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Indawo yokunakekelwa kwempilo engcolile idlala indima ebalulekile ekusabalaleni kwezinto eziphilayo ezingamelani nemithi eminingi (MDR) kanye ne-C. difficile. Inhloso yalolu cwaningo kwakuwukuhlola umphumela we-ozone okhiqizwa yi-dielectric barrier discharge (DBD) plasma reactor esenzweni se-vancomycin-resistant Enterococcus faecalis (VRE), i-carbapenem-resistant Klebsiella pneumoniae (CRE), i-carbapenem-resistant Antibacterial Imiphumela ye-antibacterial yezinto ezahlukene ezingcoliswe yi-Pseudomonas spp. Pseudomonas aeruginosa (CRPA), i-carbapenem-resistant Acinetobacter baumannii (CRAB) kanye ne-Clostridium difficile spores. Izinto ezahlukene ezingcoliswe yi-VRE, CRE, CRPA, CRAB kanye ne-C. difficile spores zaphathwa nge-ozone ngezikhathi ezahlukene zokuvezwa. I-Atomic force microscopy (AFM) ibonise ukuguqulwa kwendawo yamagciwane ngemva kokwelashwa nge-ozone. Lapho umthamo we-ozone ongu-500 ppm ufakwa ku-VRE naku-CRAB imizuzu eyi-15, kwabonakala ukwehla kwe-log10 cishe engu-2 noma ngaphezulu ensimbi engagqwali, endwangu nasezinkunini, kanti kwabonakala ukwehla kwe-log10 engu-1-2 engilazini nasepulasitikini. Ama-spores e-C. difficile atholakale emelana kakhulu ne-ozone kunawo wonke amanye ama-organic ahlolwe. Ku-AFM, ngemva kokwelashwa nge-ozone, amaseli ebhaktheriya avuvukala futhi aguquguquka. I-ozone ekhiqizwa yi-DBD Plasma Reactor iyithuluzi elilula neliwusizo lokuhlanza ama-spores e-MDRO kanye ne-C. difficile, aziwa njengezifo ezivamile ezibangelwa ukutheleleka okuhlobene nokunakekelwa kwempilo.
Ukuvela kwezinto eziphilayo ezimelana nemithi eminingi (MDR) kubangelwa ukusetshenziswa kabi kwama-antibiotic kubantu nasezilwaneni futhi kubonwe yi-World Health Organization (WHO) njengosongo olukhulu empilweni yomphakathi1. Ikakhulukazi, izikhungo zezempilo zibhekene kakhulu nokuvela nokusabalala kwama-MRO. Ama-MRO ayinhloko yi-methicillin-resistant Staphylococcus aureus kanye ne-vancomycin-resistant enterococcus (VRE), i-extended-spectrum beta-lactamase-producing enterobacteria (ESBL), i-Pseudomonas aeruginosa engamelana nemithi eminingi, i-Acinetobacter baumannii engamelana nemithi eminingi, kanye ne-carbapenem-resistant Enterobacter (CRE). Ngaphezu kwalokho, ukutheleleka kwe-Clostridium difficile kuyimbangela ehamba phambili yohudo oluhambisana nokunakekelwa kwempilo, okubeka umthwalo omkhulu ohlelweni lokunakekelwa kwempilo. I-MDRO kanye ne-C. difficile zidluliselwa ngezandla zabasebenzi bezempilo, izindawo ezingcolile, noma ngqo kusuka kumuntu kuya komunye. Izifundo zakamuva zibonise ukuthi izindawo ezingcolile ezindaweni zokunakekelwa kwempilo zidlala indima ebalulekile ekudlulisweni kwe-MDRO kanye ne-C. difficile lapho abasebenzi bezempilo (ama-HCW) behlangana nezindawo ezingcolile noma lapho iziguli zihlangana ngqo nezindawo ezingcolile 3,4. izindawo ezingcolile ezindaweni zokunakekelwa kwempilo zinciphisa ukwanda kokutheleleka kwe-MLRO kanye ne-C. difficile noma ukungena ekoloni 5,6,7. Njengoba kunenkinga yomhlaba wonke mayelana nokwanda kokumelana namagciwane, kusobala ukuthi kudingeka ucwaningo olwengeziwe ngezindlela nezinqubo zokuhlanza ezindaweni zokunakekelwa kwempilo. Muva nje, izindlela zokuhlanza ezingasetshenziswanga ukuxhumana, ikakhulukazi imishini ye-ultraviolet (UV) noma izinhlelo ze-hydrogen peroxide, ziye zaqashelwa njengezindlela ezithembisayo zokuhlanza. Kodwa-ke, lawa madivayisi e-UV noma i-hydrogen peroxide atholakala emakethe awabizi nje kuphela, ukuhlanza nge-UV kusebenza kuphela ezindaweni eziveziwe, kuyilapho ukuhlanza nge-hydrogen peroxide plasma kudinga isikhathi eside sokuhlanza ngaphambi komjikelezo olandelayo wokuhlanza 5.
I-Ozone inezakhiwo ezaziwayo zokulwa nokugqwala futhi ingakhiqizwa ngentengo ephansi8. Iyaziwa futhi ukuthi inobuthi empilweni yabantu, kodwa ingabola ngokushesha ibe yi-oxygen8. Ama-reactor e-plasma discharge (DBD) yiwona akhiqiza i-ozone avame kakhulu9. Imishini ye-DBD ikuvumela ukuthi udale i-plasma enokushisa okuphansi emoyeni futhi ukhiqize i-ozone. Kuze kube manje, ukusetshenziswa kwe-ozone okungokoqobo kuye kwanqunyelwa kakhulu ekuhlanzeni amanzi echibini lokubhukuda, amanzi okuphuza kanye nendle10. Izifundo eziningana zibike ukusetshenziswa kwayo ezindaweni zokunakekelwa kwempilo8,11.
Kulolu cwaningo, sisebenzise i-compact DBD plasma ozone generator ukukhombisa ukusebenza kwayo ekususeni i-MDRO kanye ne-C. difficile, ngisho nalezo ezifakwe izinto ezahlukahlukene ezivame ukusetshenziswa ezindaweni zezokwelapha. Ngaphezu kwalokho, inqubo yokubulala i-ozone icacisiwe kusetshenziswa izithombe ze-atomic force microscopy (AFM) zamaseli aphathwe nge-ozone.
Izinhlobo ze-strain zitholakale ezitholwe emitholampilo ezifana nalezi: i-VRE (SCH 479 kanye ne-SCH 637), i-Klebsiella pneumoniae engamelana ne-carbapenem (CRE; SCH CRE-14 kanye ne-DKA-1), i-Pseudomonas aeruginosa engamelana ne-carbapenem (CRPA; 54 kanye ne-83) kanye ne-bacteria engamelana ne-carbapenem. amabhaktheriya i-Pseudomonas aeruginosa (CRPA; 54 kanye ne-83). I-Acinetobacter baumannii engamelana ne-Acinetobacter baumannii (CRAB; F2487 kanye ne-SCH-511 engamelana nayo. I-C. difficile itholakale ku-National Pathogen Culture Collection (NCCP 11840) ye-Korea Agency for Disease Control and Prevention. Yahlukaniswa nesiguli eNingizimu Korea ngo-2019 futhi yatholakala ukuthi ingeyase-ST15 kusetshenziswa ukuthayipha kwe-multilocus sequence. Umhluzi we-Brain Heart Infusion (BHI) (BD, Sparks, MD, USA) ofakwe i-VRE, CRE, CRPA kanye ne-CRAB uxutshwe kahle futhi wafakwa ku-37° C. amahora angama-24.
I-C. difficile yafakwa imicu ku-agar yegazi amahora angu-48. Amakholoni amaningana afakwa ku-5 ml yomhluzi wenhliziyo yobuchopho futhi afakwa ngaphansi kwezimo ze-anaerobic amahora angu-48. Ngemva kwalokho, isiko lanyakaziswa, kwanezelwa u-5 ml we-ethanol engu-95%, kwanyakaziswa futhi kwashiywa ekamelweni lokushisa imizuzu engu-30. Ngemva kokufaka i-centrifugation ku-3000 g imizuzu engu-20, lahla i-supernatant bese umisa i-pellet equkethe ama-spores bese ubulala amabhaktheriya ku-0.3 ml wamanzi. Amaseli aphilayo abalwa ngokuhlwanyela imbewu ye-spiral cell suspension kuma-plate e-agar egazi ngemva kokuxutshwa okufanele. Ukufaka i-gram staining kuqinisekisile ukuthi u-85% kuya ku-90% wezakhiwo zamabhaktheriya kwakuyi-spores.
Ucwaningo olulandelayo lwenziwe ukuze kuhlolwe imiphumela ye-ozone njengesibulala-magciwane ezindaweni ezahlukahlukene ezingcoliswe yi-MDRO kanye ne-C. difficile spores, ezaziwa ngokubangela izifo ezihlobene nokunakekelwa kwempilo. Lungisa amasampula ensimbi engagqwali, indwangu (ukotini), ingilazi, ipulasitiki (i-acrylic), kanye nokhuni (iphayini) olulinganisa isentimitha elilodwa ngesentimitha elilodwa. Hlanza amakhuphoni ngaphambi kokusebenzisa. Wonke amasampula ahlanzwa nge-autoclaving ngaphambi kokutheleleka ngamagciwane.
Kulolu cwaningo, amangqamuzana ebhaktheriya asatshalaliswa ezindaweni ezahlukene ze-substrate kanye nasemapuletini e-agar. Amaphaneli abe esehlanzwa ngokuwabeka ku-ozone isikhathi esithile kanye nokuhlushwa okuthile ekamelweni elivaliwe. Ku-Fig. 1 kunesithombe semishini yokuhlanza i-ozone. Ama-reactor e-DBD plasma enziwa ngokunamathisela ama-electrode ensimbi engagqwali anezimbobo futhi avele ngaphambili nangemuva kwamapuleti e-alumina (dielectric) angu-1 mm ubukhulu. Kuma-electrode anezimbobo, indawo yokuvuleka kanye nembobo kwakungu-3 mm kanye no-0.33 mm, ngokulandelana. I-electrode ngayinye inesimo esiyindilinga esinobubanzi obungu-43 mm. Ukunikezwa kwamandla aphezulu e-voltage high frequency (GBS Elektronik GmbH Minipuls 2.2) kwasetshenziswa ukufaka i-voltage ye-sinusoidal engaba ngu-8 kV peak ukuze ifike phezulu ngemvamisa engu-12.5 kHz kuma-electrode anezimbobo ukuze kukhiqizwe i-plasma emaphethelweni ama-electrode. Njengoba ubuchwepheshe buyindlela yokubulala izinambuzane ngegesi, ukubulala izinambuzane kwenziwa ekamelweni elihlukaniswe ngobuningi libe yizingxenye eziphezulu nezingezansi, eziqukethe amasampula angcoliswe amagciwane kanye namajeneretha e-plasma, ngokulandelana. Igumbi eliphezulu linezindawo ezimbili zokukhipha nokukhipha i-ozone esele. Ngaphambi kokusebenzisa ekuhlolweni, ushintsho lwesikhathi sokuhlushwa kwe-ozone ekamelweni ngemva kokuvula ukufakwa kwe-plasma lwalulinganiswa ngokwe-spectrum yokumuncwa komugqa we-spectral ongu-253.65 nm wesibani se-mercury.
(a) Uhlelo lokusetha kokuhlola kokubulala amagciwane ezintweni ezahlukahlukene kusetshenziswa i-ozone ekhiqizwe ku-DBD plasma reactor, kanye (b) ukuhlushwa kwe-ozone kanye nesikhathi sokukhiqiza i-plasma ekamelweni lokubulala amagciwane. Isithombe senziwe kusetshenziswa inguqulo ye-OriginPro 9.0 (isofthiwe ye-OriginPro, eNorthampton, MA, e-USA; https://www.originlab.com).
Okokuqala, ngokubulala amagciwane amangqamuzana ebhaktheriya abekwe kuma-agar plates nge-ozone, ngenkathi kushintsha ukuhlushwa kwe-ozone nesikhathi sokwelashwa, kwanqunywa ukuhlushwa kwe-ozone okufanele kanye nesikhathi sokwelashwa sokususa ukungcola kwe-MDRO kanye ne-C. difficile. Ngesikhathi senqubo yokubulala amagciwane, igumbi liqale lihlanzwe ngomoya ozungezile bese ligcwaliswa nge-ozone ngokuvula iyunithi ye-plasma. Ngemva kokuba amasampula ephathwe nge-ozone isikhathi esithile esinqunyiwe, kusetshenziswa iphampu ye-diaphragm ukususa i-ozone esele. Ukulinganisa kusetshenziswe isampula yokukhula okuphelele kwamahora angama-24 (~ 108 CFU/ml). Amasampula okumiswa kwamaseli ebhaktheriya (20 μl) aqale ahlanjululwe ngokulandelana izikhathi eziyishumi nge-sterile saline, bese lawa masampula asatshalaliswa kuma-agar plates ahlanjululwe nge-ozone ekamelweni. Ngemuva kwalokho, amasampula aphindaphindwayo, aqukethe amasampula avele ngaphandle futhi angaveli ku-ozone, afakwa e-incubator kuma-37°C amahora angama-24 futhi kwabalwa amakoloni ukuze kuhlolwe ukusebenza kahle kokubulala amagciwane.
Ngaphezu kwalokho, ngokwezimo zokubulala amagciwane ezichazwe ocwaningweni olungenhla, umphumela wokuhlanza lobu buchwepheshe ku-MDRO kanye ne-C. difficile uhlolwe kusetshenziswa amakhuphoni ezinto ezahlukahlukene (insimbi engagqwali, indwangu, ingilazi, ipulasitiki kanye namakhuphoni okhuni) asetshenziswa kakhulu ezikhungweni zezokwelapha. Kwasetshenziswa ama-culture aphelele amahora angama-24 (~108 cfu/ml). Amasampula okumiswa kwamangqamuzana ebhaktheriya (20 μl) axutshwa ngokulandelana izikhathi eziyishumi nge-saline engcolile, bese amakhuphoni acwiliswa kula ma-broth axutshwe ukuze kuhlolwe ukungcola. Amasampula asusiwe ngemuva kokucwiliswa kumhluzi wokuhlanza afakwa ezitsheni zePetri ezihlanzekile futhi omiswa ekushiseni kwegumbi amahora angama-24. Beka isembozo sesitsha se-petri esilinganisweni bese usibeka ngokucophelela ekamelweni lokuhlola. Susa isembozo esitsheni sePetri bese ubeka isampula ku-500 ppm ozone imizuzu eyi-15. Amasampula okulawula afakwa kwikhabhinethi yokuphepha kwezinto eziphilayo futhi awazange avulelwe i-ozone. Ngokushesha ngemva kokuchayeka ku-ozone, amasampula kanye namasampula angashiswanga (okungukuthi okulawulayo) axutshwe ne-saline engcolile kusetshenziswa i-vortex mixer ukuhlukanisa amabhaktheriya ebusweni. Ukumiswa okuhlanjululwe kwahlanjululwa ngokulandelana izikhathi eziyi-10 nge-saline engcolile, ngemva kwalokho inani lamabhaktheriya ahlanjululwe lanqunywa kuma-plate e-agar egazi (ama-bacteria e-aerobic) noma ama-plate e-agar egazi angenayo i-aerobic e-Brucella (e-Clostridium difficile) futhi kwafakwa ku-37°C amahora angama-24. noma ngaphansi kwezimo ze-anaerobic amahora angama-48 ku-37°C ngokuphindwe kabili ukuze kunqunywe ukuhlushwa kokuqala kwe-inoculum. Umehluko ekubalweni kwamabhaktheriya phakathi kwezilawuli ezingavezwanga kanye namasampula avele avele wabalwa ukuze kunikezwe ukwehla kwerekhodi ekubalweni kwamabhaktheriya (okungukuthi, ukusebenza kahle kokubulala inzalo) ngaphansi kwezimo zokuhlolwa.
Amaseli ezinto eziphilayo kumele avinjwe epuletini lokuthwebula izithombe le-AFM; ngakho-ke, kusetshenziswa idiski ye-mica eyisicaba neyindilinga efanayo enesilinganiso sokuqina okuncane kunosayizi weseli njengesisekelo. Ububanzi nobukhulu bamadiski kwakungu-20 mm no-0.21 mm, ngokulandelana. Ukuze amaseli aqine ebusweni, ubuso be-mica bumbozwe nge-poly-L-lysine (200 µl), okwenza ukuthi ishajeke kahle futhi ulwelwesi lweseli lushajeke kabi. Ngemva kokumboza nge-poly-L-lysine, amadiski e-mica agezwa izikhathi ezintathu ngamanzi angu-1 ml a-deionized (DI) bese komiswa ngomoya ubusuku bonke. Ngemuva kwalokho, amaseli ebhaktheriya afakwa ebusweni be-mica obumbozwe nge-poly-L-lysine ngokufaka isixazululo sebhaktheriya esincibilikisiwe, sashiywa imizuzu engama-30, bese ubuso be-mica bugezwa nge-1 ml yamanzi a-deionized.
Ingxenye yamasampula iphathwe nge-ozone kanti i-surface morphology yama-mica plates agcwele i-VRE, i-CRAB kanye ne-C. ama-spores anzima aboniswe kusetshenziswa i-AFM (XE-7, izinhlelo zepaki). Imodi yokusebenza ye-AFM isethwe kwimodi yokuthepha, okuyindlela evamile yokuthwebula amaseli ebhayoloji. Kulezi zivivinyo, kusetshenziswe i-microcantilever eyenzelwe imodi yokungathintani (OMCL-AC160TS, OLYMPUS Microscopy). Izithombe ze-AFM zaqoshwa ngokusekelwe kwisilinganiso sokuskena kwe-probe esingu-0.5 Hz okwaholela ekuxazululweni kwesithombe esingu-2048 × 2048 pixels.
Ukuze sithole izimo lapho ama-reactor e-DBD plasma asebenza khona ekubulaleni inzalo, senze uchungechunge lwezivivinyo sisebenzisa i-MDRO (VRE, CRE, CRPA, kanye ne-CRAB) kanye ne-C. difficile ukushintsha ukuhlushwa kwe-ozone kanye nesikhathi sokuchayeka. Ku-Fig. 1b sibonisa ijika lesikhathi sokuhlushwa kwe-ozone yesimo ngasinye sokuhlola ngemva kokuvula idivayisi ye-plasma. Ukuhlushwa kwanda ngokwe-logarithmic, kwafinyelela ku-300 kanye no-500 ppm ngemva kwemizuzu engu-1.5 kanye no-2.5, ngokulandelana. Izivivinyo zokuqala nge-VRE zikhombisile ukuthi ubuncane obudingekayo ukuze kuhlanzwe amabhaktheriya ngempumelelo yi-300 ppm ozone imizuzu eyi-10. Ngakho-ke, kuzivivinyo ezilandelayo, i-MDRO kanye ne-C. difficile zachayeka ku-ozone ngamanani amabili ahlukene (300 kanye no-500 ppm) kanye nangezikhathi ezimbili ezihlukene zokuchayeka (imizuzu eyi-10 kanye ne-15). Ukusebenza kahle kokubulala amagciwane komthamo ngamunye we-ozone kanye nesikhathi sokuchayeka kubalwe futhi kwaboniswa kuThebula 1. Ukuchayeka ku-ozone engu-300 noma engu-500 ppm imizuzu eyi-10-15 kuholele ekunciphiseni okuphelele kwe-VRE okungu-2 noma ngaphezulu log10. Leli zinga eliphakeme lokubulawa kwamagciwane nge-CRE lafinyelelwa ngokuvezwa ku-ozone engu-300 noma engu-500 ppm imizuzu eyi-15. Ukwehla okuphezulu kwe-CRPA (> 7 log10) kutholakale ngokuchayeka ku-500 ppm ye-ozone imizuzu eyi-15. Ukwehla okuphezulu kwe-CRPA (> 7 log10) kutholakale ngokuchayeka ku-500 ppm ye-ozone imizuzu eyi-15. Высокое снижение CRPA (> 7 log10) было достигнуто при воздействии 500 частей на миллион озона в течение 15 минут. Ukwehla okuphezulu kwe-CRPA (> 7 log10) kutholakale ngokuchayeka ku-ozone engu-500 ppm imizuzu eyi-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. Ukwehla okukhulu kwe-CRPA (> 7 log10) ngemva kwemizuzu eyi-15 yokuchayeka ku-ozone engu-500 ppm.Ukubulawa okunganakwa kwamagciwane e-CRAB ku-300 ppm ozone; nokho, ku-500 ppm ozone, kwaba nokuncipha okungu-> 1.5 log10. nokho, ku-500 ppm ozone, kwaba nokuncipha okungu-> 1.5 log10. однако при концентрации озона 500 частей на миллион наблюдалось снижение > 1,5 log10. nokho, ekugxilweni kwe-ozone okungu-500 ppm, kwabonakala ukwehla okungu->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. Kodwa-ke, ekugxilweni kwe-ozone okungu-500 ppm, kwabonakala ukwehla okungu->1.5 log10. Ukuveza ama-spores e-C. difficile ku-300 noma i-500 ppm ozone kuholele ekunciphiseni okungu-> 2.5 log10. Ukuveza ama-spores e-C. difficile ku-300 noma i-500 ppm ozone kuholele ekunciphiseni okungu-> 2.5 log10. Воздействие на споры C. difficile озона с концентрацией 300 noma 500 частей на миллион приводило к снижению > 2,5 log10. Ukuvezwa kwama-spores e-C. difficile ku-300 noma i-500 ppm ozone kuholele ekunciphiseni okungu->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 noma 500 частей на миллион приводило к снижению >2,5 log10. Ukuvezwa kwama-spores e-C. difficile ku-300 noma i-500 ppm ozone kuholele ekunciphiseni okungu->2.5 log10.
Ngokusekelwe ekuhlolweni okungenhla, kutholakale isidingo esanele sokuvimbela amagciwane ngesilinganiso se-500 ppm ozone imizuzu eyi-15. Ama-spores e-VRE, CRAB kanye ne-C. difficile ahlolwe umphumela wokubulala amagciwane we-ozone ezintweni ezahlukahlukene okuhlanganisa insimbi engagqwali, indwangu, ingilazi, ipulasitiki kanye nokhuni oluvame ukusetshenziswa ezibhedlela. Ukusebenza kahle kwawo kokubulala amagciwane kuboniswe kuThebula 2. Izinto eziphilayo zokuhlola zihlolwe kabili. Ku-VRE kanye ne-CRAB, i-ozone yayingasebenzi kahle ezindaweni zengilazi kanye nepulasitiki, yize ukwehla kwe-log10 cishe kwesici esingu-2 noma ngaphezulu kwabonwa ezindaweni zensimbi engagqwali, indwangu kanye nokhuni. Ama-spores e-C. difficile atholakale emelana kakhulu nokwelashwa kwe-ozone kunazo zonke ezinye izinto eziphilayo ezihlolwe. Ukuze kufundwe ngokwezibalo umphumela we-ozone emphumeleni wokubulala wezinto ezahlukene ngokumelene ne-VRE, CRAB, kanye ne-C. difficile, kusetshenziswe ukuhlolwa kwe-t ukuqhathanisa umehluko phakathi kwenani le-CFU nge-milliliter emaqenjini okulawula nawokuhlola ezintweni ezahlukene (Isithombe 2). izinhlobo zibonise umehluko obalulekile ngokwezibalo, kodwa umehluko obaluleke kakhulu wabonwa kuma-spores e-VRE kanye ne-CRAB kunakuma-spores e-C. difficile.
Igrafu ehlakazekile yemiphumela ye-ozone ekubulaweni kwamagciwane kwezinto ezahlukahlukene (a) i-VRE, (b) i-CRAB, kanye (c) ne-C. difficile.
Ukuthwebula izithombe ze-AFM kwenziwa kuma-spores aphathwe nge-ozone kanye nalawo angaphathwanga i-ozone ukuze kufundwe ngokuningiliziwe inqubo yokubulala amagciwane ngegesi ye-ozone. Ku-Fig. 3a, c kanye no-e kukhombisa izithombe ze-AFM zama-spores angelashwanga i-VRE, CRAB kanye ne-C. difficile, ngokulandelana. Njengoba kubonwe ezithombeni ze-3D, amaseli abushelelezi futhi aphelele. Izibalo 3b, d kanye no-f zibonisa ama-spores e-VRE, CRAB kanye ne-C. difficile ngemva kokwelashwa nge-ozone. Akugcinanga nje ngokuncipha kosayizi wawo wonke amaseli ahlolwe, kodwa ubuso bawo baba buqinile kakhulu ngemva kokuchayeka ku-ozone.
Izithombe ze-AFM ze-VRE, MRAB kanye ne-C. difficile spores ezingalashwanga (a, c, e) kanye (b, d, f) eziphathwe nge-ozone engu-500 ppm imizuzu eyi-15. Izithombe zadwetshwa kusetshenziswa inguqulo 5.1.6 ye-Park Systems XEI (XEI Software, Suwon, Korea; https://www.parksystems.com/102-products/park-xe-bio).
Ucwaningo lwethu lubonisa ukuthi i-ozone ekhiqizwa yimishini ye-plasma ye-DBD ikhombisa ikhono lokususa ukungcola ngempumelelo kuma-spores e-MDRO kanye ne-C. difficile, aziwa njengezimbangela ezinkulu zokutheleleka okuhlobene nokunakekelwa kwempilo. Ngaphezu kwalokho, ocwaningweni lwethu, njengoba ukungcola kwemvelo ngama-spores e-MDRO kanye ne-C. difficile kungaba umthombo wokutheleleka okuhlobene nokunakekelwa kwempilo, umphumela wokubulala amagciwane we-ozone utholakale uphumelela ezintweni ezisetshenziswa kakhulu ezibhedlela. Ukuhlolwa kokuhlanza kwenziwa kusetshenziswa imishini ye-plasma ye-DBD ngemuva kokungcola okwenziwe kwezinto ezifana nensimbi engagqwali, indwangu, ingilazi, ipulasitiki kanye nokhuni olune-spores ye-MDRO kanye ne-C. difficile. Ngenxa yalokho, yize umphumela wokuhlanza uhlukahluka kuye ngokuthi yini, ikhono lokuhlanza i-ozone liyamangalisa.
Izinto ezithintwa njalo emakamelweni ezibhedlela zidinga ukuhlanza okuvamile, okuphansi. Indlela ejwayelekile yokuhlanza izinto ezinjalo ukuhlanza ngesandla ngesibulali-magciwane esiwuketshezi njenge-quaternary ammonium compound 13. Ngisho nangokulandela ngokuqinile izincomo zokusetshenziswa kwezibulali-magciwane, i-MPO kunzima ukuyisusa ngokuhlanza kwemvelo okuvamile (ngokuvamile ukuhlanza ngesandla)14. Ngakho-ke, kudingeka ubuchwepheshe obusha, njengezindlela zokungathintani. Ngenxa yalokho, kube nentshisekelo kuzibulali-magciwane zegesi, okuhlanganisa i-hydrogen peroxide ne-ozone10. Inzuzo yezibulali-magciwane zegesi ukuthi zingafinyelela ezindaweni nasezintweni izindlela zendabuko zesandla ezingenakuzifinyelela. I-hydrogen peroxide isanda kuqala ukusetshenziswa ezindaweni zezokwelapha, noma kunjalo i-hydrogen peroxide ngokwayo inobuthi futhi kumele iphathwe ngokwezinqubo zokuphatha eziqinile. Ukuhlanza nge-plasma nge-hydrogen peroxide kudinga isikhathi eside sokuhlanza ngaphambi komjikelezo olandelayo wokuhlanza. Ngokuphambene nalokho, i-ozone isebenza njenge-ejenti ebanzi yokulwa namagciwane, esebenza kahle ngokumelene namagciwane namagciwane amelana nezinye izibulali-magciwane8,11,15. Ngaphezu kwalokho, i-ozone ingakhiqizwa ngentengo ephansi emoyeni womoya futhi ayidingi amakhemikhali anobuthi engeziwe angashiya umkhondo oyingozi emvelweni, njengoba ekugcineni iphuka ibe umoya-mpilo. Kodwa-ke, isizathu sokuthi i-ozone ingasetshenziswa kabanzi njengesibulala-magciwane yile ndlela elandelayo. I-ozone inobuthi empilweni yabantu, ngakho-ke ukuhlushwa kwayo akudluli ku-0.07 ppm ngokwesilinganiso isikhathi esingaphezu kwamahora angu-816, ngakho-ke ama-sterilizer e-ozone athuthukiswe futhi afakwa emakethe, ikakhulukazi ekuhlanzeni amagesi okukhipha umoya. Kungenzeka futhi ukuphefumula igesi futhi kukhiqize iphunga elibi ngemva kokukhipha ukungcola5,8. I-ozone yayingasetshenziswa ngenkuthalo ezikhungweni zezokwelapha. Kodwa-ke, i-ozone ingasetshenziswa ngokuphephile emakamelweni okubulala izinambuzane kanye nezinqubo zokungenisa umoya ezifanele, futhi ukususwa kwayo kungasheshiswa kakhulu ngokusebenzisa i-catalytic converter. Kulolu cwaningo, sibonisa ukuthi ama-sterilizer e-plasma ozone angasetshenziswa ekubulaleni izinambuzane ezindaweni zokunakekelwa kwempilo. Sakhe idivayisi enamakhono aphezulu okubulala izinambuzane, ukusebenza okulula kanye nensizakalo esheshayo yeziguli ezibhedlela. Ngaphezu kwalokho, sakha iyunithi elula yokubulala izinambuzane esebenzisa umoya ozungezile ngaphandle kwezindleko ezengeziwe. Kuze kube manje, akukho ulwazi olwanele mayelana nezidingo ezincane ze-ozone zokungasebenzi kwe-MDRO. Imishini esetshenziswe ocwaningweni lwethu kulula ukuyisetha futhi inesikhathi esifushane sokusebenza futhi kulindeleke ukuthi ibe wusizo ekuhlanzeni imishini njalo.
Indlela esebenza ngayo isenzo sokubulala amagciwane se-ozone ayicaci ngokuphelele. Izifundo eziningana zikhombisile ukuthi i-ozone ilimaza ulwelwesi lwamaseli ebhaktheriya, okuholela ekuvuza kwangaphakathi kwamangqamuzana kanye nokuphela kweseli lysis17,18. I-Ozone ingaphazamisa umsebenzi we-enzymatic weseli ngokusabela namaqembu e-thiol futhi ingashintsha izisekelo ze-purine ne-pyrimidine kuma-nucleic acid. Lolu cwaningo lubonise isimo se-VRE, CRAB, kanye ne-C. difficile spores ngaphambi nangemva kokwelashwa kwe-ozone futhi lwathola ukuthi azizange nje zehle ngobukhulu, kodwa futhi zaba nzima kakhulu ebusweni, okubonisa umonakalo noma ukugqwala kwe-membrane engaphandle. Futhi izinto zangaphakathi ngenxa yegesi ye-ozone inekhono elinamandla lokuxilisa. Lo monakalo ungaholela ekungasebenzini kweseli, kuye ngokuthi izinguquko zeseli zinzima kangakanani.
Ama-spores e-C. difficile kunzima ukuwasusa emakamelweni ezibhedlela. Ama-spores ahlala ezindaweni lapho echitha khona ama-10,20. Ngaphezu kwalokho, kulolu cwaningo, yize ukwehla okuphezulu kwe-logarithmic okuphindwe kayishumi enanini lamabhaktheriya kuma-agar plates ku-500 ppm ozone imizuzu eyi-15 kwakungu-2.73, umphumela wokubulala amagciwane we-ozone ezintweni ezahlukahlukene eziqukethe ama-spores e-C. difficile uncishisiwe. Ngakho-ke, amasu ahlukahlukene angacatshangelwa ukunciphisa ukutheleleka kwe-C. difficile ezindaweni zokunakekelwa kwempilo. Ukusetshenziswa emakamelweni e-C. difficile ahlukanisiwe kuphela, kungaba usizo futhi ukulungisa isikhathi sokuchayeka kanye nokuqina kokwelashwa kwe-ozone. Ngaphezu kwalokho, kumelwe sikhumbule ukuthi indlela yokususa ukungcola kwe-ozone ayikwazi ukufaka esikhundleni sokuhlanza okuvamile ngesandla ngama-disinfectants namasu okulwa namagciwane, futhi ingasebenza kahle kakhulu ekulawuleni i-C. difficile 5. Kulolu cwaningo, ukusebenza kahle kwe-ozone njengesibulala-magciwane kwahlukahluka ezinhlotsheni ezahlukene ze-MPO. Ukusebenza kahle kungancika ezintweni eziningana njengesigaba sokukhula, udonga lweseli, kanye nokusebenza kahle kwezindlela zokulungisa21,22. Isizathu somphumela ohlukile wokubulala amagciwane we-ozone ebusweni bento ngayinye singase sibe ngenxa yokwakheka kwe-biofilm. Izifundo zangaphambilini zibonise ukuthi i-E. faecium kanye ne-E. faecium zandisa ukumelana nemvelo uma zikhona njenge-biofilms23, 24, 25. Kodwa-ke, lolu cwaningo lubonisa ukuthi i-ozone inomphumela obalulekile wokubulala amagciwane kuma-spores e-MDRO kanye ne-C. difficile.
Umkhawulo wocwaningo lwethu ukuthi sihlole umphumela wokugcinwa kwe-ozone ngemva kokulungiswa. Lokhu kungaholela ekulinganisweni ngokweqile kwenani lamaseli ebhaktheriya asebenzayo.
Nakuba lolu cwaningo lwenziwe ukuze kuhlolwe ukusebenza kahle kwe-ozone njengesibulali-magciwane esibhedlela, kunzima ukuhlanganisa imiphumela yethu kuzo zonke izindawo zesibhedlela. Ngakho-ke, kudingeka ucwaningo olwengeziwe ukuze kuhlolwe ukusebenza kanye nokuhambisana kwalesi sibulali-magciwane se-DBD ozone endaweni yangempela yesibhedlela.
I-ozone ekhiqizwa yi-DBD plasma reactors ingaba yinto elula newusizo yokuhlanza i-MDRO kanye ne-C. difficile. Ngakho-ke, ukwelashwa kwe-ozone kungabhekwa njengendlela ephumelelayo yokubulala amagciwane endaweni yesibhedlela.
Amasethi edatha asetshenzisiwe kanye/noma ahlaziywe ocwaningweni lwamanje ayatholakala kubabhali abafanele uma becelwa ngokufanele.
Isu lomhlaba wonke le-WHO lokulwa nokumelana namagciwane. https://www.who.int/drugresistance/WHO_Global_Strategy.htm/en/ Iyatholakala.
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