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Malo okhudzidwa ndi thanzi labwino amathandizira kwambiri kufalikira kwa tizilombo toyambitsa matenda (MDR) ndi C. difficile.Cholinga cha phunziroli chinali kuwunika zotsatira za ozoni opangidwa ndi dielectric chotchinga kumaliseche (DBD) plasma riyakitala pa zochita za vancomycin zosagwira Enterococcus faecalis (VRE), carbapenem zosagwira Klebsiella pneumoniae (CRE), carbapenem zosagwira Antibacterial zotsatira za zinthu zosiyanasiyana Prespp.Pseudomonas aeruginosa (CRPA), carbapenem-resistant Acinetobacter baumannii (CRAB) ndi Clostridium difficile spores.Zida zosiyanasiyana zomwe zidayipitsidwa ndi VRE, CRE, CRPA, CRAB ndi C. difficile spores zinathandizidwa ndi ozoni pazigawo zosiyanasiyana komanso nthawi zowonekera.Atomic Force Microscopy (AFM) adawonetsa kusintha kwa mabakiteriya pambuyo pa chithandizo cha ozoni.Pamene mlingo wa ozoni wa 500 ppm unagwiritsidwa ntchito ku VRE ndi CRAB kwa mphindi 15, kuchepa kwa pafupifupi 2 kapena kuposa log10 kunawonedwa muzitsulo zosapanga dzimbiri, nsalu ndi matabwa, ndipo kuchepa kwa 1-2 log10 kunawonedwa mu galasi ndi pulasitiki.Ma spores a C. difficile anapezeka kuti ndi osamva ozoni kuposa zamoyo zina zonse zoyesedwa.Pa AFM, mutalandira chithandizo ndi ozoni, maselo a bakiteriya amatupa ndi kupunduka.Ozone yopangidwa ndi DBD Plasma Reactor ndi chida chosavuta komanso chamtengo wapatali chochotsera MDRO ndi C. difficile spores, chomwe chimadziwika kuti ndi tizilombo toyambitsa matenda okhudzana ndi thanzi.
Kutuluka kwa tizilombo tosamva mankhwala ambiri (MDR) kumadza chifukwa cha kugwiritsiridwa ntchito molakwa kwa maantibayotiki mwa anthu ndi nyama ndipo zadziwika ndi World Health Organization (WHO) kuti ndizoopsa kwambiri pa thanzi la anthu1.Makamaka, mabungwe azachipatala akukumana kwambiri ndi kuwonekera ndi kufalikira kwa ma MRO.Ma MRO akuluakulu ndi Staphylococcus aureus yolimbana ndi methicillin ndi vancomycin-resistant enterococcus (VRE), extended-spectrum beta-lactamase-producing enterobacteria (ESBL), multidrug-resistant Pseudomonas aeruginosa, multidrug-resistant enterococcus (VRE), bakiteriya yolimbana ndi mankhwala amitundumitundu, ndi basterpenbacterbacter-bacter.Kuphatikiza apo, matenda a Clostridium difficile ndiye omwe amayambitsa kutsekula m'mimba komwe kumakhudzana ndiumoyo, ndikuyika mtolo waukulu pamachitidwe azaumoyo.MDRO ndi C. difficile amafalitsidwa kudzera m'manja mwa ogwira ntchito zachipatala, malo okhudzidwa, kapena mwachindunji kuchokera kwa munthu kupita kwa munthu.Kafukufuku waposachedwapa wasonyeza kuti malo oipitsidwa m'makonzedwe a chisamaliro chaumoyo amagwira ntchito yofunika kwambiri pakupatsirana kwa MDRO ndi C. difficile pamene ogwira ntchito zachipatala (HCWs) akukumana ndi malo oipitsidwa kapena pamene odwala akukumana mwachindunji ndi malo owonongeka 3,4.malo odetsedwa m'malo osamalira thanzi amachepetsa zochitika za MLRO ndi C. difficile matenda kapena colonization5,6,7.Chifukwa cha nkhawa yapadziko lonse yokhudzana ndi kukwera kwa antimicrobial resistance, n'zoonekeratu kuti kafukufuku wochuluka akufunika pa njira ndi njira zochotseratu tizilombo toyambitsa matenda m'malo azachipatala.Posachedwapa, njira zoyeretsera zosakhudzana ndi ma terminal, makamaka zida za ultraviolet (UV) kapena makina a hydrogen peroxide, zadziwika kuti ndi njira zodalirika zochotsera matenda.Komabe, zida zogulitsira za UV kapena hydrogen peroxide sizimangokwera mtengo, kuthira tizilombo toyambitsa matenda ku UV kumangogwira ntchito pamalo owonekera, pomwe hydrogen peroxide m'madzi a m'magazi amadzimadzi amafunikira nthawi yayitali yochotsa tizilombo toyambitsa matenda isanachitike5.
Ozone imadziwika kuti ndi anti-corrosion ndipo imatha kupangidwa motsika mtengo8.Amadziwikanso kuti ndi poyizoni ku thanzi la munthu, koma amatha kuwola mwachangu kukhala mpweya 8. Ma dielectric barrier discharge (DBD) plasma reactors ndi omwe amapezeka kwambiri a ozone generator9.Zipangizo za DBD zimakulolani kuti mupange plasma yotsika kwambiri mumlengalenga ndikupanga ozoni.Mpaka pano, kugwiritsa ntchito ozoni kwakhala kokha kokha pakupha tizilombo toyambitsa matenda m'madzi osambira, madzi akumwa ndi zimbudzi10.Kafukufuku wambiri wanena kuti amagwiritsidwa ntchito m'malo azachipatala8,11.
Mu phunziro ili, tinagwiritsa ntchito yaying'ono DBD plasma ozoni jenereta kusonyeza mphamvu yake kuchotsa MDRO ndi C. difficile, ngakhale amene inoculated pa zipangizo zosiyanasiyana ntchito zoikamo mankhwala.Kuphatikiza apo, njira yoletsa kutsekereza kwa ozoni yadziwika pogwiritsa ntchito zithunzi za atomic force microscopy (AFM) zama cell opangidwa ndi ozoni.
Zovuta zinapezedwa kuchokera kuzipatala zachipatala za: VRE (SCH 479 ndi SCH 637), Klebsiella pneumoniae yolimbana ndi carbapenem (CRE; SCH CRE-14 ndi DKA-1), Pseudomonas aeruginosa yolimbana ndi carbapenem (CRPA; 54 ndi 83) ndi mabakiteriya a carbapenem.mabakiteriya Pseudomonas aeruginosa (CRPA; 54 ndi 83).kugonjetsedwa ndi Acinetobacter baumannii (CRAB; F2487 ndi SCH-511).C. difficile inapezedwa kuchokera ku National Pathogen Culture Collection (NCCP 11840) ya Korea Agency for Disease Control and Prevention.Idapatulidwa kwa wodwala ku South Korea mu 2019 ndipo idapezeka kuti ndi ya ST15 pogwiritsa ntchito ma multilocus sequence typing.Brain Heart Infusion (BHI) Msuzi (BD, Sparks, MD, USA) wothiridwa ndi VRE, CRE, CRPA ndi CRAB anasakanizidwa bwino ndikuyikidwa pa 37 ° C. kwa maola 24.
C. difficile adamizidwa movutikira pa agar wamagazi kwa maola 48.Magawo angapo adawonjezeredwa ku 5 ml ya msuzi wamtima waubongo ndikuyikidwa pansi pazikhalidwe za anaerobic kwa maola 48.Pambuyo pake, chikhalidwecho chinagwedezeka, 5 ml ya 95% ya ethanol inawonjezeredwa, kugwedezeka kachiwiri ndikusiya kutentha kwa mphindi 30.Pambuyo centrifugation pa 3000 g kwa mphindi 20, kutaya supernatant ndi kuyimitsa pellet munali spores ndi kupha mabakiteriya mu 0,3 ml ya madzi.Maselo otheka amawerengedwa ndi kuyika kwa ma cell a bakiteriya pama mbale a agar amagazi pambuyo pa kuchepetsedwa koyenera.Madontho a Gram adatsimikizira kuti 85% mpaka 90% ya mabakiteriya omwe amakhalapo anali spores.
Kafukufuku wotsatirawa adachitidwa kuti afufuze zotsatira za ozoni monga mankhwala ophera tizilombo pa malo osiyanasiyana okhudzidwa ndi MDRO ndi C. difficile spores, omwe amadziwika kuti amayambitsa matenda okhudzana ndi thanzi.Konzani zitsanzo za chitsulo chosapanga dzimbiri, nsalu (thonje), galasi, pulasitiki (acrylic), ndi matabwa (paini) woyezera sentimita imodzi ndi centimita imodzi.Mankhwala makuponi musanagwiritse ntchito.Zitsanzo zonse zinali zosawilitsidwa ndi autoclaving musanayambe matenda ndi mabakiteriya.
Mu kafukufukuyu, ma cell a bakiteriya adafalikira pamalo osiyanasiyana apansi panthaka komanso pama mbale a agar.Kenako mapanelo amawatsekera powaika ku ozoni kwa nthawi inayake komanso pamalo enaake m'chipinda chosindikizidwa.Pa mkuyu.1 ndi chithunzi cha zida zowumitsa ozoni.DBD plasma reactors anapangidwa pomangirira perforated ndi poyera maelekitirodi zitsulo zosapanga dzimbiri kutsogolo ndi kumbuyo kwa 1 mm wandiweyani mbale aluminiyamu (dielectric).Pakuti perforated maelekitirodi, pobowo ndi dzenje dera anali 3 mm ndi 0.33 mm, motero.Elekitirodi iliyonse imakhala ndi mawonekedwe ozungulira okhala ndi mainchesi 43 mm.Mphamvu yamagetsi yapamwamba kwambiri (GBS Elektronik GmbH Minipuls 2.2) idagwiritsidwa ntchito kuyika voteji ya sinusoidal pafupifupi 8 kV pachimake kuti ifike pamtunda wa 12.5 kHz mpaka ma elekitirodi a perforated kuti apange plasma m'mphepete mwa maelekitirodi.ma electrodes opangidwa ndi perforated.Popeza ukadaulo ndi njira yochepetsera mpweya, kutseketsa kumachitika m'chipinda chogawidwa ndi voliyumu m'zipinda zam'mwamba ndi zapansi, zomwe zimakhala ndi zitsanzo zoipitsidwa ndi mabakiteriya ndi majenereta a plasma, motsatana.Chipinda chapamwamba chili ndi ma valavu awiri ochotsa ndikutulutsa ozoni wotsalira.Musanagwiritse ntchito poyesera, kusintha kwa nthawi ya ozoni m'chipindamo mutatha kuyatsa kuyika kwa plasma kunayesedwa molingana ndi mawonekedwe a mayamwidwe a mzere wa 253.65 nm wa nyali ya mercury.
(a) Dongosolo la kuyeserera koyeserera kwa mabakiteriya pazinthu zosiyanasiyana pogwiritsa ntchito ozoni wopangidwa mu DBD plasma reactor, ndi (b) ndende ya ozoni ndi nthawi yotulutsa madzi a m'magazi m'chipinda chotseketsa.Chithunzicho chinapangidwa pogwiritsa ntchito OriginPro version 9.0 (OriginPro software, Northampton, MA, USA; https://www.originlab.com).
Choyamba, pochotsa maselo a bakiteriya omwe amaikidwa pa mbale za agar ndi ozoni, pamene akusintha ndende ya ozoni ndi nthawi ya chithandizo, nthawi yoyenera ya ozoni ndi nthawi ya chithandizo cha decontamination ya MDRO ndi C. difficile inatsimikiziridwa.Panthawi yotseketsa, chipindacho chimatsukidwa koyamba ndi mpweya wozungulira kenako ndikudzazidwa ndi ozoni poyatsa gawo la plasma.Zitsanzozi zitathandizidwa ndi ozoni kwa nthawi yokonzedweratu, pampu ya diaphragm imagwiritsidwa ntchito kuchotsa ozone yotsalayo.Miyezo idagwiritsa ntchito chitsanzo cha chikhalidwe chathunthu cha maola 24 (~ 108 CFU/ml).Zitsanzo za kuyimitsidwa kwa ma cell a bakiteriya (20 μl) adayamba kuchepetsedwa kakhumi ndi saline wosabala, ndiyeno zitsanzozi zidagawidwa pa mbale za agar zosawilitsidwa ndi ozoni mchipindamo.Pambuyo pake, zitsanzo zobwerezabwereza, zokhala ndi zitsanzo zowonekera osati zowonekera ku ozoni, zinakulungidwa pa 37 ° C kwa maola 24 ndikuwerengera madera kuti awone momwe ntchito yolera ikuyendera.
Kupitilira apo, molingana ndi mikhalidwe yotseketsa yomwe yafotokozedwa m'maphunzirowa, mphamvu yowononga yaukadaulo iyi pa MDRO ndi C. difficile idawunikidwa pogwiritsa ntchito makuponi azinthu zosiyanasiyana (zitsulo zosapanga dzimbiri, nsalu, magalasi, pulasitiki ndi makuponi amatabwa) omwe amagwiritsidwa ntchito m'mabungwe azachipatala.Zikhalidwe zonse za maola 24 (~ 108 cfu/ml) zinagwiritsidwa ntchito.Zitsanzo za kuyimitsidwa kwa cell ya bakiteriya (20 μl) zidachepetsedwa kakhumi ndi saline wosabala, kenako makuponiwo adamizidwa mumadzi osungunuka awa kuti awone kuipitsidwa.Zitsanzo kuchotsedwa pambuyo kumizidwa mu dilution msuzi anaikidwa wosabala Petri mbale ndi zouma firiji kwa maola 24.Ikani chivindikiro cha mbale ya petri pa chitsanzo ndikuchiyika mosamala m'chipinda choyesera.Chotsani chivindikiro ku mbale ya Petri ndikuwonetsa chitsanzocho ku 500 ppm ozone kwa mphindi 15.Zitsanzo zowongolera zidayikidwa mu kabati yoteteza zachilengedwe ndipo sizinawonekere ku ozone.Atangokumana ndi ozoni, zitsanzo ndi zitsanzo zopanda ma radiation (ie zowongolera) zidasakanizidwa ndi saline wosabala pogwiritsa ntchito chosakaniza cha vortex kuti alekanitse mabakiteriya pamwamba.Kuyimitsidwa eluted kunali serially kuchepetsedwa 10 nthawi ndi wosabala saline, kenako chiwerengero cha mabakiteriya kuchepetsedwa anatsimikiza magazi agar mbale (kwa mabakiteriya aerobic) kapena anaerobic magazi agar mbale kwa Brucella (kwa Clostridium difficile) ndi incubated pa 37 ° C kwa maola 24 .kapena pansi pa mikhalidwe ya anaerobic kwa maola 48 pa 37 ° C mu chibwereza kuti mudziwe ndende yoyamba ya inoculum.Kusiyana kwa kuchuluka kwa mabakiteriya pakati pa zowongolera zomwe sizinawonekere ndi zitsanzo zowonekera zidawerengedwa kuti zichepetse kuchuluka kwa mabakiteriya (ie, kutsekereza bwino) poyesedwa.
Ma cell achilengedwe amayenera kukhala osasunthika pa mbale yoyerekeza ya AFM;Choncho, mica disk yathyathyathya komanso yofanana yokhala ndi sikelo yocheperako kuposa kukula kwa selo imagwiritsidwa ntchito ngati gawo lapansi.M'mimba mwake ndi makulidwe a disks anali 20 mm ndi 0.21 mm, motero.Kuti amangirire kwambiri ma cell pamwamba, pamwamba pa mica yokutidwa ndi poly-L-lysine (200 µl), kupangitsa kuti ikhale yodzaza bwino komanso nembanemba ya cellyo imakhala yolakwika.Pambuyo popaka ndi poly-L-lysine, ma disks a mica adatsukidwa katatu ndi madzi a 1 ml deionized (DI) ndi mpweya wouma usiku wonse.Kenako, maselo bakiteriya ankagwiritsidwa ntchito pa mica pamwamba yokutidwa ndi poly-L-lysine ndi dosing ndi kuchepetsa bakiteriya njira, anachoka kwa 30 min, ndiyeno mica pamwamba anatsukidwa ndi 1 ml ya madzi deionized.
Theka la zitsanzo zinkachitidwa ndi ozoni ndipo mawonekedwe a pamwamba a mica mbale yodzaza ndi VRE, CRAB ndi C. difficile spores ankawoneka pogwiritsa ntchito AFM (XE-7, machitidwe a paki).Njira yogwiritsira ntchito AFM imayikidwa kuti ikhale yojambula, yomwe ndi njira yodziwika bwino yojambula maselo achilengedwe.Muzoyesera, microcantilever yopangidwira mawonekedwe osalumikizana (OMCL-AC160TS, OLYMPUS Microscopy) idagwiritsidwa ntchito.Zithunzi za AFM zidajambulidwa kutengera kuchuluka kwa scan ya 0.5 Hz zomwe zimapangitsa kuti chithunzi chikhale ndi ma pixel a 2048 × 2048.
Kuti tidziwe momwe ma plasma reactors a DBD amagwirira ntchito potsekereza, tidayesa zingapo pogwiritsa ntchito MDRO (VRE, CRE, CRPA, ndi CRAB) ndi C. difficile kusinthasintha kuchuluka kwa ozoni ndi nthawi yowonekera.Pa mkuyu.1b ikuwonetsa nthawi yokhotakhota ya ozoni pachiyeso chilichonse mutatha kuyatsa chipangizo cha plasma.Kukhazikikako kudakwera molunjika, kufika 300 ndi 500 ppm pambuyo pa mphindi 1.5 ndi 2.5, motsatana.Mayeso oyambilira ndi VRE awonetsa kuti zochepa zomwe zimafunikira kuti muchepetse mabakiteriya ndi 300 ppm ozone kwa mphindi 10.Choncho, muzotsatira zotsatirazi, MDRO ndi C. difficile zinawonetsedwa ndi ozoni pazigawo ziwiri zosiyana (300 ndi 500 ppm) komanso nthawi ziwiri zosiyana (10 ndi 15 mphindi).Kuchita bwino kwa Sterilization kwa mlingo uliwonse wa ozoni ndi nthawi yowonetsera nthawi kunawerengedwa ndikuwonetsedwa mu Table 1. Kuwonekera kwa 300 kapena 500 ppm ozone kwa mphindi 10-15 kunapangitsa kuti VRE ikhale yochepa kwambiri ya 2 kapena log10 yambiri.Kupha kwa bakiteriya kwambiri ndi CRE kudakwaniritsidwa ndi mphindi 15 zowonekera ku ozone ya 300 kapena 500 ppm. Kuchepetsa kwakukulu kwa CRPA (> 7 log10) kunapezedwa ndi 500 ppm ya ozone kwa 15 min. Kuchepetsa kwakukulu kwa CRPA (> 7 log10) kunapezedwa ndi 500 ppm ya ozone kwa 15 min. Высокое снижение CRPA (> 7 log10) было достигнуто при воздействии 500 частей на миллион озона в течение 15 минут. Kuchepetsa kwakukulu kwa CRPA (> 7 log10) kunakwaniritsidwa ndi 500 ppm ozone kwa mphindi 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. Kuchepetsa kwakukulu kwa CRPA (> 7 log10) pambuyo pa mphindi 15 kukhudzana ndi 500 ppm ozone.Kupha kosayenera kwa mabakiteriya a CRAB pa 300 ppm ozone; komabe, pa 500 ppm ozoni, panali> 1.5 log10 kuchepetsa. komabe, pa 500 ppm ozoni, panali> 1.5 log10 kuchepetsa. однако при концентрации озона 500 частей на миллион наблюдалось снижение > 1,5 log10. komabe, pa ozoni ndende ya 500 ppm, kuchepa kwa> 1.5 log10 kunawonedwa.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. Komabe, pa ozone ndende ya 500 ppm, kuchepa kwa> 1.5 log10 kunawonedwa. Kuwonetsa C. difficile spores ku 300 kapena 500 ppm ozoni kunapangitsa kuti> 2.5 log10 kuchepetsa. Kuwonetsa C. difficile spores ku 300 kapena 500 ppm ozoni kunapangitsa kuti> 2.5 log10 kuchepetsa. Воздействие на споры C. difficile озона с концентрацией 300 kapena 500 частей на миллион приводило к снижению > 2,5 log10. Kuwonekera kwa C. difficile spores ku 300 kapena 500 ppm ozoni kunapangitsa kuti> 2.5 log10 ichepetse.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 kapena 500 частей на миллион приводило к снижению >2,5 log10. Kuwonekera kwa C. difficile spores ku 300 kapena 500 ppm ozoni kunapangitsa kuti> 2.5 log10 ichepetse.
Kutengera zoyeserera pamwambapa, chofunikira chokwanira chidapezeka kuti chitsegule mabakiteriya pamlingo wa 500 ppm ozone kwa mphindi 15.VRE, CRAB ndi C. difficile spores zayesedwa kuti zikhale ndi majeremusi a ozoni pazinthu zosiyanasiyana kuphatikizapo zitsulo zosapanga dzimbiri, nsalu, galasi, pulasitiki ndi nkhuni zomwe zimagwiritsidwa ntchito m'zipatala.Kugwiritsa ntchito kwawo kolera kumawonetsedwa mu Gulu 2. Zamoyo zoyesa zidawunikidwa kawiri.Mu VRE ndi CRAB, ozoni inali yochepa kwambiri pa galasi ndi pulasitiki, ngakhale kuti kutsika kwa log10 pafupifupi chinthu cha 2 kapena kuposerapo kunawonedwa pazitsulo zosapanga dzimbiri, nsalu ndi matabwa.C. difficile spores anapezeka kuti samva chithandizo cha ozoni kuposa zamoyo zina zonse zomwe zinayesedwa.Kufufuza mowerengeka zotsatira za ozoni pa kupha zotsatira za zinthu zosiyanasiyana motsutsana VRE, CRAB, ndi C. difficile, t-mayeso anagwiritsidwa ntchito kuyerekeza kusiyana kwa chiwerengero cha CFU pa millilita mu ulamuliro ndi experimental magulu pa zipangizo zosiyanasiyana (mkuyu 2).zovuta zinawonetsa kusiyana kwakukulu, koma kusiyana kwakukulu kunawonedwa kwa VRE ndi CRAB spores kusiyana ndi C. difficile spores.
Scatterplot ya zotsatira za ozone pa kupha mabakiteriya a zipangizo zosiyanasiyana (a) VRE, (b) CRAB, ndi (c) C. difficile.
Kujambula kwa AFM kunachitika pa ozone-treated and untreated VRE, CRAB, ndi C. difficile spores kuti aphunzire mwatsatanetsatane njira yochotsera mpweya wa ozoni.Pa mkuyu.3a, c ndi e amasonyeza zithunzi za AFM za VRE, CRAB ndi C. difficile spores, motsatira.Monga momwe zikuwonekera muzithunzi za 3D, maselo ndi osalala komanso osasunthika.Zithunzi 3b, d ndi f zimasonyeza VRE, CRAB ndi C. difficile spores pambuyo pa chithandizo cha ozoni.Sikuti adangochepetsa kukula kwa maselo onse omwe adayesedwa, koma mawonekedwe awo adawoneka owoneka bwino atakumana ndi ozone.
Zithunzi za AFM za VRE, MRAB ndi C. difficile spores (a, c, e) ndi (b, d, f) zothandizidwa ndi 500 ppm ozone kwa 15 min.Zithunzi zidajambulidwa pogwiritsa ntchito mtundu wa Park Systems XEI 5.1.6 (XEI Software, Suwon, Korea; https://www.parksystems.com/102-products/park-xe-bio).
Kafukufuku wathu akuwonetsa kuti ozone yopangidwa ndi zida za plasma za DBD zikuwonetsa kuthekera kowononga bwino MDRO ndi C. difficile spores, zomwe zimadziwika kuti ndizo zimayambitsa matenda okhudzana ndi thanzi.Kuonjezera apo, mu phunziro lathu, poganizira kuti kuipitsidwa kwa chilengedwe ndi MDRO ndi C. difficile spores kungakhale gwero la matenda okhudzana ndi chithandizo chamankhwala, zotsatira za germicidal za ozone zinapezeka kuti zikuyenda bwino pazinthu zomwe zimagwiritsidwa ntchito makamaka m'chipatala.Mayesero a decontamination anachitidwa pogwiritsa ntchito zipangizo za plasma za DBD pambuyo poyipitsidwa ndi zinthu monga zitsulo zosapanga dzimbiri, nsalu, galasi, pulasitiki ndi matabwa okhala ndi MDRO ndi C. difficile spores.Chotsatira chake, ngakhale kuti zotsatira za decontamination zimasiyana malinga ndi zinthu, mphamvu yowononga ozoni ndi yodabwitsa.
Zinthu zomwe zimagwiridwa pafupipafupi m'zipinda zachipatala zimafunikira kupha tizilombo toyambitsa matenda pafupipafupi.Njira yokhazikika yochotseratu zinthu zotere ndi kuyeretsa pamanja ndi mankhwala ophera tizilombo toyambitsa matenda amadzimadzi monga quaternary ammonium compound 13. Ngakhale kutsatira mosamalitsa malangizo ogwiritsira ntchito mankhwala ophera tizilombo toyambitsa matenda, MPO ndizovuta kuchotsa poyeretsa zachilengedwe (nthawi zambiri kuyeretsa pamanja)14.Choncho, matekinoloje atsopano amafunikira, monga njira zosalumikizana.Chifukwa chake, pakhala chidwi pamankhwala opha tizilombo toyambitsa matenda, kuphatikiza hydrogen peroxide ndi ozone10.Ubwino wa mankhwala ophera tizilombo ndi mpweya ndikuti amatha kufikira malo ndi zinthu zomwe njira zachikhalidwe sizingafikire.Hydrogen peroxide yayamba kugwiritsidwa ntchito m'zipatala, komabe hydrogen peroxide yokha ndi yapoizoni ndipo iyenera kusamaliridwa motsatira njira zoyendetsera bwino.Kutseketsa madzi a m'magazi ndi hydrogen peroxide kumafuna nthawi yayitali yoyeretsa isanafike mkombero wotsatira wolera.Mosiyana ndi izi, ozoni amagwira ntchito ngati antibacterial antibacterial agent, yogwira ntchito motsutsana ndi mabakiteriya ndi ma virus omwe amalimbana ndi mankhwala ena opha tizilombo8,11,15.Kuonjezera apo, ozoni akhoza kupangidwa motsika mtengo kuchokera ku mpweya wa mumlengalenga ndipo safuna mankhwala owonjezera akupha omwe angasiye malo owopsa m'chilengedwe, chifukwa pamapeto pake amasweka kukhala mpweya.Komabe, chifukwa chomwe ozoni sagwiritsidwa ntchito kwambiri ngati mankhwala ophera tizilombo ndi motere.Ozone ndi poizoni ku thanzi la munthu, kotero kuti ndende yake siposa 0.07 ppm pafupifupi kwa 8 hours16, kotero ozoni sterilizers apangidwa ndi kuikidwa pa msika, makamaka kuyeretsa mpweya utsi.N'zothekanso kutulutsa mpweya ndi kutulutsa fungo losasangalatsa pambuyo pa decontamination5,8.Ozone sanagwiritsidwe ntchito mwachangu m'mabungwe azachipatala.Komabe, ozoni angagwiritsidwe ntchito motetezeka m'zipinda zotsekera komanso ndi njira zoyendetsera mpweya wabwino, ndipo kuchotsedwa kwake kumatha kufulumizitsa kwambiri pogwiritsa ntchito chosinthira chothandizira.Mu kafukufukuyu, tikuwonetsa kuti zowumitsa ozoni za plasma zitha kugwiritsidwa ntchito popha tizilombo m'malo azachipatala.Tapanga chipangizo chokhala ndi mphamvu zambiri zoletsa kubereka, kugwiritsa ntchito kosavuta komanso ntchito yachangu kwa odwala omwe ali m'chipatala.Kuphatikiza apo, tapanga njira yosavuta yoletsa kulera yomwe imagwiritsa ntchito mpweya wozungulira popanda mtengo wowonjezera.Mpaka pano, palibe chidziwitso chokwanira pazofunikira zochepa za ozoni kuti MDRO isayimitsidwe.Zida zomwe zimagwiritsidwa ntchito mu phunziro lathu ndizosavuta kukhazikitsa ndipo zimakhala ndi nthawi yochepa ndipo zikuyembekezeka kukhala zothandiza pakuchotsa zida pafupipafupi.
Kachitidwe ka bactericidal zochita za ozoni sikudziwika bwino.Kafukufuku wambiri wasonyeza kuti ozoni amawononga maselo a bakiteriya, zomwe zimapangitsa kuti pakhale kutuluka kwa intracellular ndipo pamapeto pake cell lysis17,18.Ozone ikhoza kusokoneza ntchito ya enzymatic yama cell pochita ndi magulu a thiol ndipo imatha kusintha maziko a purine ndi pyrimidine mu nucleic acid.Kafukufukuyu adawonetsa morphology ya VRE, CRAB, ndi C. difficile spores isanayambe komanso itatha mankhwala a ozoni ndipo adapeza kuti sizinachepetse kukula kwake, komanso zimakhala zovuta kwambiri pamtunda, zomwe zimasonyeza kuwonongeka kapena kuwonongeka kwa nembanemba yakunja.ndi zipangizo zamkati chifukwa cha mpweya wa ozoni ali ndi mphamvu yamphamvu ya okosijeni.Kuwonongeka kumeneku kungayambitse kusagwira ntchito kwa selo, kutengera kuopsa kwa kusintha kwa ma cell.
C. difficile spores ndizovuta kuchotsa m'zipinda zachipatala.Njerezo zimakhalabe m’malo amene zimakhetsa 10,20.Komanso, mu phunziro ili, ngakhale pazipita logarithmic 10 kuchepetsa kuchepetsa chiwerengero cha mabakiteriya pa mbale agar pa 500 ppm ozoni kwa mphindi 15 anali 2.73, bactericidal zotsatira ozoni pa zipangizo zosiyanasiyana munali C spores .difficile yafupika.Choncho, njira zosiyanasiyana zingaganizidwe kuti zichepetse matenda a C. difficile m'malo osamalira thanzi.Kugwiritsidwa ntchito m'zipinda za C. difficile zokha, zingakhalenso zothandiza kusintha nthawi yowonekera komanso mphamvu ya mankhwala a ozoni.Komanso, tiyenera kukumbukira kuti ozoni decontamination njira sangathe kwathunthu m'malo ochiritsira ochiritsira Buku kuyeretsa ndi mankhwala ophera tizilombo ndi njira antimicrobial, komanso angakhale othandiza kwambiri kulamulira C. difficile 5 .Mu kafukufukuyu, mphamvu ya ozoni ngati mankhwala ophera tizilombo osiyanasiyana osiyanasiyana a MPO.Kuchita bwino kungadalire pazifukwa zingapo monga siteji ya kukula, khoma la cell, komanso njira zokonzetsera21,22.Chifukwa cha kusintha kosiyanasiyana kwa ozoni pamwamba pa chinthu chilichonse kungakhale chifukwa chopanga biofilm.Kafukufuku wam'mbuyo wasonyeza kuti E. faecium ndi E. faecium amawonjezera kukana kwa chilengedwe pamene alipo monga biofilms23, 24, 25. Komabe, kafukufukuyu akuwonetsa kuti ozoni ali ndi mphamvu yaikulu ya bactericidal pa MDRO ndi C. difficile spores.
Kuchepetsa kwa phunziro lathu ndikuti tidawunika momwe kusungidwa kwa ozoni pambuyo pokonzanso.Izi zingayambitse kuchulukitsidwa kwa chiwerengero cha maselo otheka a bakiteriya.
Ngakhale kuti phunziroli linachitidwa kuti liwone mphamvu ya ozoni ngati mankhwala ophera tizilombo m'chipatala, n'zovuta kulongosola zotsatira zathu kuzinthu zonse zachipatala.Chifukwa chake, kafukufuku wochulukirapo akufunika kuti afufuze momwe angagwiritsire ntchito komanso kugwirizana kwa sterilizer ya ozoni ya DBD m'malo enieni achipatala.
Ozoni yopangidwa ndi DBD plasma reactors ikhoza kukhala njira yosavuta komanso yofunika yochotsera MDRO ndi C. difficile.Chifukwa chake, chithandizo cha ozoni chimatha kuonedwa ngati njira yabwino yothetsera matenda am'chipatala.
Zolemba zomwe zagwiritsidwa ntchito ndi/kapena zowunikidwa mu kafukufuku wapano zikupezeka kuchokera kwa olemba omwe afunsidwa pazofunikira.
Njira yapadziko lonse ya WHO yokhala ndi antimicrobial resistance.https://www.who.int/drugresistance/WHO_Global_Strategy.htm/en/ Apezeka.
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