe zimadziwika kuti zimayambitsa matenda okhudzana ndi chisamaliro chaumoyo. Konzani zitsanzo za chitsulo chosapanga dzimbiri, nsalu (thonje), galasi, pulasitiki (acrylic), ndi matabwa (pine) olemera sentimita imodzi ndi sentimita imodzi. Thirani ma coupon musanagwiritse ntchito. Zitsanzo zonse zidayeretsedwa mwa kudzipangira mankhwala musanatenge kachilombo ka mabakiteriya.
Mu kafukufukuyu, maselo a bakiteriya anafalikira pamalo osiyanasiyana a substrate komanso pa mbale za agar. Kenako mapanelo amayeretsedwa mwa kuwaika ku ozone kwa nthawi inayake komanso pamlingo winawake m'chipinda chotsekedwa. Pa chithunzi 1 pali chithunzi cha zida zoyeretsera ozone. Ma DBD plasma reactors adapangidwa polumikiza ma electrode achitsulo chosapanga dzimbiri oboola ndi owonekera kutsogolo ndi kumbuyo kwa mbale za alumina (dielectric) zokhuthala za 1 mm. Pa ma electrode oboola, malo otseguka ndi dzenje anali 3 mm ndi 0.33 mm, motsatana. Electrode iliyonse ili ndi mawonekedwe ozungulira okhala ndi mainchesi a 43 mm. Mphamvu yamagetsi ... Popeza ukadaulo uwu ndi njira yoyeretsera mpweya, kuyeretsera kumachitika m'chipinda chogawidwa ndi voliyumu m'zipinda zapamwamba ndi zapansi, zomwe zimakhala ndi zitsanzo zodetsedwa ndi mabakiteriya ndi majenereta a plasma, motsatana. Chipinda chapamwamba chili ndi ma valavu awiri ochotsera ndikutulutsa ozone yotsala. Musanagwiritse ntchito mu kuyeseraku, kusintha kwa nthawi ya kuchuluka kwa ozoni m'chipindamo mutatsegula plasma kunayesedwa malinga ndi kuchuluka kwa kuyamwa kwa mzere wa spectral wa 253.65 nm wa nyali ya mercury.
(a) Ndondomeko ya njira yoyesera yoyeretsera mabakiteriya pazinthu zosiyanasiyana pogwiritsa ntchito ozone yopangidwa mu DBD plasma reactor, ndi (b) kuchuluka kwa ozone ndi nthawi yopangira plasma mu chipinda choyeretsera. Chithunzicho chinapangidwa pogwiritsa ntchito OriginPro version 9.0 (OriginPro software, Northampton, MA, USA; https://www.originlab.com).
Choyamba, mwa kuyeretsa maselo a bakiteriya omwe amaikidwa pa mbale za agar ndi ozone, pomwe akusintha kuchuluka kwa ozone ndi nthawi yochizira, kuchuluka kwa ozone koyenera komanso nthawi yochizira yochotsa MDRO ndi C. difficile kunadziwika. Panthawi yoyeretsa, chipindacho chimatsukidwa kaye ndi mpweya wozungulira kenako nkudzazidwa ndi ozone poyatsa plasma unit. Zitsanzozo zitachiritsidwa ndi ozone kwa nthawi yoikidwiratu, pampu ya diaphragm imagwiritsidwa ntchito kuchotsa ozone yotsalayo. Muyesowo unagwiritsa ntchito chitsanzo cha culture yonse ya maola 24 (~ 108 CFU/ml). Zitsanzo za suspensions za maselo a bakiteriya (20 μl) poyamba zinachepetsedwa kakhumi ndi saline wosabala, kenako zitsanzozi zinagawidwa pa mbale za agar zosabala ndi ozone mchipindamo. Pambuyo pake, zitsanzo zobwerezabwereza, zokhala ndi zitsanzo zomwe sizinabalalitsidwe ndi ozone, zinasungidwa pa 37°C kwa maola 24 ndikuwerengera makoloni kuti awone momwe sterilization imagwirira ntchito.
Kuphatikiza apo, malinga ndi momwe zinthu zimayeretsedwera zomwe zafotokozedwa mu kafukufukuyu, mphamvu ya ukadaulo uwu pa MDRO ndi C. difficile idayesedwa pogwiritsa ntchito makuponi azinthu zosiyanasiyana (chitsulo chosapanga dzimbiri, nsalu, galasi, pulasitiki ndi matabwa) omwe amagwiritsidwa ntchito kwambiri m'mabungwe azachipatala. Kuchuluka kwa maola 24 (~108 cfu/ml) kunagwiritsidwa ntchito. Zitsanzo za maselo a bakiteriya (20 μl) zinasungunuka motsatizana kakhumi ndi saline wosabala, kenako makuponiwo anamizidwa mu msuzi wosungunukawu kuti awone kuipitsidwa. Zitsanzo zomwe zinachotsedwa mutazimitsidwa mu msuzi wosungunuka zinayikidwa mu mbale za Petri wosabala ndikuwumitsidwa kutentha kwa chipinda kwa maola 24. Ikani chivindikiro cha mbale ya petri pa chitsanzocho ndikuchiyika mosamala m'chipinda choyesera. Chotsani chivindikirocho mu mbale ya Petri ndikuyika chitsanzocho ku 500 ppm ozone kwa mphindi 15. Zitsanzo zowongolera zinayikidwa mu kabati yotetezeka yachilengedwe ndipo sizinaphatikizidwe ku ozone. Nthawi yomweyo mutakumana ndi ozone, zitsanzo ndi zitsanzo zosawala (monga zowongolera) zinasakanizidwa ndi saline wosabala pogwiritsa ntchito chosakaniza cha vortex kuti zilekanitse mabakiteriya pamwamba. Chotsukiracho chopanda madzi chinachepetsedwa ka 10 ndi saline wosabala, kenako chiwerengero cha mabakiteriya osungunuka chinapezeka pa mbale za agar ya magazi (za mabakiteriya othamanga) kapena mbale za agar ya magazi osabala (za Brucella) ndikuyikidwa pa 37°C kwa maola 24. kapena pansi pa mikhalidwe yosabala kwa maola 48 pa 37°C kawiri kuti mudziwe kuchuluka koyambirira kwa inoculum. Kusiyana kwa kuchuluka kwa mabakiteriya pakati pa zowongolera zosawonekera ndi zitsanzo zowonekera kunawerengedwa kuti kuchepetse kuchuluka kwa mabakiteriya (monga, mphamvu yoyeretsa) pansi pa mikhalidwe yoyesedwa.
Maselo achilengedwe ayenera kutsekedwa pa mbale yojambulira ya AFM; chifukwa chake, diski ya mica yosalala komanso yofanana yokhala ndi sikelo yolimba yochepera kukula kwa selo imagwiritsidwa ntchito ngati substrate. M'mimba mwake ndi makulidwe a ma disk anali 20 mm ndi 0.21 mm, motsatana. Kuti ma cell akhazikike bwino pamwamba, pamwamba pa mica pamakhala ndi poly-L-lysine (200 µl), zomwe zimapangitsa kuti ikhale ndi mphamvu yabwino ndipo nembanemba ya selo imakhala ndi mphamvu yoipa. Pambuyo popaka poly-L-lysine, ma disk a mica adatsukidwa katatu ndi madzi a 1 ml deionized (DI) ndikuumitsidwa ndi mpweya usiku wonse. Kenako, ma cell a bakiteriya adayikidwa pamwamba pa mica popaka mankhwala a bakiteriya ochepetsedwa, osiyidwa kwa mphindi 30, kenako pamwamba pa mica padatsukidwa ndi 1 ml ya madzi deionized.
Hafu ya zitsanzozo inachiritsidwa ndi ozone ndipo mawonekedwe a pamwamba pa mbale za mica zodzaza ndi VRE, CRAB ndi C. spores zovuta zinawonetsedwa pogwiritsa ntchito AFM (XE-7, park systems). Njira ya AFM yogwirira ntchito imayikidwa mu tapping mode, yomwe ndi njira yodziwika bwino yojambulira maselo achilengedwe. Mu zoyesererazi, microcantilever yopangidwira mode yosakhudzana (OMCL-AC160TS, OLYMPUS Microscopy) idagwiritsidwa ntchito. Zithunzi za AFM zidajambulidwa kutengera kuchuluka kwa probe scan ya 0.5 Hz zomwe zidapangitsa kuti chithunzi chikhale ndi resolution ya 2048 × 2048 pixels.
Kuti tidziwe momwe ma DBD plasma reactors amagwirira ntchito poyeretsa, tinachita kafukufuku wosiyanasiyana pogwiritsa ntchito MDRO (VRE, CRE, CRPA, ndi CRAB) ndi C. difficile kusintha kuchuluka kwa ozone ndi nthawi yowonekera. Pa chithunzi 1b chikuwonetsa nthawi yowonekera kwa ozone pa vuto lililonse loyesa mutatsegula chipangizo cha plasma. Kuchulukako kunawonjezeka motsatira logarithmic, kufika pa 300 ndi 500 ppm pambuyo pa mphindi 1.5 ndi 2.5, motsatana. Mayeso oyamba ndi VRE awonetsa kuti osachepera omwe amafunikira kuti achotse mabakiteriya bwino ndi ozone 300 ppm kwa mphindi 10. Chifukwa chake, mu mayeso otsatirawa, MDRO ndi C. difficile adawonetsedwa ku ozone pamitundu iwiri yosiyana (300 ndi 500 ppm) komanso pamitundu iwiri yosiyana yowonekera (mphindi 10 ndi 15). Kugwira ntchito bwino kwa mankhwala ophera tizilombo toyambitsa matenda pa mlingo uliwonse wa ozoni ndi nthawi yowonekera kunawerengedwa ndikuwonetsedwa mu Gome 1. Kuwonekera ku ozoni 300 kapena 500 ppm kwa mphindi 10-15 kunapangitsa kuti VRE ichepe kwambiri ndi log10. Kupha kwakukulu kwa mabakiteriya ndi CRE kunapezeka ndi mphindi 15 zowonekera ku ozoni 300 kapena 500 ppm. Kuchepa kwakukulu kwa CRPA (> 7 log10) kunapezeka pokhudzana ndi ozone ya 500 ppm kwa mphindi 15. Kuchepa kwakukulu kwa CRPA (> 7 log10) kunapezeka pokhudzana ndi ozone ya 500 ppm kwa mphindi 15. Высокое снижение CRPA (> 7 log10) было достигнуто при воздействии 500 частей на миллион озона в течение 15 минут. Kuchepa kwakukulu kwa CRPA (> 7 log10) kunapezeka pokhudzana ndi ozone ya 500 ppm kwa mphindi 15.暴露于500 ppm 的臭氧15 分钟后，可大幅降低CRPA (> 7 log10).暴露于500 ppm 的臭氧15 分钟后，可大幅降低CRPA (> 7 log10). Существенное снижение CRPA (> 7 log10) после 15-минутного воздействия озона с концентрацией 500 ppm. Kuchepa kwakukulu kwa CRPA (> 7 log10) pambuyo pa mphindi 15 kukhudzidwa ndi ozone ya 500 ppm.Kuphedwa kosayenera kwa mabakiteriya a CRAB pa ozone ya 300 ppm; Komabe, pa ozone ya 500 ppm, panali kuchepa kwa > 1.5 log10. Komabe, pa ozone ya 500 ppm, panali kuchepa kwa > 1.5 log10. однако при концентрации озона 500 частей на миллион наблюдалось снижение > 1,5 log10. Komabe, pa kuchuluka kwa ozone kwa 500 ppm, kuchepa kwa >1.5 log10 kunawonedwa.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. Komabe, pa kuchuluka kwa ozone kwa 500 ppm, kuchepa kwa >1.5 log10 kunawonedwa. Kuwonetsa spores za C. difficile ku ozone ya 300 kapena 500 ppm kunapangitsa kuti pakhale kuchepa kwa >2.5 log10. Kuwonetsa spores za C. difficile ku ozone ya 300 kapena 500 ppm kunapangitsa kuti pakhale kuchepa kwa >2.5 log10. Воздействие на споры C. difficile озона с концентрацией 300 kapena 500 частей на миллион приводило к снижению > 2,5 log10. Kuwonekera kwa spores za C. difficile ku ozone ya 300 kapena 500 ppm kunapangitsa kuti pakhale kuchepa kwa >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 kapena 500 частей на миллион приводило к снижению >2,5 log10. Kuwonekera kwa spores za C. difficile ku ozone ya 300 kapena 500 ppm kunapangitsa kuti pakhale kuchepa kwa >2.5 log10.
Kutengera ndi zoyeserera zomwe zili pamwambapa, papezeka zofunikira zokwanira kuti zithetse mabakiteriya pa mlingo wa ozone wa 500 ppm kwa mphindi 15. Ma spores a VRE, CRAB ndi C. difficile ayesedwa kuti awone zotsatira za ozone zophera majeremusi pazinthu zosiyanasiyana kuphatikizapo chitsulo chosapanga dzimbiri, nsalu, galasi, pulasitiki ndi matabwa zomwe zimagwiritsidwa ntchito kwambiri m'zipatala. Kugwira ntchito kwawo koyeretsa kwawonetsedwa mu Gome 2. Zamoyo zoyesera zidayesedwa kawiri. Mu VRE ndi CRAB, ozone sinali yogwira ntchito bwino pagalasi ndi pulasitiki, ngakhale kuti kuchepa kwa log10 kwa pafupifupi factor ya 2 kapena kuposerapo kunawonedwa pa chitsulo chosapanga dzimbiri, nsalu ndi matabwa. Ma spores a C. difficile adapezeka kuti ndi olimbana kwambiri ndi chithandizo cha ozone kuposa zamoyo zina zonse zomwe zidayesedwa. Kuti aphunzire ziwerengero za zotsatira za ozone pa zotsatira zakupha za zinthu zosiyanasiyana motsutsana ndi VRE, CRAB, ndi C. difficile, mayeso a t adagwiritsidwa ntchito poyerekeza kusiyana pakati pa chiwerengero cha CFU pa milliliter m'magulu olamulira ndi oyesera pazinthu zosiyanasiyana (Chithunzi 2). Mitundu ina ya tizilombo inasonyeza kusiyana kwakukulu pa ziwerengero, koma kusiyana kwakukulu kunawonedwa pa spores za VRE ndi CRAB kuposa za spores za C. difficile.
Kufotokozera za zotsatira za ozoni pa kupha mabakiteriya pazinthu zosiyanasiyana (a) VRE, (b) CRAB, ndi (c) C. difficile.
Chithunzi cha AFM chinachitidwa pa spores za VRE, CRAB, ndi C. difficile zomwe zinachiritsidwa ndi ozone komanso zomwe sizinachiritsidwe kuti ziphunzire mwatsatanetsatane njira yophera mpweya wa ozone. Pa chithunzi 3a, c ndi e zikuwonetsa zithunzi za AFM za spores za VRE, CRAB ndi C. difficile zomwe sizinachiritsidwe, motsatana. Monga momwe taonera pazithunzi za 3D, maselowo ndi osalala komanso osawonongeka. Zithunzi 3b, d ndi f zikuwonetsa spores za VRE, CRAB ndi C. difficile pambuyo pa chithandizo cha ozone. Sikuti zinangochepetsa kukula konse kwa maselo onse omwe ayesedwa, komanso pamwamba pawo panakhala kolimba kwambiri atakumana ndi ozone.
Zithunzi za AFM za ma spores a VRE, MRAB ndi C. difficile osachiritsidwa (a, c, e) ndi (b, d, f) omwe amachiritsidwa ndi ozone ya 500 ppm kwa mphindi 15. Zithunzizo zidajambulidwa pogwiritsa ntchito mtundu wa Park Systems XEI 5.1.6 (XEI Software, Suwon, Korea; https://www.parksystems.com/102-products/park-xe-bio).
Kafukufuku wathu akuwonetsa kuti ozone yopangidwa ndi zida za plasma za DBD ikuwonetsa kuthekera kochotsa bwino spores za MDRO ndi C. difficile, zomwe zimadziwika kuti ndi zomwe zimayambitsa matenda okhudzana ndi chisamaliro chaumoyo. Kuphatikiza apo, mu kafukufuku wathu, popeza kuipitsidwa kwa chilengedwe ndi spores za MDRO ndi C. difficile kumatha kukhala gwero la matenda okhudzana ndi chisamaliro chaumoyo, mphamvu yopha majeremusi ya ozone idapezeka kuti yathandiza pazinthu zomwe zimagwiritsidwa ntchito kwambiri m'zipatala. Mayeso ochotsa majeremusi adachitika pogwiritsa ntchito zida za plasma za DBD pambuyo poipitsa zinthu monga chitsulo chosapanga dzimbiri, nsalu, galasi, pulasitiki ndi matabwa okhala ndi spores za MDRO ndi C. difficile. Zotsatira zake, ngakhale kuti mphamvu yochotsa majeremusi imasiyana malinga ndi zinthuzo, mphamvu yochotsa majeremusi ya ozone ndi yodabwitsa.
Zinthu zomwe zimakhudzidwa kawirikawiri m'zipinda zachipatala zimafuna kutsukidwa nthawi zonse komanso mopanda kuwononga. Njira yodziwika bwino yotsukitsira zinthu zotere ndi kutsuka ndi manja ndi mankhwala ophera tizilombo monga quaternary ammonium compound 13. Ngakhale mutatsatira malangizo ogwiritsira ntchito mankhwala ophera tizilombo, MPO ndi yovuta kuchotsa poyeretsa zachilengedwe (nthawi zambiri kutsuka ndi manja)14. Chifukwa chake, ukadaulo watsopano umafunika, monga njira zosakhudzana. Chifukwa chake, pakhala chidwi ndi mankhwala ophera tizilombo toyambitsa matenda a gasi, kuphatikizapo hydrogen peroxide ndi ozone10. Ubwino wa mankhwala ophera tizilombo a gasi ndikuti amatha kufikira malo ndi zinthu zomwe njira zachikhalidwe zogwiritsira ntchito pamanja sizingafikire. Hydrogen peroxide yayamba kugwiritsidwa ntchito posachedwapa m'malo azachipatala, komabe hydrogen peroxide yokha ndi yoopsa ndipo iyenera kuchitidwa motsatira njira zokhwima zogwirira ntchito. Kuyeretsa plasma ndi hydrogen peroxide kumafuna nthawi yayitali yoyeretsa plasma isanayambe njira yotsatira yoyeretsera. Mosiyana ndi zimenezi, ozone imagwira ntchito ngati mankhwala ophera tizilombo toyambitsa matenda, yogwira ntchito motsutsana ndi mabakiteriya ndi mavairasi omwe sagonjetsedwa ndi mankhwala ena ophera tizilombo toyambitsa matenda8,11,15. Kuphatikiza apo, ozone imatha kupangidwa motchipa kuchokera mumlengalenga ndipo sikufuna mankhwala ena oopsa omwe angasiye malo owopsa m'chilengedwe, chifukwa pamapeto pake imasweka kukhala mpweya. Komabe, chifukwa chomwe ozone sigwiritsidwa ntchito kwambiri ngati mankhwala ophera tizilombo ndi motere. Ozone ndi poizoni ku thanzi la anthu, kotero kuchuluka kwake sikupitirira 0.07 ppm pa avareji kwa maola opitilira 816, kotero ma sterilizer a ozone apangidwa ndikugulitsidwa pamsika, makamaka poyeretsa mpweya wotulutsa utsi. N'zothekanso kupuma mpweya ndikupanga fungo losasangalatsa mutachotsa kuipitsidwa5,8. Ozone sinagwiritsidwe ntchito mwachangu m'mabungwe azachipatala. Komabe, ozone ingagwiritsidwe ntchito mosamala m'zipinda zoyeretsera komanso ndi njira zoyenera zopumira, ndipo kuchotsa kwake kumatha kufulumizitsidwa kwambiri pogwiritsa ntchito chosinthira chothandizira. Mu kafukufukuyu, tikuwonetsa kuti ma sterilizer a ozone a plasma angagwiritsidwe ntchito poyeretsera utsi m'malo azaumoyo. Tapanga chipangizo chokhala ndi mphamvu zambiri zoyeretsera utsi, ntchito yosavuta komanso ntchito yachangu kwa odwala omwe ali m'chipatala. Kuphatikiza apo, tapanga chipangizo chosavuta choyeretsera utsi chomwe chimagwiritsa ntchito mpweya wozungulira popanda ndalama zina zowonjezera. Mpaka pano, palibe chidziwitso chokwanira pa zofunikira zochepa za ozone kuti MDRO isagwire ntchito. Zipangizo zomwe zagwiritsidwa ntchito mu kafukufuku wathu ndizosavuta kukhazikitsa ndipo zimakhala ndi nthawi yochepa yogwira ntchito ndipo zikuyembekezeka kukhala zothandiza pakuyeretsa zida pafupipafupi.
Kachitidwe ka ntchito yopha mabakiteriya ya ozone sikudziwika bwino. Kafukufuku wambiri wasonyeza kuti ozone imawononga nembanemba ya maselo a bakiteriya, zomwe zimapangitsa kuti kutuluka kwa mkati mwa maselo kutayike komanso kuti maselo ayambe kusokonekera. Ozone imatha kusokoneza ntchito ya enzymatic ya maselo pochita zinthu ndi magulu a thiol ndipo imatha kusintha maziko a purine ndi pyrimidine mu nucleic acids. Kafukufukuyu adawonetsa mawonekedwe a spores a VRE, CRAB, ndi C. difficile asanayambe komanso atalandira chithandizo cha ozone ndipo adapeza kuti sizinangochepa kukula kokha, komanso zinakhala zolimba kwambiri pamwamba, zomwe zimasonyeza kuwonongeka kapena kuwonongeka kwa nembanemba yakunja. Ndipo zinthu zamkati chifukwa cha mpweya wa ozone zimakhala ndi mphamvu yayikulu yotulutsa okosijeni. Kuwonongeka kumeneku kungayambitse kulephera kwa maselo, kutengera kuopsa kwa kusintha kwa maselo.
Ma spores a C. difficile ndi ovuta kuwachotsa m'zipinda za chipatala. Ma spores amakhalabe m'malo omwe amataya 10,20. Kuphatikiza apo, mu kafukufukuyu, ngakhale kuti kuchepa kwakukulu kwa mabakiteriya pa ma agar plates pa 500 ppm ozone kwa mphindi 15 kunali 2.73, mphamvu ya ozone yopha mabakiteriya pazinthu zosiyanasiyana zomwe zili ndi spores a C. difficile yachepetsedwa. Chifukwa chake, njira zosiyanasiyana zitha kuganiziridwa kuti zichepetse matenda a C. difficile m'malo azaumoyo. Kuti mugwiritse ntchito m'zipinda za C. difficile zokha, zingakhalenso zothandiza kusintha nthawi yowonekera komanso mphamvu ya chithandizo cha ozone. Kuphatikiza apo, tiyenera kukumbukira kuti njira yochotsera mabakiteriya ku ozone singathe kusintha kwathunthu kuyeretsa kwachizolowezi ndi mankhwala ophera tizilombo toyambitsa matenda ndi njira zophera tizilombo toyambitsa matenda, ndipo ingakhalenso yothandiza kwambiri poletsa C. difficile 5. Mu kafukufukuyu, mphamvu ya ozone ngati mankhwala ophera tizilombo imasiyana pamitundu yosiyanasiyana ya MPO. Kugwira ntchito bwino kungadalire zinthu zingapo monga gawo la kukula, khoma la maselo, ndi magwiridwe antchito a njira zokonzanso21,22. Chifukwa cha kusiyana kwa mphamvu ya ozone yoyeretsera pamwamba pa chinthu chilichonse chikhoza kukhala chifukwa cha kupangidwa kwa biofilm. Kafukufuku wakale wasonyeza kuti E. faecium ndi E. faecium zimawonjezera kukana kwa chilengedwe zikapezeka ngati biofilms23, 24, 25. Komabe, kafukufukuyu akuwonetsa kuti ozone ili ndi mphamvu yowononga mabakiteriya pa spores za MDRO ndi C. difficile.
Cholepheretsa cha kafukufuku wathu ndichakuti tinayesa momwe ozoni imasungidwira pambuyo pokonzanso. Izi zingayambitse kuwerengera mopitirira muyeso kuchuluka kwa maselo a bakiteriya omwe ali ndi mphamvu.
Ngakhale kuti kafukufukuyu adachitika kuti awone momwe ozone imagwirira ntchito ngati mankhwala ophera tizilombo m'chipatala, n'zovuta kufotokoza zotsatira zathu m'zipatala zonse. Chifukwa chake, kafukufuku wowonjezereka akufunika kuti afufuze momwe DBD ozone sterilizer iyi imagwirira ntchito komanso momwe imagwirizanirana ndi chipatala chenicheni.
Ozoni yomwe imapangidwa ndi ma DBD plasma reactors ikhoza kukhala njira yosavuta komanso yothandiza yochotsera kuipitsidwa kwa MDRO ndi C. difficile. Chifukwa chake, chithandizo cha ozoni chingaganizidwe ngati njira ina yothandiza m'malo mochotsa kuipitsidwa kwa malo ochizira matenda m'zipatala.
Ma data omwe agwiritsidwa ntchito ndi/kapena omwe afufuzidwa mu kafukufukuyu akupezeka kwa olemba omwewo ngati atapemphedwa moyenera.
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