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Nzvimbo yehutano ine utachiona ine basa guru mukupararira kwezvipembenene zvisingapindi mishonga yakawanda (MDR) uye C. difficile. Chinangwa chechidzidzo ichi chaive chekuongorora mhedzisiro ye ozone inogadzirwa ne dielectric barrier discharge (DBD) plasma reactor pakushanda kwe vancomycin-resistant Enterococcus faecalis (VRE), carbapenem-resistant Klebsiella pneumoniae (CRE), carbapenem-resistant Antibacterial effects yezvinhu zvakasiyana zvakasvibiswa nePseudomonas spp. Pseudomonas aeruginosa (CRPA), carbapenem-resistant Acinetobacter baumannii (CRAB) uye Clostridium difficile spores. Zvinhu zvakasiyana-siyana zvakasvibiswa neVRE, CRE, CRPA, CRAB neC. difficile spores zvakarapwa ne ozone panguva dzakasiyana-siyana uye panguva dzekuratidzwa. Atomic force microscopy (AFM) yakaratidza shanduko yepamusoro yebhakitiriya mushure mekurapwa kwe ozone. Kana dose ye500 ppm ozone yaiswa paVRE neCRAB kwemaminitsi gumi nemashanu, kuderera kweinenge log10 mbiri kana kupfuura kwakaonekwa musimbi isingatsvi, jira nematanda, uye kuderera kwe1-2 log10 kwakaonekwa mugirazi nepurasitiki. C. difficile spores dzakawanikwa dzichidzivirira ozone kupfuura zvimwe zvipenyu zvese zvakaedzwa. PaAFM, mushure mekurapwa neozone, masero emabhakitiriya akazvimba uye akaremara. Ozone inogadzirwa neDBD Plasma Reactor chishandiso chiri nyore uye chinokosha chekubvisa utachiona hweMDRO neC. difficile spores, dzinozivikanwa sehutachiona hunowanzo pararira hunokonzerwa nehutano.
Kubuda kwezvipembenene zvisingadi mishonga yakawanda (MDR) kunokonzerwa nekushandiswa zvisina kunaka kwemishonga inorwisa mabhakitiriya muvanhu nemhuka uye kwakacherechedzwa neWorld Health Organization (WHO) senjodzi huru kuhutano hwevanhu1. Kunyanya, masangano ehutano ari kuramba achitarisana nekubuda nekupararira kweMROs. MaMRO makuru iStaphylococcus aureus isingadi methicillin uye vancomycin-resistant enterococcus (VRE), extended-spectrum beta-lactamase-producing enterobacteria (ESBL), Pseudomonas aeruginosa isingadi mishonga yakawanda, Acinetobacter baumannii isingadi mishonga yakawanda, uye Enterobacter (CRE) isingadi carbapenem. Pamusoro pezvo, hutachiona hweClostridium difficile ndicho chikonzero chikuru chemanyoka anokonzerwa nehutano, zvichiisa mutoro wakakura pahutano. MDRO neC. difficile zvinotapuriranwa nemaoko evashandi vehutano, nharaunda dzakasvibiswa, kana zvakananga kubva kumunhu kuenda kumunhu. Ongororo dzichangobva kuitwa dzakaratidza kuti nzvimbo dzakasvibiswa munzvimbo dzehutano dzinoita basa guru mukutapurirana kwe MDRO ne C. difficile kana vashandi vehutano (HCWs) vakasangana nenzvimbo dzakasvibiswa kana varwere vakasangana zvakananga nenzvimbo dzakasvibiswa 3,4. nzvimbo dzakasvibiswa munzvimbo dzehutano dzinoderedza kuwanda kwehutachiona hweMLRO ne C. difficile kana kupinda mudzimba 5,6,7. Zvichienderana nekunetseka kuripo pasi rose nezvekukwira kwekusagona kurwisa mabhakitiriya, zviri pachena kuti kutsvagurudza kwakawanda kunodiwa panzira nemaitiro ekubvisa utachiona munzvimbo dzehutano. Munguva pfupi yapfuura, nzira dzekuchenesa dzisingabatanidzwe, kunyanya michina ye ultraviolet (UV) kana masisitimu e hydrogen peroxide, dzave dzichizivikanwa senzira dzinovimbisa dzekubvisa utachiona. Zvisinei, zvishandiso izvi zve UV kana hydrogen peroxide zvinowanikwa mumusika hazvingodhuri chete, UV disinfecting inoshanda chete panzvimbo dzakafumurwa, nepo hydrogen peroxide plasma disinfecting inoda nguva yakareba yekubvisa utachiona usati watanga kutenderera kwehutachiona 5.
Ozone ine hunhu hunozivikanwa hwekudzivirira ngura uye inogona kugadzirwa zvisingadhuri8. Inozivikanwawo kuti ine chepfu kuhutano hwevanhu, asi inogona kuora nekukurumidza kuita oxygen8. Dielectric barrier discharge (DBD) plasma reactors ndiyo inonyanya kushandiswa kugadzira ozone9. Midziyo yeDBD inokutendera kuti ugadzire plasma inodziya zvishoma mumhepo uye ugadzire ozone. Kusvika pari zvino, kushandiswa kwe ozone kwave kuchingogumira pakubvisa utachiona mumvura yedziva rekushambira, mvura yekunwa uye tsvina10. Zvidzidzo zvakati wandei zvakashuma kushandiswa kwayo munzvimbo dzehutano8,11.
Muchidzidzo ichi, takashandisa compact DBD plasma ozone generator kuratidza kushanda kwayo mukubvisa MDRO neC. difficile, kunyangwe izvo zvakabayiwa pazvinhu zvakasiyana-siyana zvinowanzoshandiswa muzvipatara. Pamusoro pezvo, maitiro ekubvisa ozone sterilization akajekeswa uchishandisa mifananidzo yeatomic force microscopy (AFM) yemasero akarapwa ozone.
Mabhakitiriya aya akawanikwa kubva muzvirwere zvekurapa zvinoti: VRE (SCH 479 naSCH 637), Klebsiella pneumoniae isingadyiwi necarbapenem (CRE; SCH CRE-14 naDKA-1), Pseudomonas aeruginosa isingadyiwi necarbapenem (CRPA; 54 na83) uye mabhakitiriya asingadyiwi necarbapenem. mabhakitiriya Pseudomonas aeruginosa (CRPA; 54 na83). Acinetobacter baumannii isingadyiwi necarbapenem (CRAB; F2487 naSCH-511). C. difficile yakawanikwa kubva kuNational Pathogen Culture Collection (NCCP 11840) yeKorea Agency for Disease Control and Prevention. Yakatorwa kubva kumurwere muSouth Korea muna 2019 uye yakawanikwa iri yeST15 uchishandisa multilocus sequence typing. Muto weBrain Heart Infusion (BHI) (BD, Sparks, MD, USA) wakabayiwa neVRE, CRE, CRPA neCRAB wakasanganiswa zvakanaka ndokuiswa pa37°C. kwemaawa makumi maviri nemana.
C. difficile yakaiswa mitsetse isina mweya paagar yeropa kwemaawa makumi mana nemasere. Makoroni akati wandei akabva awedzerwa ku5 ml yemuto wemwoyo weuropi ndokuiswa pasi pemamiriro ekusashanda kwemaawa makumi mana nemasere. Mushure meizvozvo, culture yakazununguswa, 5 ml ye95% ethanol yakawedzerwa, yakazununguswa zvakare ndokusiyiwa patembiricha yemukamuri kwemaminitsi makumi matatu. Mushure mekuiswa pa3000 g kwemaminitsi makumi maviri, rasa supernatant woisa pellet ine spores wouraya mabhakitiriya mu0.3 ml yemvura. Masero anoshanda akaverengwa nekuiswa kwe spiral ye bacterial cell suspension pamaplate e blood agar mushure mekusanganiswa kwakakodzera. Gram staining yakaratidza kuti 85% kusvika 90% yezvivakwa zvebhakitiriya zvaive spores.
Chidzidzo chinotevera chakaitwa kuti chiongorore migumisiro ye ozone semushonga wekuuraya utachiona panzvimbo dzakasiyana-siyana dzakasvibiswa ne MDRO ne C. difficile spores, dzinozivikanwa kuti dzinokonzera hutachiona hunokonzerwa nehutano. Gadzirira mienzaniso yesimbi isingatsvedzeri, jira (donje), girazi, purasitiki (acrylic), uye huni (pine) dzine masendimita imwe nehafu. Bvisa hutachiona mumakuponi usati washandisa. Mienzaniso yese yakacheneswa ne autoclaving usati wabatwa nehutachiona.
Muchidzidzo ichi, masero emabhakitiriya akapararira panzvimbo dzakasiyana-siyana dzepasi pamwe chete nemaplate eagar. Mapaneru acho anozoiswa mushonga wekuuraya utachiona nekuisa mu ozone kwenguva yakati uye pakuwanda kwakati mukamuri rakavharwa. Pamufananidzo 1 pane mufananidzo wemidziyo yekuchenesa ozone. DBD plasma reactors dzakagadzirwa nekubatanidza maelectrode esimbi isina maburi akaboorwa uye akafumurwa kumberi nekumashure kwemaplate e alumina (dielectric) ane ukobvu hwe 1 mm. Kune maelectrode akaboorwa, nzvimbo yekuvhura neburi yaive 3 mm uye 0.33 mm, zvichiteerana. Electrode yega yega ine chimiro chedenderedzwa ine dhayamita ye 43 mm. Simba remagetsi rine voltage yakakwira (GBS Elektronik GmbH Minipuls 2.2) rakashandiswa kuisa voltage ye sinusoidal yeinenge 8 kV peak kuti isvike pa frequency ye 12.5 kHz kumaelectrode akaboorwa kuti igadzire plasma pamucheto wemaelectrode. Sezvo tekinoroji iyi iri nzira yekubvisa mabhakitiriya mugasi, kubvisa mabhakitiriya kunoitwa mukamuri rakakamurwa nehuwandu kuita zvikamu zvepamusoro nepazasi, zvine masampuli akasvibiswa nemabhakitiriya uye zvinogadzira plasma, zvichiteerana. Chikamu chepamusoro chine mavharuvhu maviri ekubvisa nekubvisa ozone yakasara. Usati washandisa mukuyedza, shanduko yenguva yehuwandu hwe ozone mukamuri mushure mekubatidza kuiswa kweplasma yakayerwa zvichienderana ne absorption spectrum yemutsara we spectral we 253.65 nm werambi re mercury.
(a) Chirongwa chekuedza kwekugadzirisa mabhakitiriya pazvinhu zvakasiyana-siyana uchishandisa ozone inogadzirwa muDBD plasma reactor, uye (b) kuwanda kwe ozone uye nguva yekugadzira plasma mukamuri rekuuraya mabhakitiriya. Mufananidzo wakagadzirwa uchishandisa OriginPro version 9.0 (OriginPro software, Northampton, MA, USA; https://www.originlab.com).
Kutanga, nekuuraya hutachiona mumasero emabhakitiriya akaiswa pamaplate eagar ne ozone, ukuwo vachichinja huwandu hwe ozone nenguva yekurapa, huwandu hwakakodzera hwe ozone nenguva yekurapa yekubvisa kusvibiswa kwe MDRO ne C. difficile zvakaonekwa. Munguva yekubvisa hutachiona, kamuri rinotanga racheneswa nemhepo yemuchadenga uye rozozadzwa ne ozone nekubatidza plasma unit. Mushure mekunge sampuli dzarapwa ne ozone kwenguva yakatarwa, pombi ye diaphragm inoshandiswa kubvisa ozone yasara. Kuyerwa kwacho kwakashandisa sampuli ye culture yakazara yemaawa makumi maviri nemana (~ 108 CFU/ml). Mienzaniso ye suspensions yemasero emabhakitiriya (20 μl) yakatanga yadirwa kagumi ne sterile saline, uye ipapo sampuli idzi dzakagoverwa pamaplate e agar dzakadirwa sterile ne ozone mukamuri. Mushure meizvozvo, sampuli dzakadzokororwa, dzinosanganisira sampuli dzakaratidzwa uye dzisina kuratidzwa ku ozone, dzakaiswa pa37°C kwemaawa makumi maviri nemana uye dzakaverengwa makoroni kuti dziongorore kushanda kwe sterilization.
Uyezve, zvichienderana nemamiriro ekuuraya utachiona akatsanangurwa muchidzidzo chiri pamusoro apa, mhedzisiro yekubvisa utachiona iyi pa MDRO ne C. difficile yakaongororwa uchishandisa makuponi ezvinhu zvakasiyana-siyana (simbi isina ngura, jira, girazi, mapurasitiki nematanda) anoshandiswa zvakanyanya muzvipatara. Kushandiswa kwemaawa makumi maviri nemana (~108 cfu/ml) kwakaitwa. Mienzaniso yebhakitiriya inonyungudutswa (20 μl) yakasanganiswa kagumi ne sterile saline, uye makuponi acho akanyudzwa mumisanganiswa iyi yakasanganiswa kuti aone kusvibiswa. Mienzaniso yakabviswa mushure mekunyudzwa mumisanganiswa yakasanganiswa yakaiswa mumidziyo yePetri isina ngura uye yakaomeswa patembiricha yemukamuri kwemaawa makumi maviri nemana. Isa chivharo chepetri dish pachienzaniso wochiisa nokungwarira mukamuri yekuyedza. Bvisa chivharo kubva mundiro yePetri woisa sampuli ku500 ppm ozone kwemaminitsi gumi nemashanu. Mienzaniso yekudzora yakaiswa mukabati rekuchengetedza rebhayoloji uye haina kuiswa mu ozone. Mushure mekusangana ne ozone, sampuli nesampuli dzisina kupiswa nemwaranzi (kureva kuti kudzora) dzakasanganiswa ne sterile saline uchishandisa musanganiswa wevortex kuti uparadzanise mabhakitiriya kubva pamusoro. Mushonga we eluted wakasanganiswa kagumi ne sterile saline, mushure mezvo huwandu hwebhakitiriya hwakasanganiswa hwakaonekwa pamaplate e blood agar (e aerobic bacteria) kana maplate e blood agar asina aerobic e Brucella (e Clostridium difficile) ndokuiswa pa 37°C kwemaawa makumi maviri nemana. kana pasi pemamiriro e anaerobic kwemaawa makumi mana nemasere pa 37°C kaviri kuti uone huwandu hwekutanga hwe inoculum. Musiyano mukuverengwa kwebhakitiriya pakati pezvinhu zvisina kuratidzwa uye masampuli akafumurwa wakaverengerwa kuti upe kudzikiswa kwehuwandu hwebhakitiriya (kureva, kushanda zvakanaka kwe sterilization) pasi pemamiriro ekuyedzwa.
Masero ezvipenyu anofanira kuvharwa paplate yeAFM imaging; saka, dhisiki remica rakati sandara uye rakafanana rine chikero chekukombama chidiki pane saizi yesero rinoshandiswa se substrate. Upamhi neukobvu hwemadiski zvaive 20 mm uye 0.21 mm, zvichiteerana. Kuti masero asimbiswe pamusoro, pamusoro pemica pakafukidzwa nepoly-L-lysine (200 µl), zvichiita kuti ive nechaji yakanaka uye membrane yesero ishaikwe nechaji isina kunaka. Mushure mekuputirwa nepoly-L-lysine, madhisiki emica akagezwa katatu nemvura ye1 ml deionized (DI) uye mhepo yakaomeswa husiku hwese. Zvadaro, masero ebhakitiriya akaiswa pamusoro pemica yakafukidzwa nepoly-L-lysine nekuyedza mushonga webhakitiriya wakaderera, wakasiyiwa kwemaminitsi makumi matatu, uye pamusoro pemica pakagezwa ne1 ml yemvura yakabviswa ionized.
Hafu yemasampuli akarapwa ne ozone uye chimiro chepamusoro chemapureti e mica akazadzwa neVRE, CRAB ne C. spores dzakaoma dzakaratidzwa uchishandisa AFM (XE-7, park systems). Maitiro eAFM akagadzirirwa tapping mode, inova nzira yakajairika yekufungidzira masero ebhayoloji. Mukuyedza, microcantilever yakagadzirirwa non-contact mode (OMCL-AC160TS, OLYMPUS Microscopy) yakashandiswa. Mifananidzo yeAFM yakarekodhwa zvichibva pa probe scan rate ye0.5 Hz zvichikonzera resolution yemufananidzo ye2048 × 2048 pixels.
Kuti tione mamiriro ezvinhu ayo DBD plasma reactors inoshanda pakuuraya utachiona, takaita miedzo yakawanda tichishandisa MDRO (VRE, CRE, CRPA, uye CRAB) uye C. difficile kuchinja huwandu hwe ozone nenguva yekubuda. Pamufananidzo 1b panoratidza nguva yekubuda kwe ozone yemamiriro ese ebvunzo mushure mekubatidza mudziyo weplasma. Kuwanda kwacho kwakawedzera ne logarithmically, kusvika 300 ne500 ppm mushure memaminitsi 1.5 ne2.5, zvichiteerana. Miedzo yekutanga neVRE yakaratidza kuti chiyero chidiki chinodiwa kuti ubvise utachiona zvinobudirira i300 ppm ozone kwemaminitsi gumi. Saka, mumiedzo inotevera, MDRO neC. difficile dzakasangana ne ozone pamatanho maviri akasiyana (300 ne500 ppm) uye panguva mbiri dzakasiyana dzekubuda (maminitsi gumi negumi nemashanu). Kushanda zvakanaka kwekubvisa utachiona pahuwandu hwega hwega hwe ozone uye nguva yekubuda kwacho kwakaverengerwa uye kwakaratidzwa muTafura 1. Kubuda mu ozone 300 kana 500 ppm kwemaminitsi 10-15 kwakaita kuti VRE ideredzwe ne2 kana kupfuura log10. Kuuraya mabhakitiriya uku kwakanyanya neCRE kwakawanikwa nemaminitsi gumi nemashanu ekubuda mu ozone 300 kana 500 ppm. Kudzikira kwakanyanya kweCRPA (> 7 log10) kwakawanikwa nekusangana ne500 ppm ye ozone kwemaminitsi gumi nemashanu. Kudzikira kwakanyanya kweCRPA (> 7 log10) kwakawanikwa nekusangana ne500 ppm ye ozone kwemaminitsi gumi nemashanu. Высокое снижение CRPA (> 7 log10) было достигнуто при воздействии 500 частей на миллион озона в течение 15 минут. Kudzikira kukuru kweCRPA (> 7 log10) kwakawanikwa nekushandisa ozone ye500 ppm kwemaminitsi gumi nemashanu.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. Kuderera kukuru kweCRPA (> 7 log10) mushure memaminitsi gumi nemashanu ekushandiswa ne500 ppm ozone.Kuurayiwa kwemabhakitiriya eCRAB zvisina basa pa300 ppm ozone; zvisinei, pa500 ppm ozone, pakanga paine kuderedzwa kwe >1.5 log10. zvisinei, pa500 ppm ozone, pakanga paine kuderedzwa kwe >1.5 log10. однако при концентрации озона 500 частей на миллион наблюдалось снижение > 1,5 log10. zvisinei, pakuwanda kwe ozone kwe500 ppm, kudzikira kwe >1.5 log10 kwakaonekwa.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. Zvisinei, pakuwanda kwe ozone kwe500 ppm, kudzikira kwe >1.5 log10 kwakaonekwa. Kuisa C. difficile spores ku300 kana 500 ppm ozone kwakaita kuti >2.5 log10 ideredzwe. Kuisa C. difficile spores ku300 kana 500 ppm ozone kwakaita kuti >2.5 log10 ideredzwe. Воздействие на споры C. difficile озона с концентрацией 300 или 500 частей на миллион приводило к снижению > 2,5 log10. Kuonekwa kweC. difficile spores ku300 kana 500 ppm ozone kwakaita kuti >2.5 log10 iderere.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。 C. difficile озона с концентрацией 300 или 500 частей на миллион приводило к снижению >2,5 log10. Kuonekwa kweC. difficile spores ku300 kana 500 ppm ozone kwakaita kuti >2.5 log10 iderere.
Zvichibva pakuedza kuri pamusoro apa, kwakawanikwa chinodiwa chakakwana chekudzima mabhakitiriya nechiyero che500 ppm ozone kwemaminitsi gumi nemashanu. VRE, CRAB neC. difficile spores dzakaedzwa kuti dzingauraye ozone pazvinhu zvakasiyana-siyana zvinosanganisira simbi isina ngura, jira, girazi, purasitiki nehuni zvinowanzoshandiswa muzvipatara. Kushanda kwazvo mukuuraya zvipembenene kunoratidzwa muTafura 2. Zvipenyu zvekuedza zvakaongororwa kaviri. MuVRE neCRAB, ozone yakanga isingashande zvakanaka pamusoro pegirazi nepurasitiki, kunyangwe kudzikira kwelog10 kweinenge factor ye2 kana kupfuura kwakaonekwa pamusoro pesimbi isina ngura, jira nehuni. C. difficile spores dzakawanikwa dzichiramba kurapwa neozone kupfuura zvimwe zvipenyu zvese zvakaedzwa. Kuti tiongorore huwandu hwe ozone pakuuraya zvinhu zvakasiyana-siyana zvinopesana neVRE, CRAB, neC. difficile, t-tests dzakashandiswa kuenzanisa mutsauko pakati pehuwandu hweCFU pa milliliter mumapoka ekudzora nekuyedza pazvinhu zvakasiyana (Mufananidzo 2). mhando dzakaratidza mutsauko wakakosha muhuwandu, asi mutsauko wakakosha wakaonekwa kune spores dzeVRE neCRAB pane dzespores dzeC. difficile.
Kupararira kwemigumisiro ye ozone pakuuraya mabhakitiriya kwezvinhu zvakasiyana-siyana (a) VRE, (b) CRAB, uye (c) C. difficile.
Mifananidzo yeAFM yakaitwa pamasero eVRE, CRAB, uye C. difficile akarapwa ne ozone uye asina kurapwa kuti vadzidze zvakadzama maitiro ekubvisa mabhakitiriya mu ozone gas sterilization. Pamufananidzo 3a, c uye e zvinoratidza mifananidzo yeAFM yemasero eVRE, CRAB uye C. difficile asina kurapwa, zvichiteerana. Sezvakaratidzwa mumifananidzo ye3D, masero acho akapfava uye haana kukuvadzwa. Mifananidzo 3b, d uye f inoratidza masero eVRE, CRAB uye C. difficile mushure mekurapwa ne ozone. Haana kungodzikira muhukuru hwese hwemasero ese akaedzwa, asi pamusoro pawo pakava nekushomeka kwakanyanya mushure mekusangana ne ozone.
Mifananidzo yeAFM yeVRE, MRAB neC. difficile spores dzisina kurapwa (a, c, e) uye (b, d, f) dzakarapwa ne500 ppm ozone kwemaminitsi gumi nemashanu. Mifananidzo yakatorwa uchishandisa Park Systems XEI version 5.1.6 (XEI Software, Suwon, Korea; https://www.parksystems.com/102-products/park-xe-bio).
Ongororo yedu inoratidza kuti ozone inogadzirwa nemidziyo yeplasma yeDBD inoratidza kugona kubvisa zvinobudirira spores dzeMDRO neC. difficile, idzo dzinozivikanwa sedzinokonzera hutachiona hunokonzerwa nehutano. Pamusoro pezvo, mukudzidza kwedu, tichifunga kuti kusvibiswa kwezvakatipoteredza neMSDRO neC. difficile spores kunogona kukonzera hutachiona hunokonzerwa nehutano, ozone inogona kuuraya hutachiona zvakanyanya muzvipatara. Miedzo yekubvisa hutachiona yakaitwa uchishandisa michina yeplasma yeDBD mushure mekusvibiswa kwezvinhu zvakaita sesimbi isina ngura, jira, girazi, purasitiki nehuni dzine MSDRO neC. difficile spores. Nekuda kweizvozvo, kunyangwe mhedzisiro yekubvisa hutachiona ichisiyana zvichienderana nechinhu chacho, kugona kubvisa hutachiona kweOzone kunoshamisa.
Zvinhu zvinobatwa kakawanda mumakamuri ezvipatara zvinoda kucheneswa kwemishonga nguva dzose, uye kwakaderera. Nzira yakajairika yekubvisa tsvina pazvinhu zvakadaro ndeyekuchenesa nemaoko nemushonga wekuuraya utachiona wakaita se quaternary ammonium compound 13. Kunyangwe nekutevedzera zvakanyanya mazano ekushandisa mishonga yekuuraya utachiona, MPO inonetsa kubvisa nekuchenesa kwezvakatipoteredza kwechinyakare (kazhinji kuchenesa nemaoko)14. Nokudaro, matekinoroji matsva anodiwa, akadai senzira dzisingabatanidzi. Nekuda kweizvozvo, kwave nekufarira mishonga yekuuraya utachiona yegasi, kusanganisira hydrogen peroxide ne ozone10. Kubatsira kwemishonga yekuuraya utachiona yegasi ndekwekuti inogona kusvika kunzvimbo nezvinhu zvisingagone kusvika nenzira dzechinyakare dzemaoko. Hydrogen peroxide yave kushandiswa munguva pfupi yapfuura munzvimbo dzekurapa, zvisinei hydrogen peroxide pachayo ine chepfu uye inofanira kubatwa zvichienderana nemaitiro ekubata akaomarara. Kuchenesa plasma nehydrogen peroxide kunoda nguva yakareba yekuchenesa usati watanga kuvhiyiwa. Kusiyana neizvi, ozone inoshanda semushonga unorwisa mabhakitiriya, unoshanda kurwisa mabhakitiriya nemavhairasi anodzivirira kune mamwe mishonga yekuuraya utachiona8,11,15. Pamusoro pezvo, ozone inogona kugadzirwa zvakachipa kubva mumhepo yemuchadenga uye haidi mamwe makemikari ane chepfu anogona kusiya chiratidzo chinokuvadza munharaunda, sezvo ichizopedzisira yaparara kuita okisijeni. Zvisinei, chikonzero nei ozone isingashandiswe zvakanyanya semushonga wekuuraya utachiona ndeichi chinotevera. Ozone ine chepfu kuhutano hwevanhu, saka huwandu hwayo hahupfuure 0.07 ppm paavhareji kwemaawa anopfuura 816, saka ma sterilizer e ozone akagadzirwa uye akaiswa pamusika, kunyanya ekuchenesa magasi eutsi. Zvinokwanisikawo kufema gasi uye kugadzira hwema husina kunaka mushure mekubvisa kusvibiswa5,8. Ozone haina kushandiswa zvakanyanya muzvipatara. Zvisinei, ozone inogona kushandiswa zvakachengeteka mumakamuri ekuchenesa uye nemaitiro ekufema akakodzera, uye kubviswa kwayo kunogona kukurumidzirwa zvikuru nekushandisa catalytic converter. Muchidzidzo ichi, tinoratidza kuti ma sterilizer e plasma ozone anogona kushandiswa kuuraya utachiona munzvimbo dzehutano. Takagadzira mudziyo une kugona kwakanyanya kuuraya kusvibiswa, kushanda kuri nyore uye sevhisi inokurumidza kune varwere vari muchipatara. Pamusoro pezvo, takagadzira unit iri nyore yekuchenesa inoshandisa mhepo iri munzvimbo isina muripo wekuwedzera. Kusvika pari zvino, hapana ruzivo rwakakwana pamusoro pezvinodiwa zvishoma zve ozone kuti MDRO isashande. Midziyo inoshandiswa muchidzidzo chedu iri nyore kuisa uye ine nguva pfupi uye inotarisirwa kubatsira pakuchenesa michina nguva nenguva.
Maitiro ekushanda kwe ozone mukuuraya mabhakitiriya haana kunyatsojeka. Zvidzidzo zvakati wandei zvakaratidza kuti ozone inokuvadza ma bacterial cell membranes, zvichikonzera kubuda kwemvura mukati memasero uye pakupedzisira cell lysis17,18. Ozone inogona kukanganisa cellular enzymatic activity nekuita ne thiol groups uye inogona kugadzirisa purine ne pyrimidine bases mu nucleic acids. Chidzidzo ichi chakaratidza morphology yeVRE, CRAB, uye C. difficile spores isati yatanga uye mushure mekurapa ozone uye yakawana kuti haina kungodzikira muhukuru chete, asi yakavawo yakaoma pamusoro, zvichiratidza kukuvara kana ngura kwe enterest membrane. uye zvinhu zvemukati nekuda kwe ozone gas zvine simba guru re oxidizing. Kukuvara uku kunogona kutungamira mukusashanda kwemasero, zvichienderana nekuoma kwekuchinja kwemasero.
Zvipembenene zveC. difficile zvakaoma kubvisa mumakamuri echipatara. Zvipembenene izvi zvinoramba zviri munzvimbo dzavanodonhedza 10,20. Pamusoro pezvo, muchidzidzo ichi, kunyangwe kuderedzwa kwakanyanya kwelogarithmic ka10 muhuwandu hwemabhakitiriya ari pamaplate eagar pa500 ppm ozone kwemaminitsi gumi nemashanu kwaive 2.73, mhedzisiro yekurwisa mabhakitiriya yeOzone pazvinhu zvakasiyana-siyana zvine C spores .difficile yakaderedzwa. Nokudaro, nzira dzakasiyana-siyana dzinogona kufungwa nezvekuderedza hutachiona hweC. difficile munzvimbo dzehutano. Kuti zvishandiswe mumakamuri eC. difficile akaparadzaniswa chete, zvinogonawo kubatsira kugadzirisa nguva yekusangana uye simba rekurapa ozone. Pamusoro pezvo, tinofanira kuyeuka kuti nzira yekubvisa ozone haigone kutsiva zvachose kuchenesa kwemaoko nemaoko nemishonga inouraya utachiona uye nzira dzinorwisa utachiona, uye inogonawo kushanda zvakanyanya mukudzora C. difficile 5. Muchidzidzo ichi, kushanda kweOzone semushonga wekuuraya utachiona kwakasiyana kune mhando dzakasiyana dzeMPO. Kushanda kunogona kutsamira pazvinhu zvakati wandei zvakaita sedanho rekukura, madziro esero, uye kushanda zvakanaka kwenzira dzekugadzirisa21,22. Chikonzero chekusiyana kwemhedzisiro ye ozone pamusoro pechinhu chimwe nechimwe chinogona kunge chiri nekuda kwekuumbwa kwebiofilm. Zvidzidzo zvekare zvakaratidza kuti E. faecium neE. faecium zvinowedzera kusapindirana kwezvakatipoteredza kana zviripo sebiofilms23, 24, 25. Zvisinei, chidzidzo ichi chinoratidza kuti ozone ine simba guru rekuuraya mabhakitiriya pa MDRO neC. difficile spores.
Chinogumira pakudzidza kwedu ndechekuti takaongorora kuti ozone inochengetwa sei mushure mekugadziriswa. Izvi zvinogona kukonzera kuti pave nekufungidzira kwakawandisa kwehuwandu hwemasero ebhakitiriya anoshanda.
Kunyangwe chidzidzo ichi chakaitwa kuti chiongorore kushanda kwe ozone semushonga wekuuraya utachiona muchipatara, zvakaoma kuti tinzwisise zvatakawana muzvipatara zvese. Saka, panodiwa tsvakiridzo yakawanda kuti tiongorore kushanda uye kushanda kwemushonga uyu wekurapa weDBD ozone munzvimbo chaiyo yechipatara.
Ozone inogadzirwa neDBD plasma reactors inogona kuva mushonga uri nyore uye unobatsira wekubvisa utachiona hwe MDRO ne C. difficile. Saka, kurapwa kwe ozone kunogona kutorwa senzira inoshanda pane kubvisa utachiona munzvimbo yechipatara.
Dataseti dzakashandiswa uye/kana dzakaongororwa muchidzidzo chazvino dzinowanikwa kubva kuvanyori kana zvikakumbirwa zvine musoro.
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