JaLCDOI 10.18926/15186
Title Alternative Investigation of the tracheal suctioning-related microbialcolonization in home care patients with tracheotomy
FullText URL 015_2_063_069.pdf
Author Watanabe, Kumi| Kanzaki, Hitomi| Senda, Yoshiko| Okamoto, Motoi|
Abstract 気管内吸引を必要とする在宅療養患者に対し,安全で経済的な感染管理方法を検討するため,在宅ケアにおける気管内吸引の実態と,吸引関連物品の細菌学的調査を実施した。対象は気管切開がされ,医療依存度の高い患者3名であり,気管内吸引は全て患者の妻が行っていた。吸引後のカテーテルは外側をアルコール綿で清拭し,内腔を洗浄水で洗浄していた。カテーテルは,0.05%グルコン酸クロルヘキシジンに浸漬あるいは,清潔な乾燥容器に保管されていた。カテーテルの交換時期は,1.5日から7日とばらつきがあった。カテーテル,洗浄水,浸潰液等の試料を,一般細菌,黄色ブドウ球菌,大腸菌群の寒天培地で培養したところ,各試料から一般細菌,黄色ブドウ球菌,大腸菌群が検出されたが,カテーテルの保管方法の違いによる細菌汚染に差は認められなかった。また,気管切開部ガーゼからは,一般細菌,黄色ブドウ球菌,大腸菌群が検出された。これらより,気管内吸引カテーテルおよび,洗浄水や浸溝用消毒液の清潔管理の必要性が示唆された。
Abstract Alternative Microbial colonization related to tracheal toilet was investigated in three home care patients who had tracheotomy with or without mechanical ventilation. We focused on the manipulation of suctioning tube to develop a effective and low-cost guidline for infection control. Tracheal suctioning was doned by wife in all the patients. Catheters used for suctioning was generally wiped with alcohol, washed in deionized or boiled water, and stored in alcohol-wiped container or immersed in 0.05% gluconate chlorhexizine. Catheter was changed into new one every 1.5 to 7 days. Samples were obtained from catheter, water used for washing, container as well as patients and their caregivers, and cultured on agar culture plate for Staphylococcus aureus, or Escherichia coli. Colonization of gauze around tracheotomy and water used for washing was detected in two patinets. E. coli and S. aureus were common organism colonizing gauze around tracheotomy. Therefore, it was suggested that the manipulation of the tracheal suctioning in home care influence on microbial colonization.
Keywords 感染管理 (Infection control) 気管内吸引 (tracheal suctioning) 在宅ケア (home care) 介護者 (caregiver)
Publication Title 岡山大学医学部保健学科紀要
Published Date 2005-03-31
Volume volume15
Issue issue2
Start Page 63
End Page 69
ISSN 1345-0948
language 日本語
File Version publisher
NAID 120002307656