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Ib puag ncig saib xyuas kev noj qab haus huv uas muaj kab mob ua lub luag haujlwm tseem ceeb hauv kev sib kis ntawm ntau yam tshuaj tiv thaiv kab mob (MDR) thiab C. difficile.Lub hom phiaj ntawm txoj kev tshawb no yog los soj ntsuam cov txiaj ntsig ntawm ozone tsim los ntawm dielectric barrier discharge (DBD) plasma reactor ntawm kev ua ntawm vancomycin-resistant Enterococcus faecalis (VRE), carbapenem-resistant Klebsiella pneumoniae (CRE), carbapenem-resistant Antibacterial teebmeem ntawm cov ntaub ntawv sib txawv ntawm cov kab mob sib kis.Pseudomonas aeruginosa (CRPA), carbapenem-resistant Acinetobacter baumannii (CRAB) thiab Clostridium difficile spores.Ntau yam ntaub ntawv uas muaj kab mob VRE, CRE, CRPA, CRAB thiab C. difficile spores raug kho nrog ozone nyob rau ntau qhov ntau thiab ntau lub sij hawm raug.Atomic force microscopy (AFM) tau pom qhov hloov pauv ntawm cov kab mob tom qab kho ozone.Thaum ib koob tshuaj ntawm 500 ppm ozone tau siv rau VRE thiab CRAB rau 15 feeb, qhov txo qis ntawm kwv yees li 2 lossis ntau dua log10 tau pom nyob rau hauv stainless hlau, ntaub thiab ntoo, thiab qhov txo qis ntawm 1-2 log10 tau pom hauv iav thiab yas.C. difficile spores tau pom tias tiv taus ozone ntau dua li lwm yam kab mob uas tau sim.Ntawm AFM, tom qab kev kho mob nrog ozone, cov kab mob hlwb o thiab deformed.Cov ozone uas tsim los ntawm DBD Plasma Reactor yog ib qho yooj yim thiab muaj txiaj ntsig zoo rau kev tshem tawm cov kab mob MDRO thiab C. difficile spores, uas paub tias yog cov kab mob sib kis ntawm kev noj qab haus huv cuam tshuam.
Qhov tshwm sim ntawm ntau yam tshuaj tiv thaiv kab mob (MDR) yog tshwm sim los ntawm kev siv tshuaj tua kab mob tsis raug rau tib neeg thiab tsiaj txhu thiab tau raug txheeb xyuas los ntawm World Health Organization (WHO) tias yog ib qho kev hem thawj loj rau pej xeem kev noj qab haus huv1.Tshwj xeeb, cov tsev kho mob tau ntsib kev tshwm sim thiab kev sib kis ntawm MROs.Lub ntsiab MROs yog methicillin-resistant Staphylococcus aureus thiab vancomycin-resistant enterococcus (VRE), ncua-spectrum beta-lactamase-producing enterobacteria (ESBL), multidrug-resistant Pseudomonas aeruginosa, multidrug-resistant Acinetobacter baumanpeniem (CRE) .Tsis tas li ntawd, Clostridium difficile tus kab mob yog ib qho ua rau muaj kev noj qab haus huv-koom nrog raws plab, ua rau lub nra hnyav rau txoj kev kho mob.MDRO thiab C. difficile kis tau los ntawm txhais tes ntawm cov neeg ua haujlwm kho mob, cov chaw muaj kab mob, lossis ncaj qha los ntawm ib tus neeg mus rau lwm tus.Cov kev tshawb fawb tsis ntev los no tau pom tias qhov chaw tsis muaj kab mob hauv cov chaw kho mob ua lub luag haujlwm tseem ceeb hauv kev sib kis ntawm MDRO thiab C. nyuaj thaum cov neeg ua haujlwm noj qab haus huv (HCWs) tau ntsib nrog cov kab mob sib kis lossis thaum cov neeg mob nkag mus rau qhov chaw kis kab mob 3,4.Cov cheeb tsam uas muaj kab mob hauv cov chaw kho mob txo qis qhov tshwm sim ntawm MLRO thiab C. kab mob difficile lossis colonization5,6,7.Muab qhov kev txhawj xeeb thoob ntiaj teb txog qhov nce ntawm cov tshuaj tiv thaiv kab mob, nws yog qhov tseeb tias yuav tsum muaj kev tshawb fawb ntxiv txog cov txheej txheem thiab cov txheej txheem rau decontamination hauv chaw kho mob.Tsis ntev los no, cov txheej txheem tsis sib cuag nrog lub davhlau ya nyob twg, tshwj xeeb tshaj yog cov cuab yeej siv ultraviolet (UV) lossis cov tshuab hydrogen peroxide, tau lees paub tias yog txoj kev cog lus ntawm kev tshem tawm.Txawm li cas los xij, cov khoom lag luam muaj UV lossis hydrogen peroxide tsis yog kim xwb, UV tshuaj tua kab mob tsuas yog siv tau rau ntawm qhov chaw raug, thaum hydrogen peroxide plasma tshuaj tua kab mob yuav tsum tau siv sijhawm ntev ntev ua ntej kev tua kab mob tom ntej 5.
Ozone tau paub txog kev tiv thaiv corrosion thiab tuaj yeem tsim tau pheej yig8.Nws kuj tseem paub tias muaj tshuaj lom rau tib neeg kev noj qab haus huv, tab sis tuaj yeem tawg sai sai rau hauv oxygen 8. Dielectric barrier discharge (DBD) plasma reactors yog nyob deb ntawm cov ozone generators ntau tshaj 9.DBD cov cuab yeej tso cai rau koj los tsim cov ntshav plasma qis hauv huab cua thiab tsim ozone.Txog rau tam sim no, kev siv ozone tau siv tsuas yog txwv rau kev tua kab mob hauv pas dej da dej, dej haus thiab dej phwj tuaj 10.Ntau qhov kev tshawb fawb tau tshaj tawm nws siv hauv kev kho mob 8,11.
Nyob rau hauv txoj kev tshawb no, peb siv lub compact DBD plasma ozone generator los qhia nws cov hauj lwm zoo ntawm clearing MDRO thiab C. difficile, txawm cov inoculated rau ntau yam ntaub ntawv uas feem ntau siv nyob rau hauv kev kho mob chaw.Tsis tas li ntawd, cov txheej txheem ozone sterilization tau elucidated siv atomic force microscopy (AFM) cov duab ntawm ozone-kho hlwb.
Cov kab mob tau txais los ntawm kev soj ntsuam cais ntawm: VRE (SCH 479 thiab SCH 637), carbapenem-resistant Klebsiella pneumoniae (CRE; SCH CRE-14 thiab DKA-1), carbapenem-resistant Pseudomonas aeruginosa (CRPA; 54 thiab 83) thiab carbapenem-resistant.Cov kab mob Pseudomonas aeruginosa (CRPA; 54 thiab 83).resistant Acinetobacter baumannii (CRAB; F2487 thiab SCH-511).C. difficile tau txais los ntawm National Pathogen Culture Collection (NCCP 11840) ntawm Kaus Lim Kauslim Lub Chaw Haujlwm Saib Xyuas Kab Mob thiab Tiv Thaiv.Nws tau raug cais tawm ntawm tus neeg mob hauv Kaus Lim Qab Teb hauv xyoo 2019 thiab pom tias muaj nyob rau ST15 siv ntau qhov sib txuas sib txuas.Brain Heart Infusion (BHI) Broth (BD, Sparks, MD, USA) inoculated nrog VRE, CRE, CRPA thiab CRAB yog tov zoo thiab incubated ntawm 37 ° C. rau 24 teev.
C. difficile tau streaked anaerobically ntawm cov ntshav agar rau 48 teev.Tom qab ntawd ob peb lub zos tau ntxiv rau 5 ml ntawm lub paj hlwb lub plawv thiab incubated nyob rau hauv anaerobic mob rau 48 teev.Tom qab ntawd, cov kab lis kev cai tau shaken, 5 ml ntawm 95% ethanol tau ntxiv, co dua thiab tawm hauv chav sov li 30 feeb.Tom qab centrifugation ntawm 3000 g rau 20 feeb, muab pov tseg lub supernatant thiab tshem tawm cov pellet uas muaj spores thiab tua kab mob nyob rau hauv 0.3 ml ntawm dej.Cov hlwb uas muaj peev xwm raug suav los ntawm kev muab kauv noob ntawm cov kab mob ntawm tes raug tshem tawm mus rau cov ntshav agar daim hlau tom qab tsim nyog dilution.Gram staining paub tseeb tias 85% mus rau 90% ntawm cov kab mob kab mob yog spores.
Cov kev tshawb fawb hauv qab no tau ua los tshawb xyuas qhov cuam tshuam ntawm ozone ua cov tshuaj tua kab mob ntawm ntau qhov chaw uas muaj kab mob MDRO thiab C. difficile spores, uas paub tias yuav ua rau muaj kab mob kev noj qab haus huv.Npaj cov qauv ntawm stainless hlau, ntaub (paj rwb), iav, yas (acrylic), thiab ntoo (pine) ntsuas ib centimeter los ntawm ib centimeter.Disinfect daim coupons ua ntej siv.Tag nrho cov qauv raug sterilized los ntawm autoclaving ua ntej kis kab mob.
Hauv txoj kev tshawb no, cov kab mob kab mob tau kis rau ntawm ntau qhov chaw substrate nrog rau ntawm daim phiaj agar.Cov vaj huam sib luag yog tom qab ntawd ua kom tsis muaj menyuam los ntawm kev nthuav tawm lawv rau ozone rau ib lub sijhawm ntawm lub sijhawm thiab ntawm qee qhov kev xav hauv ib chav kaw.Ntawm daim duab.1 yog daim duab ntawm ozone sterilization khoom.DBD plasma reactors tau tsim los ntawm kev txuas perforated thiab nthuav tawm stainless hlau electrodes rau pem hauv ntej thiab nraub qaum ntawm 1 hli tuab alumina (dielectric) daim hlau.Rau perforated electrodes, lub aperture thiab lub qhov cheeb tsam yog 3 hli thiab 0.33 hli, feem.Txhua lub electrode muaj ib puag ncig zoo nrog txoj kab uas hla ntawm 43 hli.Lub tshuab hluav taws xob muaj zog siab zaus (GBS Elektronik GmbH Minipuls 2.2) tau siv los siv qhov hluav taws xob sinusoidal ntawm kwv yees li 8 kV ncov mus rau qhov siab ntawm 12.5 kHz mus rau perforated electrodes los tsim cov ntshav ntawm cov npoo ntawm cov electrodes.perforated electrodes.Txij li cov thev naus laus zis yog txoj kev ua kom tsis muaj roj, kev ua kom tsis muaj menyuam yog ua nyob rau hauv lub chamber muab faib los ntawm ntim rau hauv cov thawv sab sauv thiab sab qis, uas muaj cov kab mob kis kab mob thiab cov plasma generators, feem.Sab saum toj compartment muaj ob qhov chaw nres nkoj valve kom tshem tawm thiab tso pa tawm ozone.Ua ntej siv hauv kev sim, qhov kev hloov pauv ntawm lub sijhawm ntawm ozone concentration hauv chav tom qab tig lub teeb tsa ntshav tau ntsuas raws li qhov nqus spectrum ntawm spectral kab ntawm 253.65 nm ntawm lub teeb mercury.
(a) Lub tswv yim ntawm kev sim teeb tsa rau kev ua kom tsis muaj kab mob ntawm ntau yam khoom siv ozone generated hauv DBD plasma reactor, thiab (b) ozone concentration thiab plasma tiam lub sij hawm nyob rau hauv lub sterilization chamber.Daim duab tau tsim los siv OriginPro version 9.0 (OriginPro software, Northampton, MA, USA; https://www.originlab.com).
Ua ntej, los ntawm kev ua kom tsis muaj kab mob hauv cov kab mob tso rau ntawm agar daim hlau nrog ozone, thaum hloov cov ozone concentration thiab lub sij hawm kho, qhov tsim nyog ozone concentration thiab lub sij hawm kho rau decontamination ntawm MDRO thiab C. difficile raug txiav txim.Thaum lub sij hawm sterilization txheej txheem, lub chamber yog thawj purged nrog ambient cua thiab ces puv nrog ozone los ntawm tig rau lub plasma chav tsev.Tom qab cov qauv tau kho nrog ozone rau lub sijhawm ua ntej, lub twj tso kua mis diaphragm yog siv los tshem tawm cov ozone ntxiv.Kev ntsuas tau siv cov qauv ntawm kev ua tiav 24-teev kab lis kev cai (~ 108 CFU / ml).Cov qauv ntawm kev tshem tawm cov kab mob ntawm cov kab mob (20 μl) yog thawj zaug serially diluted kaum zaug nrog sterile saline, thiab tom qab ntawd cov qauv no tau muab faib rau ntawm agar daim hlau sterilized nrog ozone hauv chamber.Tom qab ntawd, rov ua cov qauv, suav nrog cov qauv raug thiab tsis raug rau ozone, tau muab tso rau ntawm 37 ° C rau 24 teev thiab suav cov colony los ntsuas kev ua kom tsis muaj menyuam.
Tsis tas li ntawd, raws li kev ua kom tsis muaj menyuam uas tau teev tseg hauv txoj kev tshawb fawb saum toj no, qhov cuam tshuam tsis zoo ntawm cov thev naus laus zis no ntawm MDRO thiab C. difficile tau soj ntsuam siv daim coupon ntawm ntau yam ntaub ntawv (stainless steel, ntaub, iav, yas thiab ntoo daim coupons) feem ntau siv hauv tsev kho mob.Ua kom tiav 24 teev kab lis kev cai (~ 108 cfu / ml) tau siv.Cov qauv ntawm cov kab mob ntawm tes raug tshem tawm (20 μl) tau serially diluted kaum zaug nrog tsis muaj ntsev saline, thiab tom qab ntawd cov coupons tau muab tso rau hauv cov kua txiv hmab txiv ntoo no los ntsuas kev sib kis.Cov qauv raug tshem tawm tom qab immersion nyob rau hauv dilution broth tau muab tso rau hauv sterile Petri tais diav thiab qhuav nyob rau hauv chav tsev kub rau 24 teev.Muab lub hau petri tais rau ntawm tus qauv thiab ua tib zoo muab tso rau hauv chav kuaj.Tshem lub hau ntawm Petri tais thiab nthuav tawm cov qauv mus rau 500 ppm ozone rau 15 feeb.Cov qauv tswj tau muab tso rau hauv lub txee kev nyab xeeb thiab tsis raug ozone.Tam sim ntawd tom qab raug ozone, cov qauv thiab cov qauv uas tsis yog-irradiated (piv txwv li kev tswj hwm) tau sib xyaw nrog cov kua qaub uas tsis muaj kuab lom uas siv cov vortex tov rau cais cov kab mob ntawm qhov chaw.Qhov kev tshem tawm eluted tau serially diluted 10 zaug nrog tsis muaj ntsev ntsev, tom qab ntawd cov kab mob diluted tau txiav txim siab ntawm cov ntshav agar daim hlau (rau cov kab mob aerobic) lossis anaerobic ntshav agar daim hlau rau Brucella (rau Clostridium difficile) thiab incubated ntawm 37 ° C rau 24 teev.los yog nyob rau hauv anaerobic tej yam kev mob rau 48 teev ntawm 37 ° C nyob rau hauv duplicate los txiav txim qhov pib concentration ntawm inoculum.Qhov sib txawv ntawm cov kab mob suav nrog cov kev tswj tsis tau pom thiab cov qauv raug raug suav kom muab cov cav txo qis hauv cov kab mob suav (piv txwv li, kev ua kom tsis muaj menyuam) nyob rau hauv kev sim ntsuas.
Cov hlwb yuav tsum tau immobilized ntawm AFM daim duab phaj;Yog li ntawd, ib tug ca thiab uniformly ntxhib mica disk nrog ib tug roughness scale me dua lub cell loj yog siv raws li ib tug substrate.Txoj kab uas hla thiab thickness ntawm cov disks yog 20 hli thiab 0.21 hli, feem.Txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhav nws yuav khov kho cov hlwb mus rau saum npoo, qhov saum npoo ntawm mica yog coated nrog poly-L-lysine (200 μl), ua rau nws zoo thiab cov cell membrane tsis zoo.Tom qab txheej txheej nrog poly-L-lysine, cov mica disks tau ntxuav 3 zaug nrog 1 ml deionized (DI) dej thiab cua qhuav ib hmos.Tom qab ntawd, cov kab mob ntawm cov kab mob tau muab tso rau hauv mica nto coated nrog poly-L-lysine los ntawm kev siv cov tshuaj tua kab mob diluted, sab laug rau 30 min, thiab tom qab ntawd cov mica saum npoo yog ntxuav nrog 1 ml ntawm dej deionized.
Ib nrab ntawm cov qauv raug kho nrog ozone thiab qhov chaw morphology ntawm mica daim hlau thauj khoom nrog VRE, CRAB thiab C. difficile spores tau pom tau siv AFM (XE-7, chaw ua si).AFM hom kev ua haujlwm yog teem rau tapping hom, uas yog ib txoj hauv kev zoo rau kev txheeb xyuas cov hlwb.Hauv kev sim, microcantilever tsim rau hom tsis sib cuag (OMCL-AC160TS, OLYMPUS Microscopy) tau siv.AFM cov duab raug kaw raws li kev sojntsuam ntsuas tus nqi ntawm 0.5 Hz ua rau cov duab daws teeb meem ntawm 2048 × 2048 pixels.
Txhawm rau txiav txim siab cov xwm txheej raws li DBD plasma reactors zoo rau kev ua kom tsis muaj menyuam, peb tau ua ntau qhov kev sim siv ob qho tib si MDRO (VRE, CRE, CRPA, thiab CRAB) thiab C. nyuaj rau qhov sib txawv ntawm ozone concentration thiab lub sij hawm raug.Ntawm daim duab.1b qhia txog ozone concentration lub sij hawm nkhaus rau txhua qhov kev kuaj mob tom qab tig rau cov cuab yeej plasma.Cov concentration nce logarithmically, mus txog 300 thiab 500 ppm tom qab 1.5 thiab 2.5 feeb, feem.Kev sim ua ntej nrog VRE tau pom tias qhov tsawg kawg nkaus uas yuav tsum tau ua kom muaj cov kab mob kis tau zoo yog 300 ppm ozone rau 10 feeb.Yog li, hauv kev sim hauv qab no, MDRO thiab C. difficile tau raug ozone ntawm ob qhov sib txawv (300 thiab 500 ppm) thiab ntawm ob lub sijhawm sib txawv (10 thiab 15 feeb).Kev ua kom tsis muaj menyuam rau txhua qhov koob tshuaj ozone thiab lub sijhawm raug teeb tsa raug suav thiab qhia hauv Table 1. Kev raug rau 300 lossis 500 ppm ozone rau 10-15 feeb ua rau tag nrho cov kev txo qis hauv VRE ntawm 2 lossis ntau dua log10.Qhov kev tua kab mob siab no nrog CRE tau ua tiav nrog 15 feeb ntawm kev raug rau 300 lossis 500 ppm ozone. Kev txo qis hauv CRPA (> 7 log10) tau ua tiav nrog rau 500 ppm ntawm ozone rau 15 min. Kev txo qis hauv CRPA (> 7 log10) tau ua tiav nrog rau 500 ppm ntawm ozone rau 15 min. Высокое снижение CRPA (> 7 log10) было достигнуто при воздействии 500 частей на миллион озона в течение 15 . Kev txo qis hauv CRPA (> 7 log10) tau ua tiav nrog kev raug rau 500 ppm ozone rau 15 feeb.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. Kev txo qis hauv CRPA (> 7 log10) tom qab 15 feeb raug rau 500 ppm ozone.Tsis pom zoo tua cov kab mob CRAB ntawm 300 ppm ozone; Txawm li cas los xij, ntawm 500 ppm ozone, muaj> 1.5 log10 txo. Txawm li cas los xij, ntawm 500 ppm ozone, muaj> 1.5 log10 txo. однако при концентрации озона 500 частей на миллион наблюдалось снижение > 1,5 log10. Txawm li cas los xij, ntawm ozone concentration ntawm 500 ppm, qhov txo qis ntawm> 1.5 log10 tau pom.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. Txawm li cas los xij, ntawm ozone concentration ntawm 500 ppm, qhov txo qis ntawm> 1.5 log10 tau pom. Kev nthuav tawm C. difficile spores rau 300 lossis 500 ppm ozone ua rau txo qis> 2.5 log10. Kev nthuav tawm C. difficile spores rau 300 lossis 500 ppm ozone ua rau txo qis> 2.5 log10. Воздействие на споры C. difficile озона с концентрацией 300 или 500 частей на миллион приводило к снижению 10 , . Kev nthuav tawm ntawm C. difficile spores rau 300 lossis 500 ppm ozone ua rau > 2.5 log10 txo.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 или 500 частей на миллион приводило к сни5жению > 2. Kev nthuav tawm ntawm C. difficile spores rau 300 lossis 500 ppm ozone ua rau > 2.5 log10 txo.
Raws li cov kev sim saum toj no, ib qho kev xav tau txaus tau pom los ua kom tsis muaj kab mob ntawm qhov koob tshuaj ntawm 500 ppm ozone rau 15 feeb.VRE, CRAB thiab C. difficile spores tau raug kuaj rau cov kab mob ozone ntawm ntau yam khoom xws li cov hlau tsis muaj steel, ntaub, iav, yas thiab ntoo feem ntau siv hauv tsev kho mob.Lawv cov kev ua kom tsis muaj menyuam muaj nyob rau hauv Table 2. Cov kab mob kuaj tau raug soj ntsuam ob zaug.Hauv VRE thiab CRAB, ozone tsis tshua muaj txiaj ntsig ntawm cov iav thiab yas, txawm hais tias qhov kev txo qis ntawm 10 txog 2 lossis ntau dua tau pom ntawm cov hlau tsis muaj steel, ntaub thiab ntoo.C. difficile spores tau pom tias muaj kev tiv thaiv ntau dua rau kev kho ozone dua li lwm yam kab mob uas tau sim.Txhawm rau tshawb xyuas cov txiaj ntsig ntawm ozone rau kev tua cov nyhuv ntawm cov khoom sib txawv tiv thaiv VRE, CRAB, thiab C. difficile, t-tests tau siv los sib piv qhov sib txawv ntawm tus naj npawb ntawm CFU ib milliliter hauv kev tswj thiab kev sim pab pawg ntawm cov khoom sib txawv (Fig. 2).Cov kab mob tau pom qhov sib txawv tseem ceeb, tab sis qhov sib txawv tseem ceeb dua tau pom rau VRE thiab CRAB spores dua li C. difficile spores.
Scatterplot ntawm cov teebmeem ntawm ozone ntawm cov kab mob tua kab mob ntawm ntau yam ntaub ntawv (a) VRE, (b) CRAB, thiab (c) C. difficile.
AFM imaging tau ua tiav ntawm ozone-kho thiab tsis kho VRE, CRAB, thiab C. difficile spores los kawm paub meej txog cov txheej txheem ozone gas sterilization.Ntawm daim duab.3a, c thiab e qhia AFM dluab ntawm untreated VRE, CRAB thiab C. difficile spores, feem.Raws li pom hauv cov duab 3D, cov hlwb yog du thiab tsis zoo.Daim duab 3b, d thiab f qhia VRE, CRAB thiab C. difficile spores tom qab kho ozone.Tsis tsuas yog lawv txo qis hauv tag nrho qhov loj me rau txhua lub hlwb kuaj, tab sis lawv qhov chaw tau dhau los ua qhov tsis zoo tom qab raug ozone.
AFM cov duab tsis kho VRE, MRAB thiab C. difficile spores (a, c, e) thiab (b, d, f) kho nrog 500 ppm ozone rau 15 min.Cov duab tau kos siv Park Systems XEI version 5.1.6 (XEI Software, Suwon, Kauslim; https://www.parksystems.com/102-products/park-xe-bio).
Peb cov kev tshawb fawb qhia tau hais tias cov ozone tsim los ntawm DBD plasma cov cuab yeej qhia tau hais tias muaj peev xwm ua tau zoo decontaminate MDRO thiab C. difficile spores, uas paub tias yog ib qho tseem ceeb ntawm kev noj qab haus huv cov kab mob.Tsis tas li ntawd, nyob rau hauv peb txoj kev tshawb fawb, muab hais tias ib puag ncig kev sib kis nrog MDRO thiab C. difficile spores tuaj yeem yog qhov chaw ntawm kev noj qab haus huv cov kab mob, cov tshuaj tua kab mob ntawm ozone tau pom tias ua tiav rau cov khoom siv feem ntau siv hauv tsev kho mob.Kev ntsuam xyuas decontamination tau ua tiav siv cov khoom siv DBD plasma tom qab cov khoom siv tsis zoo xws li stainless hlau, ntaub, iav, yas thiab ntoo nrog MDRO thiab C. difficile spores.Yog li ntawd, txawm hais tias cov nyhuv decontamination txawv nyob ntawm cov khoom siv, lub peev xwm decontamination ntawm ozone yog qhov zoo kawg li.
Nquag kov cov khoom hauv cov chav tsev kho mob yuav tsum tau ua raws li niaj hnub, tshuaj tua kab mob qis.Tus qauv txheej txheem rau decontaminating cov khoom no yog phau ntawv tu nrog cov kua tshuaj tua kab mob xws li quaternary ammonium compound 13. Txawm tias muaj kev ua raws li cov lus pom zoo rau kev siv tshuaj tua kab mob, MPO yog qhov nyuaj rau tshem tawm los ntawm kev tu ib puag ncig ib puag ncig (feem ntau yog phau ntawv tu) 14.Yog li ntawd, yuav tsum muaj cov cuab yeej tshiab, xws li cov txheej txheem tsis sib cuag.Yog li ntawd, tau muaj kev txaus siab rau cov tshuaj tua kab mob gaseous, suav nrog hydrogen peroxide thiab ozone10.Qhov kom zoo dua ntawm cov tshuaj tua kab mob gaseous yog tias lawv tuaj yeem ncav cuag qhov chaw thiab cov khoom uas ib txwm siv cov txheej txheem tsis tuaj yeem ncav cuag.Hydrogen peroxide tsis ntev los no tau los siv rau hauv kev kho mob, txawm li cas los xij hydrogen peroxide nws tus kheej yog tshuaj lom thiab yuav tsum tau ua raws li cov txheej txheem tuav nruj.Plasma sterilization nrog hydrogen peroxide yuav tsum tau siv sij hawm ntev tshem tawm ua ntej lub voj voog ua kom tsis muaj menyuam tom ntej.Nyob rau hauv sib piv, ozone ua raws li ib tug dav-spectrum antibacterial neeg sawv cev, zoo tiv thaiv kab mob thiab cov kab mob uas resistant rau lwm yam tshuaj tua kab mob 8,11,15.Tsis tas li ntawd, ozone tuaj yeem tsim tau pheej yig los ntawm huab cua hauv huab cua thiab tsis tas yuav muaj cov tshuaj lom neeg ntxiv uas tuaj yeem ua rau muaj kev phom sij nyob rau hauv ib puag ncig, vim tias nws thiaj li tawg mus rau oxygen.Txawm li cas los xij, vim li cas vim li cas ozone tsis siv dav los ua tshuaj tua kab mob yog raws li hauv qab no.Ozone yog tshuaj lom rau tib neeg noj qab haus huv, yog li nws cov concentration tsis tshaj 0.07 ppm nyob rau nruab nrab rau ntau tshaj 8 teev 16, yog li ozone sterilizers tau tsim thiab muab tso rau hauv kev ua lag luam, feem ntau yog ntxuav cov pa roj.Nws tseem tuaj yeem nqus tau cov pa thiab tsim cov ntxhiab tsw qab ntxiag tom qab decontamination5,8.Ozone tsis tau nquag siv hauv tsev kho mob.Txawm li cas los xij, ozone tuaj yeem siv tau nyab xeeb hauv chav ua kom tsis muaj menyuam thiab nrog cov txheej txheem ua pa kom zoo, thiab nws qhov kev tshem tawm tuaj yeem ua kom nrawm heev los ntawm kev siv lub catalytic converter.Hauv txoj kev tshawb no, peb pom tau hais tias cov plasma ozone sterilizers tuaj yeem siv los tua kab mob hauv cov chaw kho mob.Peb tau tsim ib lub cuab yeej uas muaj peev xwm ua kom tsis muaj menyuam, ua haujlwm yooj yim thiab kev pabcuam sai rau cov neeg mob hauv tsev kho mob.Tsis tas li ntawd, peb tau tsim ib qho kev ua kom tsis muaj menyuam yooj yim uas siv cov cua ambient yam tsis muaj nqi ntxiv.Txog niaj hnub no, muaj cov ntaub ntawv tsis txaus ntawm qhov tsawg kawg nkaus ozone cov cai rau MDRO inactivation.Cov cuab yeej siv hauv peb txoj kev tshawb fawb tau yooj yim teeb tsa thiab muaj lub sijhawm ua haujlwm luv luv thiab xav tias yuav muaj txiaj ntsig zoo rau cov khoom siv kom tsis muaj menyuam.
Cov txheej txheem ntawm cov kab mob bactericidal ntawm ozone tsis meej meej.Ntau qhov kev tshawb fawb tau pom tias ozone ua rau cov kab mob hauv cov kab mob ua rau cov kab mob hauv lub cev, ua rau cov kab mob hauv lub cev thiab qhov tshwm sim ntawm cov cell lysis17,18.Ozone tuaj yeem cuam tshuam nrog cellular enzymatic kev ua haujlwm los ntawm kev ua haujlwm nrog thiol pawg thiab tuaj yeem hloov kho purine thiab pyrimidine hauv paus hauv nucleic acids.Txoj kev tshawb no pom cov morphology ntawm VRE, CRAB, thiab C. difficile spores ua ntej thiab tom qab kev kho mob ozone thiab pom tias tsis tsuas yog lawv txo qhov loj me, tab sis lawv kuj tau ua rougher rau saum npoo, qhia txog kev puas tsuaj los yog corrosion ntawm daim nyias nyias.thiab cov khoom siv sab hauv vim ozone gas muaj zog oxidizing muaj peev xwm.Qhov kev puas tsuaj no tuaj yeem ua rau cell inactivation, nyob ntawm qhov hnyav ntawm cov cellular hloov.
C. difficile spores yog qhov nyuaj rau tshem tawm ntawm chav tsev kho mob.Cov spores tseem nyob hauv qhov chaw uas lawv tso 10,20.Tsis tas li ntawd, nyob rau hauv txoj kev tshawb no, txawm hais tias qhov siab tshaj plaws logarithmic 10-fold txo tus naj npawb ntawm cov kab mob ntawm agar daim hlau ntawm 500 ppm ozone rau 15 feeb yog 2.73, cov kab mob bactericidal ntawm ozone ntawm ntau yam ntaub ntawv uas muaj C spores .difficile tau raug txo.Yog li ntawd, ntau lub tswv yim tuaj yeem txiav txim siab kom txo tau tus kab mob C. difficile hauv cov chaw kho mob.Rau kev siv nyob rau hauv cais C. difficile chambers nkaus xwb, nws kuj yuav pab tau los kho lub sij hawm raug thiab siv ntawm ozone kev kho mob.Tsis tas li ntawd, peb yuav tsum nco ntsoov tias txoj kev ozone decontamination tsis tuaj yeem hloov pauv cov lus qhia kev ntxuav nrog cov tshuaj tua kab mob thiab cov tswv yim tshuaj tua kab mob, thiab tseem tuaj yeem ua tau zoo heev hauv kev tswj C. difficile 5 .Hauv txoj kev tshawb no, qhov ua tau zoo ntawm ozone ua cov tshuaj tua kab mob sib txawv rau ntau hom MPO.Kev ua tau zoo yuav nyob ntawm ntau yam xws li theem kev loj hlob, phab ntsa ntawm tes, thiab kev ua haujlwm ntawm kev kho cov txheej txheem21,22.Yog vim li cas rau qhov sib txawv sterilizing nyhuv ntawm ozone nyob rau saum npoo ntawm txhua yam khoom yuav yog vim lub tsim ntawm ib tug biofilm.Cov kev tshawb fawb yav dhau los tau pom tias E. faecium thiab E. faecium nce ib puag ncig tiv thaiv thaum tam sim no biofilms23, 24, 25. Txawm li cas los xij, txoj kev tshawb no qhia tau hais tias ozone muaj cov kab mob tseem ceeb ntawm MDRO thiab C. difficile spores.
Ib qho kev txwv ntawm peb txoj kev tshawb fawb yog tias peb ntsuas qhov cuam tshuam ntawm ozone tuav tom qab kho.Qhov no tuaj yeem ua rau muaj qhov overestimation ntawm tus naj npawb ntawm cov kab mob uas siv tau.
Txawm hais tias txoj kev tshawb no tau ua los ntsuas qhov ua tau zoo ntawm ozone ua cov tshuaj tua kab mob hauv tsev kho mob, nws nyuaj rau kev nthuav dav peb cov txiaj ntsig rau txhua qhov chaw kho mob.Yog li, kev tshawb fawb ntxiv yog xav tau los tshawb xyuas qhov kev siv tau thiab kev sib raug zoo ntawm DBD ozone sterilizer hauv tsev kho mob tiag tiag.
Lub ozone tsim los ntawm DBD plasma reactors tuaj yeem yog ib qho yooj yim thiab muaj txiaj ntsig decontamination tus neeg sawv cev rau MDRO thiab C. difficile.Yog li, kev kho ozone tuaj yeem suav hais tias yog lwm txoj hauv kev zoo rau kev tua kab mob hauv tsev kho mob ib puag ncig.
Cov ntaub ntawv siv thiab / lossis tshuaj ntsuam hauv txoj kev tshawb fawb tam sim no muaj los ntawm cov kws sau ntawv raws li qhov kev thov tsim nyog.
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