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Ibidukikije by’ubuzima byanduye bigira uruhare runini mu gukwirakwira kw’uturemangingo turwanya imiti myinshi (MDR) na C. difficile. Intego y’ubu bushakashatsi kwari ukureba ingaruka za ozone ikorwa na dielectric barrier discharge (DBD) plasma reactor ku gikorwa cya vancomycin-resistant Enterococcus faecalis (VRE), carbapenem-resistant Klebsiella pneumoniae (CRE), carbapenem-resistant Antibacterial Ingaruka za bagiteri z’ibintu bitandukanye byanduye Pseudomonas spp. Pseudomonas aeruginosa (CRPA), carbapenem-resistant Acinetobacter baumannii (CRAB) na Clostridium difficile spores. Ibintu bitandukanye byandujwe na VRE, CRE, CRPA, CRAB na C. difficile spores byavuwe na ozone ku rugero rutandukanye no mu bihe bitandukanye byo kwibasirwa. Mikroskopi y’imbaraga za atomiki (AFM) yagaragaje impinduka ku buso bwa bagiteri nyuma yo kuvurwa na ozone. Iyo dose ya ozone ya 500 ppm yashyirwaga kuri VRE na CRAB mu minota 15, yagabanutseho log10 hafi 2 cyangwa zirenga mu byuma bitarangwamo ifu, imyenda n'ibiti, kandi yagabanutseho log10 1-2 mu birahure na pulasitiki. Imbuto za C. difficile zagaragaye ko zirwanya ozone kurusha izindi nyamaswa zose zapimwe. Kuri AFM, nyuma yo kuvurwa na ozone, uturemangingo twa bagiteri twarabyimbye kandi turahinduka. Ozone ikorwa na DBD Plasma Reactor ni igikoresho cyoroshye kandi cy'agaciro cyo gukuraho ubwandu kuri MDRO na C. difficile spores, bizwiho kuba indwara zikunze kugaragara mu ndwara ziterwa n'ubuvuzi.
Kugaragara kw'uturemangingo turwanya imiti myinshi (MDR) biterwa no gukoresha nabi imiti yica udukoko mu bantu no mu matungo, kandi byagaragajwe n'Ishami ry'Umuryango w'Abibumbye ryita ku Buzima (OMS) nk'ikibazo gikomeye ku buzima rusange1. By'umwihariko, ibigo by'ubuvuzi bikomeje guhura n'ikibazo cyo kugaragara no gukwirakwira kwa MRO. MRO z'ingenzi ni Staphylococcus aureus idakira methicillin na enterococcus idakira vancomycin (VRE), enterobacteria ikora beta-lactamase (ESBL), Pseudomonas aeruginosa idakira imiti myinshi, Acinetobacter baumannii idakira imiti myinshi, na Enterobacter idakira carbapenem (CRE). Byongeye kandi, ubwandu bwa Clostridium difficile ni imwe mu mpamvu zikomeye zitera impiswi ziterwa n'ubuvuzi, zishyira umutwaro ukomeye ku rwego rw'ubuvuzi. MDRO na C. difficile byandurira mu maboko y'abakozi bo mu rwego rw'ubuzima, ahantu handuye, cyangwa umuntu ku giti cye. Ubushakashatsi buherutse bwerekanye ko ibidukikije byanduye mu bigo by’ubuvuzi bigira uruhare runini mu kwanduzanya kwa MDRO na C. difficile iyo abakozi bo mu rwego rw’ubuzima (HCWs) bahuye n’ahantu handuye cyangwa iyo abarwayi bahuye n’ahantu handuye 3,4. ibidukikije byanduye mu bigo by’ubuvuzi bigabanya ubwandu bwa MLRO na C. difficile cyangwa kwibasirwa n’uturemangingo 5,6,7. Bitewe n’impungenge isi yose ifite ku kwiyongera k’ubudahangarwa bw’imiti irwanya udukoko, biragaragara ko hakenewe ubushakashatsi bwinshi ku buryo n’uburyo bwo gukuraho ubwandu mu bigo by’ubuvuzi. Vuba aha, uburyo bwo gusukura ahantu hadakoreshejwe imiti ikoreshwa mu gusukura, cyane cyane ibikoresho bya ultraviolet (UV) cyangwa sisitemu ya hydrogen peroxide, byagaragaye ko ari uburyo bwiza bwo gukuraho ubwandu. Ariko, ibi bikoresho bya UV cyangwa hydrogen peroxide bigurishwa ku isoko ntabwo bihenze gusa, gusukura UV bigira akamaro gusa ku hantu hagaragara, mu gihe gusukura plasma ya hydrogen peroxide bisaba igihe kirekire cyo gukuraho ubwandu mbere y’uko habaho ubundi buryo bwo gukuraho ubwandu5.
Ozone ifite ubushobozi bwo kurwanya ingese kandi ishobora gukorwa ku buryo buhendutse8. Izwi kandi ko ihumanya ubuzima bw'abantu, ariko ishobora kubora vuba ikaba ogisijeni 8. Imashini zitunganya plasma zikoresha amashanyarazi (DBD) ni zo zikunze gukoreshwa cyane mu gutanga ozone9. Ibikoresho bya DBD bigufasha gukora plasma y'ubushyuhe buke mu kirere no gukora ozone. Kugeza ubu, ikoreshwa rya ozone ryakoreshejwe ahanini mu gusukura amazi yo mu kidendezi, amazi yo kunywa n'imyanda10. Ubushakashatsi bwinshi bwagaragaje ko ikoreshwa mu buvuzi8,11.
Muri ubu bushakashatsi, twakoresheje icyuma gito gitanga ozone muri plasma cya DBD kugira ngo tugaragaze ko gifite akamaro mu gukuraho MDRO na C. difficile, ndetse n’ibyatewe n’ibikoresho bitandukanye bikunze gukoreshwa mu buvuzi. Byongeye kandi, inzira yo kuvura ozone yasobanuwe hakoreshejwe amashusho ya atome force mikroskopi (AFM) y’uturemangingo twavuwe na ozone.
Ubwoko bw'indwara bwavuye mu bipimo bya VRE (SCH 479 na SCH 637), Klebsiella pneumoniae idakira carbapenem (CRE; SCH CRE-14 na DKA-1), Pseudomonas aeruginosa idakira carbapenem (CRPA; 54 na 83) na bagiteri idakira carbapenem. Bagiteri Pseudomonas aeruginosa (CRPA; 54 na 83). Acinetobacter baumannii idakira (CRAB; F2487 na SCH-511). C. difficile yavuye mu Ikusanyirizo ry'Imiterere y'Indwara z'Igihugu (NCCP 11840) ry'Ikigo cya Koreya gishinzwe Kurwanya no Kurwanya Indwara. Yakuwe ku murwayi wo muri Koreya y'Epfo mu 2019 kandi yasanze ari iya ST15 hakoreshejwe uburyo bwa multilocus sequence. Umutobe w’ubwonko (BHI) (BD, Sparks, MD, USA) watewemo VRE, CRE, CRPA na CRAB wavanzwe neza hanyuma ushyirwa ku bushyuhe bwa 37°C. mu gihe cy’amasaha 24.
C. difficile yashyizwemo imirongo idafite umwuka ku maraso mu gihe cy'amasaha 48. Hanyuma amatsinda menshi yongewe kuri 5 ml y'umuti w'umutima wo mu bwonko hanyuma ashyirwa mu gihe cy'amasaha 48. Nyuma y'ibyo, ubwiza bwaranyeganyejwe, hongerwamo 5 ml ya 95% bya ethanol, yongera kunyeganyezwa hanyuma isigara ku bushyuhe bw'icyumba mu gihe cy'iminota 30. Nyuma yo gukaraba kuri 3000 g mu gihe cy'iminota 20, jugunya supernatant hanyuma ushyiremo utubuto turimo hanyuma wice bagiteri muri 0.3 ml y'amazi. Uturemangingo dufite ubuzima twabazwe hakoreshejwe uburyo bwo gutera imbuto ku dusate twa bacteria nyuma yo gushonga neza. Ibara rya gram ryagaragaje ko 85% kugeza 90% by'imiterere ya bagiteri ari utubuto.
Ubushakashatsi bukurikira bwakozwe kugira ngo harebwe ingaruka za ozone nk'umuti wica udukoko ku buso butandukanye bwandujwe na spores za MDRO na C. difficile, zizwiho gutera indwara ziterwa n'ubuvuzi. Tegura ingero z'icyuma kidashonga, imyenda (ipamba), ikirahure, pulasitiki (acrylic), n'ibiti (pinusi) bipima santimetero imwe kuri santimetero imwe. Sukura udukoko mbere yo gukoresha. Ingero zose zasuzumwe hifashishijwe autoclaving mbere yo kwandura bagiteri.
Muri ubu bushakashatsi, uturemangingo twa bagiteri twakwirakwijwe ku buso butandukanye bw’ubutaka ndetse no ku masahani ya agar. Hanyuma utwo duce dushyirwamo imiti igabanya ubukana binyuze mu gushyira muri ozone mu gihe runaka no ku rugero runaka mu cyumba gifunze. Ku ishusho ya 1 hari ifoto y’ibikoresho byo gusukura ozone. Imashini zitunganya plasma za DBD zakozwe hakoreshejwe electrode z’icyuma zitoboye kandi zigaragara imbere n’inyuma by’isahani ya alumina (dielectric) ifite ubugari bwa mm 1. Ku electrode zitoboye, umwanya n’umwobo byari mm 3 na mm 0.33, uko bikurikirana. Buri electrode ifite ishusho izengurutse ifite umurambararo wa mm 43. Ingufu nyinshi zitanga ingufu nyinshi (GBS Elektronik GmbH Minipuls 2.2) zakoreshejwe mu gushyiramo voltage ya sinusoidal ya 8 kV peak ku nshuro ya 12.5 kHz kuri electrode zitoboye kugira ngo hakorwe plasma ku nkengero z’iyo electrode. Kubera ko ikoranabuhanga ari uburyo bwo gusukura umwuka, gusukura umubiri bikorwa mu cyumba kigabanyijemo ingano mu bice byo hejuru n'ibyo hasi, birimo ingero zanduye bagiteri n'ibikoresho bikora plasma. Igice cyo hejuru gifite imiyoboro ibiri yo gukuramo no gusohora umwuka wa ozone usigaye. Mbere yo gukoresha mu igerageza, impinduka mu gihe cy'ubwinshi bwa ozone mu cyumba nyuma yo gufungura plasma yapimwe hakurikijwe spectrum y'umuyoboro wa spectral wa 253.65 nm w'itara rya mercure.
(a) Gahunda y'igerageza ryo gushyiraho uburyo bwo gukingira bagiteri ku bikoresho bitandukanye hakoreshejwe ozone ikorerwa muri DBD plasma reactor, na (b) ubwinshi bwa ozone n'igihe cyo gukora plasma mu cyumba cyo gukingira. Ishusho yakozwe hakoreshejwe verisiyo ya OriginPro 9.0 (OriginPro software, Northampton, MA, USA; https://www.originlab.com).
Ubwa mbere, hakoreshejwe uburyo bwo gusukura uturemangingo twa bagiteri dushyirwa ku masahani ya agar ukoresheje ozone, mu gihe hahindurwa ingano ya ozone n'igihe cyo kuyivura, hagenwa ingano ikwiye ya ozone n'igihe cyo kuyivura cyo gukuraho ubwandu bwa MDRO na C. difficile. Mu gihe cyo kuyisukura, icyumba kibanza gusukurwa n'umwuka wo mu kirere hanyuma kikazura ozone hakoreshejwe plasma unit. Nyuma y'uko ingero zivuwe na ozone mu gihe cyagenwe, ipompe ya diaphragm ikoreshwa mu gukuraho ozone isigaye. Ibipimo byakoreshejwe icyitegererezo cy'uburyo bwose bwo kuyisukura amasaha 24 (~ 108 CFU/ml). Ingero z'uturemangingo twa bagiteri (20 μl) zabanje gukurwamo inshuro icumi zivanze n'umunyu wa saline, hanyuma izi ngero zigakwirakwizwa ku masahani ya agar asukurwa na ozone mu cyumba. Nyuma y'ibyo, ingero zisubiwemo, zigizwe n'ingero zagaragaye kandi zitagaragaye kuri ozone, zashyizwe ku bushyuhe bwa 37°C mu gihe cy'amasaha 24 kandi zibarwa amakoloni kugira ngo harebwe akamaro ko kuyisukura.
Byongeye kandi, hakurikijwe uburyo bwo gusukura bwasobanuwe mu bushakashatsi bwavuzwe haruguru, ingaruka z'ubu buryo bwo gukuraho ubwandu kuri MDRO na C. difficile zasuzumwe hakoreshejwe amakaroni y'ibikoresho bitandukanye (ibyuma bitagira umwanda, imyenda, ikirahure, pulasitiki n'ibiti) bikunze gukoreshwa mu bigo by'ubuvuzi. Hakoreshejwe amakaroni yuzuye amasaha 24 (~108 cfu/ml). Ingero z'uturemangingo twa bagiteri (20 μl) zavanzwe inshuro icumi n'umunyu wanduye, hanyuma amakaroni yinjizwa muri iyi minyu kugira ngo hamenyekane ubwandu. Ingero zakuwemo nyuma yo kwinjizwa mu munyu wanduye zashyizwe mu masahani ya Petri yanduye hanyuma ziyumishwa ku bushyuhe bw'icyumba mu gihe cy'amasaha 24. Shyira umupfundikizo w'isahani ya petri ku gipimo hanyuma ushyire witonze mu cyumba cy'igeragezwa. Kura umupfundikizo mu isahani ya Petri hanyuma ushyire icyitegererezo kuri ozone ya 500 ppm mu gihe cy'iminota 15. Ingero zo kugenzura zashyizwe mu kabati k'umutekano w'ibinyabuzima kandi ntizashyizwe muri ozone. Ako kanya nyuma yo kwinjizwa muri ozone, ingero n'ingero zitari zirimo imirasire (ni ukuvuga igenzura) zavanzwe na saline yanduye hakoreshejwe imvange ya vortex kugira ngo bagiteri zitanduzwe hejuru. Iyi suspension yakuwemo amazi inshuro 10 ikoresheje saline yanduye, hanyuma umubare wa bagiteri zavuyemo amazi ugaragazwa ku mabara ya agar y'amaraso (kuri bagiteri za aerobic) cyangwa ku mabara ya agar y'amaraso ya anaerobic kuri Brucella (kuri Clostridium difficile) hanyuma ishyirwa ku bushyuhe bwa 37°C mu gihe cy'amasaha 24. cyangwa mu gihe cy'adafite umwuka wanduye mu gihe cy'amasaha 48 kuri 37°C mu buryo bubiri kugira ngo hamenyekane urugero rw'ibanze rw'iyi syringe. Itandukaniro mu mibare ya bagiteri hagati y'abagenzurwa batagaragaye n'ibipimo byagaragaye ryabazwe kugira ngo hagabanuke umubare wa bagiteri (ni ukuvuga ubushobozi bwo gusukura) mu gihe cy'igeragezwa.
Uturemangingo tw’ibinyabuzima tugomba kubuzwa kugenda ku isahani ikoreshwa mu gushushanya ya AFM; bityo, hakoreshwa disiki ya mica irambuye kandi ingana ifite igipimo cy’ubukana buto ugereranyije n’ingano y’uturemangingo nk’ishingiro. Ubugari n’ubugari bwa disiki byari mm 20 na mm 0.21, uko bikurikirana. Kugira ngo uturemangingo dukomere ku buso, ubuso bwa mica butwikiriwe na poly-L-lysine (200 µl), bigatuma ishyushye neza naho uturemangingo tw’uturemangingo dushyushye nabi. Nyuma yo gusigwa na poly-L-lysine, disiki za mica zogejwe inshuro 3 n’amazi ya ml 1 deionized (DI) hanyuma umwuka ukamurika mu ijoro ryose. Hanyuma, uturemangingo twa bagiteri twashyizwe ku buso bwa mica butwikiriwe na poly-L-lysine binyuze mu gupima umuti wa bagiteri utose, usigara iminota 30, hanyuma ubuso bwa mica bwogezwa na ml 1 y’amazi ya deionized.
Kimwe cya kabiri cy’ibipimo byavuwe na ozone kandi imiterere y’ubuso bw’amasahani ya mica yuzuye VRE, CRAB na C. spores difficile yagaragajwe hakoreshejwe AFM (XE-7, sisitemu za pariki). Uburyo bwa AFM bwo gukora bwashyizwe kuri tapping mode, ari na bwo buryo busanzwe bwo gufotora ingirabuzimafatizo z’ibinyabuzima. Mu igerageza, hakoreshejwe microcantilever yagenewe uburyo butarimo gukorana (OMCL-AC160TS, OLYMPUS Microscopy). Amashusho ya AFM yafashwe hashingiwe ku gipimo cya probe scan cya 0.5 Hz bigatuma ishusho igaragara kuri pixel 2048 × 2048.
Kugira ngo tumenye imiterere y’uburyo DBD plasma reactors ikora mu gukingira indwara, twakoze ubushakashatsi butandukanye dukoresheje MDRO (VRE, CRE, CRPA, na CRAB) na C. difficile guhindura ingano ya ozone n’igihe cyo kuyishyira mu kaga. Ku ishusho ya 1b hagaragazwa igihe cyo kuyishyira mu kaga kuri buri kibazo nyuma yo kuyikoresha mu gupima igikoresho cya plasma. ingano yiyongereye mu buryo bwa logarithmic, igera kuri 300 na 500 ppm nyuma y’iminota 1.5 na 2.5. Ibizamini bya mbere bya VRE byagaragaje ko nibura gisabwa kugira ngo bagiteri zihumanuke neza ari ozone ya 300 ppm mu minota 10. Bityo, mu bushakashatsi bwakurikiyeho, MDRO na C. difficile byahuye na ozone ku rugero rubiri rutandukanye (300 na 500 ppm) no ku nshuro ebyiri zitandukanye zo kuyishyira mu kaga (iminota 10 na 15). Uburyo bwo gusukura buri gipimo cya ozone n'igihe cyo kuyishyira mu bikorwa byabazwe kandi bigaragazwa mu mbonerahamwe ya 1. Kwishyira mu bikorwa kuri ozone ya 300 cyangwa 500 ppm mu gihe cy'iminota 10-15 byatumye VRE igabanuka muri rusange inshuro 2 cyangwa zirenga. Iki kigero cyo hejuru cy'ubwicanyi bwa bagiteri hamwe na CRE cyagezweho mu minota 15 yo kwishyira mu bikorwa kuri ozone ya 300 cyangwa 500 ppm. Kugabanuka cyane kwa CRPA (> 7 log10) byagezweho no guhura na ozone ya ozone ya 500 ppm mu gihe cy'iminota 15. Kugabanuka cyane kwa CRPA (> 7 log10) byagezweho no guhura na ozone ya ozone ya 500 ppm mu gihe cy'iminota 15. Высокое снижение CRPA (> 7 log10) было достигнуто при воздействии 500 частей на на гона в течение 15 мин. Kugabanuka cyane kwa CRPA (> 7 log10) byagezweho mu gihe cyo guhumeka kuri ozone ya 500 ppm mu gihe cy'iminota 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-минного воздействия କାନона снараций 500 ppm. Kugabanuka gukomeye kwa CRPA (> 7 log10) nyuma y'iminota 15 umuntu ahuye na ozone ya 500 ppm.Kwica bagiteri za CRAB ku gipimo cya ozone cya 300 ppm bikabije; icyakora, kuri ozone ya 500 ppm, habayeho kugabanuka kwa > 1.5 log10. icyakora, kuri ozone ya 500 ppm, habayeho kugabanuka kwa > 1.5 log10. однако при прирации କାନона 500 частей на наблюдалось снижение> 1.5 log10. icyakora, ku gipimo cya ozone cya 500 ppm, hagaragaye igabanuka rya >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 прирации କାନона 500 частей на наблюдалось снижение> 1.5 log10. Ariko, ku gipimo cya ozone cya 500 ppm, hagaragaye igabanuka rya >1.5 log10. Gushyira spores za C. difficile kuri ozone ya 300 cyangwa 500 ppm byatumye igabanuka rya log10 rigera kuri 2.5. Gushyira spores za C. difficile kuri ozone ya 300 cyangwa 500 ppm byatumye igabanuka rya log10 rigera kuri 2.5. Воздействие на сп сп. Guhura kwa C. difficile na ozone ya 300 cyangwa 500 ppm byatumye habaho kugabanuka 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 сп сп. Guhura kwa C. difficile na ozone ya 300 cyangwa 500 ppm byatumye habaho kugabanuka kwa >2.5 log10.
Hashingiwe ku bushakashatsi bwavuzwe haruguru, habonetse ibisabwa bihagije kugira ngo hakorwe mikorobe ku gipimo cya ozone ya 500 ppm mu gihe cy'iminota 15. Imbuto za VRE, CRAB na C. difficile zageragejwe kugira ngo harebwe ingaruka za ozone ku bintu bitandukanye birimo icyuma kidashonga, imyenda, ikirahure, pulasitiki n'ibiti bikunze gukoreshwa mu bitaro. Ubushobozi bwazo bwo gusukura bugaragazwa mu mbonerahamwe ya 2. Udukoko twapimwe kabiri. Muri VRE na CRAB, ozone ntiyagiraga ingaruka nziza ku buso bw'ibirahure na pulasitiki, nubwo hagaragaye kugabanuka kwa log10 kwa factor 2 cyangwa irenga ku buso bw'ibyuma bidashonga, imyenda n'ibiti. Imbuto za C. difficile zagaragaye ko zirwanya cyane ubuvuzi bwa ozone kurusha izindi nyamaswa zose zapimwe. Kugira ngo higwe neza ingaruka za ozone ku ngaruka z'ubwicanyi bw'ibikoresho bitandukanye kuri VRE, CRAB, na C. difficile, ibizamini bya t byakoreshejwe kugira ngo hagereranywe itandukaniro riri hagati y'umubare wa CFU kuri mililitiro mu matsinda yo kugenzura n'igerageza ku bikoresho bitandukanye (Ishusho ya 2). Ubwoko bwagaragaje itandukaniro rikomeye mu mibare, ariko itandukaniro rikomeye ryagaragaye ku spores za VRE na CRAB kurusha ku spores za C. difficile.
Isesengura ry'ingaruka za ozone ku kwica bagiteri ku bikoresho bitandukanye (a) VRE, (b) CRAB, na (c) C. difficile.
Ishusho ya AFM yakozwe ku turemangingo twa VRE, CRAB, na C. difficile twavuwe na ozone kandi tutavuwe kugira ngo higwe birambuye inzira yo gusukura imyuka ya ozone. Ku ishusho ya 3a, c na e herekana amashusho ya AFM y’uturemangingo twa VRE, CRAB na C. difficile twavuwe, uko bikurikirana. Nkuko bigaragara ku mashusho ya 3D, uturemangingo turaryoshye kandi nta kibazo dufite. Ishusho ya 3b, d na f yerekana uturemangingo twa VRE, CRAB na C. difficile nyuma yo kuvurwa na ozone. Ntabwo byagabanutse gusa mu bunini bw’uturemangingo twose twapimwe, ahubwo no ku buso bwatwo bwarushijeho kuba bubi cyane nyuma yo guhura na ozone.
Amashusho ya AFM y’udukoko twa VRE, MRAB na C. difficile tutavuwe (a, c, e) na (b, d, f) twavuwe na ozone ya 500 ppm mu gihe cy’iminota 15. Amashusho yafashwe hakoreshejwe verisiyo ya Park Systems XEI 5.1.6 (XEI Software, Suwon, Koreya; https://www.parksystems.com/102-products/park-xe-bio).
Ubushakashatsi bwacu bwerekana ko ozone ikorwa n'ibikoresho bya plasma bya DBD bigaragaza ubushobozi bwo gukuraho ubwandu bwa MDRO na C. difficile, bizwiho kuba impamvu zikomeye z'ubwandu buterwa n'ubuvuzi. Byongeye kandi, mu bushakashatsi bwacu, bitewe n'uko kwanduza ibidukikije hamwe n'udukoko twa MDRO na C. difficile bishobora kuba isoko y'ubwandu buterwa n'ubuvuzi, ingaruka zo kwica za ozone zagaragaye ko zagize ingaruka nziza ku bikoresho bikoreshwa cyane cyane mu bitaro. Ibizamini byo gukuraho ubwandu byakozwe hakoreshejwe ibikoresho bya plasma bya DBD nyuma yo kwanduza ibikoresho nk'icyuma kidashonga, igitambaro, ikirahure, pulasitiki n'ibiti hamwe n'udukoko twa MDRO na C. difficile. Kubera iyo mpamvu, nubwo ingaruka zo gukuraho ubwandu zitandukanye bitewe n'ibikoresho, ubushobozi bwo gukuraho ubwandu bwa ozone buratangaje.
Ibintu bikunze gukorwaho mu bitaro bisaba ko bisuzumwa buri gihe kandi ku rwego rwo hasi. Uburyo busanzwe bwo gukuraho ibintu nk'ibyo ni ugusukura n'intoki hakoreshejwe umuti wica udukoko nk'umuti wa ammonium quaternary 13. Nubwo hubahirizwa amabwiriza yo gukoresha imiti yica udukoko, MPO iragoye kuyikuraho hakoreshejwe isuku gakondo (ubusanzwe isukura n'intoki)14. Kubwibyo, hakenewe ikoranabuhanga rishya, nko gukoresha uburyo bwo kudakora. Kubera iyo mpamvu, habayeho gushishikazwa n'imiti yica udukoko ikoresha umwuka, harimo peroxide ya hydrogen na ozone10. Akamaro k'imiti yica udukoko ikoresha umwuka ni uko ishobora kugera ahantu n'ibintu uburyo gakondo budashobora kugeraho. Peroxide ya hydrogen iherutse gukoreshwa mu buvuzi, ariko peroxide ya hydrogen ubwayo ni uburozi kandi igomba gufatwa hakurikijwe uburyo bwo kuyikoresha buhamye. Gusukura plasma hakoreshejwe peroxide ya hydrogen bisaba igihe kirekire cyo kuyisukura mbere y'uko habaho uburyo bushya bwo kuyisukura. Mu buryo bunyuranye, ozone ikora nk'umuti urwanya bagiteri na virusi zirwanya izindi miti8,11,15. Byongeye kandi, ozone ishobora gukorwa ku giciro gito iturutse mu mwuka wo mu kirere kandi ntisaba indi miti y’uburozi ishobora gusiga ikirenge mu bidukikije, kuko amaherezo ihinduka ogisijeni. Ariko, impamvu ozone idakoreshwa cyane nk'umuti wica udukoko ni iyi ikurikira. Ozone ni uburozi ku buzima bw'abantu, bityo ingano yayo ntirenga 0.07 ppm mu gihe kirenga amasaha 816, bityo ibikoresho byo gusukura ozone byarakozwe kandi bishyirwa ku isoko, ahanini mu gusukura imyuka ihumanya. Birashoboka kandi guhumeka umwuka no gutanga impumuro mbi nyuma yo gukuraho umwanda5,8. Ozone ntiyakoreshwaga cyane mu bigo by'ubuvuzi. Ariko, ozone ishobora gukoreshwa mu buryo bwizewe mu byumba byo gusukura no mu buryo bukwiye bwo guhumeka, kandi kuyikuraho bishobora kwihutishwa cyane hakoreshejwe icyuma gihindura umwuka. Muri ubu bushakashatsi, twerekanye ko ibikoresho byo gusukura ozone mu maraso bishobora gukoreshwa mu gusukura mu bigo by'ubuvuzi. Twakoze igikoresho gifite ubushobozi bwo gusukura umwuka, cyoroshye gukora kandi gitanga serivisi yihuse ku barwayi bari mu bitaro. Byongeye kandi, twakoze igikoresho cyoroshye cyo gusukura umwuka gikoresha umwuka wo mu kirere nta kiguzi cyiyongereyeho. Kugeza ubu, nta makuru ahagije ku bisabwa na ozone kugira ngo MDRO idakora. Ibikoresho byakoreshejwe mu bushakashatsi bwacu biroroshye gushyiraho kandi bigira igihe gito kandi byitezwe ko bizaba ingirakamaro mu gusukura ibikoresho kenshi.
Uburyo ozone ikora mu kwica bagiteri ntabwo busobanutse neza. Ubushakashatsi bwinshi bwagaragaje ko ozone yangiza uturemangingo twa bagiteri, bigatera kuva mu turemangingo no gucika kw'uturemangingo17,18. Ozone ishobora kubangamira imikorere ya enzymes mu turemangingo ikoresheje imikoranire n'amatsinda ya thiol kandi ishobora guhindura purine na pyrimidine bases muri aside nucleic. Ubu bushakashatsi bwagaragaje imiterere ya VRE, CRAB, na C. difficile spores mbere na nyuma yo kuvurwa ozone kandi bwasanze zitagabanutse gusa mu bunini, ahubwo zararushijeho kuba mbi cyane ku buso, bigaragaza kwangirika cyangwa kwangirika k'uturemangingo two hanze. Kandi ibikoresho by'imbere bitewe na gaze ya ozone bifite ubushobozi bukomeye bwo gukurura ogisijeni. Uku kwangirika gushobora gutuma uturemangingo tudakora, bitewe n'ubukana bw'impinduka mu turemangingo.
Imbuto za C. difficile ziragoye gukura mu byumba by’ibitaro. Imbuto ziguma ahantu zamenetse 10,20. Byongeye kandi, muri ubu bushakashatsi, nubwo umubare wa bagiteri ku mapine ya agar ugabanuka inshuro 10 kuri ozone ya 500 ppm mu minota 15 wari 2.73, ingaruka za ozone ku bikoresho bitandukanye birimo mbuto za C. difficile zaragabanutse. Kubwibyo, ingamba zitandukanye zishobora gufatwa mu kugabanya ubwandu bwa C. difficile mu bigo by’ubuvuzi. Kugira ngo bikoreshwe mu byumba bya C. difficile gusa, bishobora no kuba ingirakamaro guhindura igihe cyo guhura n’indwara n’ubukana bw’ubuvuzi bwa ozone. Byongeye kandi, tugomba kuzirikana ko uburyo bwo gukuraho imbuto za ozone budashobora gusimbuza burundu isuku isanzwe ikoreshwa n’intoki hakoreshejwe imiti yica udukoko n’imiti irwanya udukoko, kandi bushobora no kugira akamaro kanini mu kurwanya C. difficile ya 5. Muri ubu bushakashatsi, ingaruka za ozone nk’imiti yica udukoko zaratandukanye ku bwoko butandukanye bwa MPO. Ingufu zishobora guterwa n’ibintu byinshi nko mu cyiciro cyo gukura, urukuta rw’uturemangingo, n’ubushobozi bw’uburyo bwo gusana21,22. Impamvu y’ingaruka zitandukanye zo gusukura ozone ku buso bwa buri kintu ishobora kuba iterwa no gukora biofilm. Ubushakashatsi bwakozwe mbere bwagaragaje ko E. faecium na E. faecium byongera ubudahangarwa bw’ibidukikije iyo bihari nk’ibyerekeye biofilms23, 24, 25. Ariko, ubu bushakashatsi bwerekana ko ozone igira ingaruka zikomeye ku mikorobe za MDRO na C. difficile.
Imbogamizi mu bushakashatsi bwacu ni uko twasuzumye ingaruka zo kubika ozone nyuma yo kuyitunganya. Ibi bishobora gutuma umubare w’uturemangingo twa bagiteri tudashobora gupimwa urenza urugero.
Nubwo ubu bushakashatsi bwakozwe kugira ngo harebwe akamaro ka ozone nk'umuti wica udukoko mu bitaro, biragoye gushyira ibisubizo byacu mu bitaro byose. Bityo, hakenewe ubushakashatsi bwinshi kugira ngo harebwe niba iyi DBD ozone sterilizer ikoreshwa kandi ihuye n'uko ikoreshwa mu bitaro nyabyo.
Ozone ikorwa na DBD plasma reactors ishobora kuba ikintu cyoroshye kandi cy'agaciro cyo gukuraho ubwandu bwa MDRO na C. difficile. Bityo, kuvura ozone bishobora gufatwa nk'uburyo bwiza bwo gusimbura kwica udukoko mu bitaro.
Amakuru yakoreshejwe cyangwa yasesenguwe muri ubu bushakashatsi araboneka ku banditsi babishinzwe mu gihe babisabye mu buryo bwumvikana.
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