종합병원 영상의학과의 감염관리 대한 분석

Abstract

경상북도에 소재한 5개 종합병원 영상의학과의 오염도를 계수하고, 오염 원인균을 배양하여 동정하고 이를 토대로 지역사회 영상의학과의 효율적인 감염관리 방안을 모색하고자 하였다. 확인된 표면오염 균주는 Staphylococcus, Micrococcus, Pseudomonas stutzeri, Pseudomonas oryzihabitans로 병원 감염의 원인균으로 알려진 균주였고 영상의학과의 오염원으로 특이성을 가진 균주는 없었다. 조사대상 병원은 비슷한 감염관리교육을 실시하고 있었으나 병원별 오염도의 차이는 유의한 차이를 보였다. 조사대상 병원별 접촉원에 따른 오염도의 차이는 방사선사 사용, 환자사용, 공통사용으로 구분하여 분석한 결과 환자사용이 방사선사사용, 공통사용에 비해 유의하게 높은 오염도를 보였다(p<0.001). 병원별 월평균 검사건수의 차이가 적은 장치는 모든 병원에서 유의한 차이를 보이지 않았으나 이에 비해 촬영건수가 가장 많은 일반촬영장치, 흉부전용촬영대의 오염도가 다른 촬영장치에 비해 오염도가 높았다. 또한 월평균 촬영건수가 많은 A, B, C 병원은 방사선사가 단독으로 사용하거나 또는 환자와 공통으로 사용하는 방사선조사장치, 사무용책상, 출입문 손잡이에서 비교적 높은 오염도를 보였다. This study aims to find a way to control infection of community radiology effectively by calculating the degree of contamination, culture and identifying the flora in radiology of five general hospitals in Gyeongsangbuk-do. Staphylococcus, Micrococcus, Pseudomonas stutzeri, Pseudomonas oryzihabitans were identified as surface flora. These are know to be pathogens of hospital acquired infection and there was no radiology-specific flora. Research subject hospitals were conducting similar infection control education but degree of contamination of each hospital showed significant difference. Difference in degree of contamination according to contact sources were analyzed by Contact sources were classified into technologist-using, patients-using and common-using materials. Analysis of each hospital's degree of contamination showed that patient-using materials were significantly more contaminated than technologist-using and common-using materials (p<0.001). Devices which are similar to each other in monthly average frequency of use showed no significant difference in degree of contamination, but general X-ray devices and chest boards which are used most frequently showed higher degree of contamination than others. In addition, hospital A, B and C which have heavier monthly average caseload showed relatively high degree of contamination on irradiation devices which are used by technologists only or by technologists and patients commonly, office desks and doorpulls. Hence it is considered that intensity of infection control education should be different according to the degree of monthly average caseload. This study provided an opportunity to aware that technologists' feeling of contamination is crucial for infection control of radiology, and the Accupoint ATP public hygiene monitoring system which was used in this study for measuring the degree of contamination was proved to be an effective measuring device for hospital acquired infection management.