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Deegaanka daryeelka caafimaad ee wasakhaysan ayaa door muhiim ah ka ciyaara faafinta noolaha u adkaysta daawooyinka badan (MDR) iyo C. difficile.Ujeedada daraasaddan ayaa ahayd in la qiimeeyo saamaynta ozone ay soo saarto dareeraha xannibaadda dielectric (DBD) plasma reactor ee ficilka vancomycin u adkaysta Enterococcus faecalis (VRE), carbapenem u adkaysta Klebsiella pneumoniae (CRE), carbapenem u adkaysta saamaynta Antibacterial ee walxo kala duwan oo wasakhaysan Pseudomonas spp.Pseudomonas aeruginosa (CRPA), carbapenem u adkaysta Acinetobacter baumannii (CRAB) iyo Clostridium difficile kudka.Alaabooyin kala duwan oo ay ku wasakhoobeen VRE, CRE, CRPA, CRAB iyo C. kudka adag ayaa lagu daweeyay ozone waqtiyo kala duwan oo soo-gaadhis ah.Mikroskoobyada xoogga atomiga (AFM) ayaa muujiyay isbeddelka dusha sare ee bakteeriyada ka dib daaweynta ozone.Marka qiyaasta 500 ppm ozone lagu dabaqay VRE iyo CRAB 15 daqiiqo, hoos u dhac ku dhawaad ​​2 ama in ka badan log10 ayaa lagu arkay birta, dhar iyo alwaax, hoos u dhac 1-2 log10 ah ayaa lagu arkay dhalo iyo caag.C. xadhkaha adag waxa la ogaaday in ay u adkeysan karaan ozone marka loo eego dhammaan noolaha kale ee la tijaabiyey.On AFM, ka dib markii lagu daaweeyay ozone, unugyada bakteeriyada ayaa bararay oo qallafsan.Ozone-ka ay soo saarto DBD Plasma Reactor waa qalab wasakhayn fudud oo qiimo leh oo loogu talagalay MDRO iyo C. kudka adag, kuwaas oo la og yahay inay yihiin cudur-sidaha caadiga ah ee caabuqyada la xiriira daryeelka caafimaadka.
Soo ifbaxa noolaha u adkaysta dawooyinka badan (MDR) waxa sababa si xun u isticmaalka antibiyootiga ee dadka iyo duunyada, waxaana hay’adda caafimaadka adduunka ee WHO ay ku tilmaantay mid khatar weyn ku ah caafimaadka bulshada1.Gaar ahaan, xarumaha daryeelka caafimaadku waxay si isa soo taraysa uga hortagayaan soo bixitaanka iyo fiditaanka MRO-yada.MRO-yada ugu muhiimsan waa Staphylococcus aureus-u adkaysta methicillin iyo enterococcus vancomycin-u adkaysta (VRE), fidsan-soo-saarka enterobacteria beta-lactamase (ESBL), Pseudomonas aeruginosa u adkaysta dawooyinka badan, Acinetobacter baumannii u adkaysta dawooyinka badan, iyo Enterobterobteremka u adkaysta.Intaa waxaa dheer, infekshanka Clostridium difficile waa sababta ugu weyn ee shuban la xiriirta daryeelka caafimaadka, oo culeys weyn saaraysa nidaamka daryeelka caafimaadka.MDRO iyo C. difficile waxaa lagu kala qaadaa gacmaha shaqaalaha daryeelka caafimaadka, bay'ada wasakhaysan, ama si toos ah qof ilaa qof.Daraasadihii ugu dambeeyay ayaa muujiyay in deegaanka wasakhaysan ee goobaha daryeelka caafimaadku ay door muhiim ah ka ciyaaraan gudbinta MDRO iyo C. adag marka shaqaalaha caafimaadku (HCWs) ay la kulmaan sagxadaha wasakhaysan ama marka bukaanku si toos ah ula xiriiraan sagxadaha wasakhaysan 3,4.bay'ada wasakhaysan ee goobaha daryeelka caafimaadku waxay yareeyaan dhacdooyinka MLRO iyo C. caabuqa adag ama gumaysiga5,6,7.Marka la eego walaaca caalamiga ah ee ku saabsan kor u kaca iska caabbinta antimicrobial, way caddahay in cilmi baaris dheeraad ah loo baahan yahay hababka iyo hababka sun-saaridda ee goobaha daryeelka caafimaadka.Dhowaan, hababka nadiifinta terminaalka aan xiriirka lahayn, gaar ahaan qalabka ultraviolet (UV) ama hababka hydrogen peroxide, ayaa loo aqoonsaday habab rajo-saar ah oo wasakhaysan.Si kastaba ha ahaatee, qalabkan UV ama hydrogen peroxide ee ganacsi ahaan loo heli karo kaliya maahan kuwo qaali ah, jeermiska UV ayaa kaliya waxtar u leh sagxadaha bannaanka ah, halka jeermiska balaasaha ee hydrogen peroxide uu u baahan yahay waqti dheer oo sun-saarid ah ka hor wareegga jeermiska ee soo socda5.
Ozone waxay leedahay sifooyin liddi ku ah daxalka waxaana lagu soo saari karaa si aan qaali ahayn8.Waxa kale oo la og yahay inay sun ku tahay caafimaadka bini'aadamka, laakiin waxay si degdeg ah u burburi kartaa ogsijiin 8. Dielectric barrier discharge (DBD) balasmaha reactors ayaa ilaa hadda ah kuwa ugu badan ee soo saara ozone9.Qalabka DBD wuxuu kuu ogolaanayaa inaad ku abuurto balasmaha heerkulka hooseeya ee hawada oo aad soo saarto ozone.Ilaa hadda, isticmaalka dhabta ah ee ozone waxa uu badiyaa ku koobnaa jeermi-dilista biyaha barkada dabaasha, biyaha la cabbo iyo bulaacada10.Daraasado dhowr ah ayaa ka warbixiyay isticmaalkeeda goobaha daryeelka caafimaadka8,11.
Daraasaddan, waxaan isticmaalnay koronto-dhaliyaha ozone ee DBD balaasmaha si aan u muujino waxtarkeeda nadiifinta MDRO iyo C. adag, xitaa kuwa lagu tallaalay agabyo kala duwan oo caadi ahaan loo isticmaalo goobaha caafimaadka.Intaa waxaa dheer, habka jeermiska ozone ayaa lagu faahfaahiyay iyada oo la adeegsanayo sawirada awoodda atomikada ee microscopy (AFM) ee unugyada ozone-daaweeyay.
Cadaadiska ayaa laga helay go'doomin bukaan-socod oo kala ah: VRE (SCH 479 iyo SCH 637), carbapenem u adkaysta Klebsiella pneumoniae (CRE; SCH CRE-14 iyo DKA-1), carbapenem u adkaysta Pseudomonas aeruginosa (CRPA; 54 iyo 83) iyo bakteeriyada carbapenem u adkaysta.bakteeriyada Pseudomonas aeruginosa (CRPA; 54 iyo 83).Acinetobacter baumannii adkaysi u leh (CRAB; F2487 iyo SCH-511).C. difficile waxaa laga helay Ururinta Dhaqanka Pathogen National (NCCP 11840) ee Wakaaladda Koorayada ee Xakamaynta iyo Kahortagga Cudurrada.Waxaa laga go'doomiyay bukaan ku sugan Kuuriyada Koonfureed sanadka 2019 waxaana la ogaaday inuu ka tirsan yahay ST15 iyadoo la adeegsanayo isku xigxiga isku xigxiga.Faleebo Wadnaha Maskaxda ah (BHI) maraq (BD, Sparks, MD, USA) oo lagu talaalay VRE, CRE, CRPA iyo CRAB ayaa si wanaagsan loo qasay waxaana lagu duray 37° C. muddo 24 saacadood ah.
C. difficile ayaa si anaerobically ah loogu dhuftey agar dhiiga muddo 48 saacadood ah.Dhawr deegaan ayaa markaa lagu daray 5 ml oo maraq wadnaha maskaxda ah waxaana lagu duray xaaladaha anaerobic ee 48 saacadood.Taas ka dib, dhaqanka waa la ruxay, 5 ml oo ah 95% ethanol ayaa lagu daray, mar kale ruxay oo ka tagay heerkulka qolka 30 daqiiqo.Ka dib markii centrifugation at 3000 g 20 daqiiqo, iska tuur supernatant oo laali pellet ka kooban kudka iyo dilay bakteeriyada 0.3 ml oo biyo ah.Unugyada shaqayn kara waxaa lagu tiriyey abuur wareeg ah oo ah joojinta unugga bakteeriyada ee taarikada dhiigga ka dib marka la qaso.Midabaynta garaamku waxay xaqiijisay in 85% ilaa 90% dhismayaasha bakteeriyada ay yihiin kudka.
Daraasaddan soo socota ayaa la sameeyay si loo baaro saamaynta ozone sida jeermiska dile ee dusha kala duwan ee wasakhaysan MDRO iyo C. kudka adag, kuwaas oo loo yaqaan inay sababaan caabuqyada la xiriira daryeelka caafimaadka.Diyaari muunado ka samaysan birta, dhar (suuf), galaas, balaastiig (acrylic), iyo alwaax ( geed) oo cabbiraya hal senti mitir hal sentimitir.Jeermis ka-saar tigidhada ka hor isticmaalka.Dhammaan shaybaarada waxaa lagu jeermilay autoclaving ka hor inta aan la qaadin bakteeriyada.
Daraasaddan, unugyada bakteeriyada ayaa ku faafay dusha sare ee kala duwan iyo sidoo kale taarikada agar.Dabaqyada ayaa markaa la nadiifiyaa iyada oo loo soo bandhigayo ozone waqti cayiman iyo meel gaar ah oo lagu hayo qol xiran.On berde.1 waa sawirka qalabka jeermiska dila.Dib-u-kicinta balasmaha ee DBD waxaa la sameeyay iyadoo lagu dhejiyay korantada birta ah ee dalool iyo bannaanka ah xagga hore iyo gadaal ee 1 mm dhumucdiisuna waxay tahay alumina (dielectric).Electrodes daloolsan, aperture-ka iyo aagga daloolku waxay ahaayeen 3 mm iyo 0.33 mm, siday u kala horreeyaan.Electrode kastaa wuxuu leeyahay qaab wareegsan oo leh dhexroor 43 mm.Koronto sare oo soo noqnoqota tamarta soo noqnoqda (GBS Elektronik GmbH Minipuls 2.2) ayaa loo adeegsaday in lagu dabaqo korantada sinusoidal ee ku dhawaad ​​8 kV ugu sarreysa si ay ugu sarreyso soo noqnoqoshada 12.5 kHz ilaa electrodes daloolsan si loo dhaliyo balaasmaha cidhifyada elektirodyada.electrodes daloolin.Maadaama ay tignoolajiyadu tahay habka jeermiska gaaska, jeermiska waxaa lagu fuliyaa qol loo qaybiyay mugga qaybo sare iyo hoose, kuwaas oo ka kooban muunado wasakhaysan bakteeriyada iyo matoorayaasha balaasmaha, siday u kala horreeyaan.Qaybta sare waxay leedahay laba dekedood oo waalka ah si ay meesha uga saarto ugana soo saarto hadhaaga ozone.Ka hor inta aan la isticmaalin tijaabada, isbeddelka wakhtiga fiirsashada ozone ee qolka ka dib markii la shiday rakibaadda balasmaha ayaa lagu qiyaasay iyadoo loo eegayo xajmiga nuugista ee xariiqda muraayadda ee 253.65 nm ee nalka meerkuriga.
(a) Qorshaha habaynta tijaabada ah ee jeermiska jeermiska ee walxaha kala duwan iyadoo la isticmaalayo ozone ka soo saaray falcelinta plasma ee DBD, iyo (b) feejignaanta ozone iyo wakhtiga jiilka balaasmaha qolka jeermiska.Sawirka waxaa la sameeyay iyadoo la adeegsanayo OriginPro nooca 9.0 (OriginPro software, Northampton, MA, USA; https://www.originlab.com).
Marka hore, iyada oo la nadiifiyo unugyada bakteeriyada ee lagu dhejiyo taarikada agar ee ozone, iyada oo la beddelayo feejignaanta ozone iyo wakhtiga daaweynta, feejignaanta ozone ee ku habboon iyo wakhtiga daaweynta sun-saarista MDRO iyo C. difficile ayaa la go'aamiyay.Inta lagu jiro habka jeermis-diridda, qolka marka hore waxaa lagu nadiifiyaa hawada jawiga ka dibna waxaa lagu buuxiyaa ozone iyadoo la shidinayo unugga balaasmaha.Ka dib shaybaarada lagu daaweeyay ozone muddo cayiman, bamka diaphragm ayaa loo isticmaalaa si looga saaro ozone soo hadhay.Cabbiradu waxay adeegsadeen muunad dhaqan 24-saac ah oo dhammaystiran (~ 108 CFU/ml).Tusaalooyinka cayrinta unugyada bakteeriyada (20 μl) ayaa marka hore si taxane ah loogu qasi jiray toban jeer iyadoo lagu daray salineed nadiif ah, ka dibna muunadahan waxaa lagu qaybiyey taarikada agar ee lagu nadiifiyey ozone ee qolka.Intaa ka dib, muunado soo noqnoqda, oo ka kooban muunado qaawan oo aan soo gaadhin ozone, ayaa lagu duray 37°C muddo 24 saacadood ah waxaana la tiriyey deegaamada si loo qiimeeyo waxtarka jeermiska.
Dheeraad ah, marka loo eego xaaladaha jeermiska ee lagu qeexay daraasaddan kor ku xusan, saamaynta sun-saarka ee tignoolajiyadan ee MDRO iyo C. difficile ayaa lagu qiimeeyay iyada oo la adeegsanayo tigidhada alaabta kala duwan (birta aan la taaban karin, dharka, muraayadda, caagagga iyo qoryaha qoryaha) sida caadiga ah loo isticmaalo xarumaha caafimaadka.Dhaqan 24 saac oo dhameystiran (~ 108 cfu/ml) ayaa la isticmaalay.Tusaalooyinka cayrinta unugyada bakteeriyada (20 μl) ayaa si isdaba joog ah loogu qasi jiray toban jeer milix nadiif ah, ka dibna rasiidhada ayaa la dhex galiyay maraqyadan la qasay si loo qiimeeyo wasakhda.Muunado la saaray ka dib markii la dhex geliyo maraq fuuq-baxa waxaa lagu riday suxuunta Petri ee aan nadiifka ahayn waxaana lagu qalajiyey heerkulka qolka 24 saacadood.Daboolka saxanka saara muunada oo si taxadar leh u rid qolka tijaabada.Ka saar daboolka saxanka Petri oo u bandhig muunada 500 ppm ozone 15 daqiiqo.Saambalada xakamaynta ayaa la dhex dhigay golaha badbaadada noolaha oo aan la gaadhin ozone.Isla markiiba ka dib soo-gaadhista ozone, muunado iyo muunado aan shucaac ahayn (ie kontaroolada) ayaa lagu qasi jiray milix aan nadiif ahayn iyadoo la isticmaalayo qasiyaha vortex si looga saaro bakteeriyada dusha sare.Joojinta la caddeeyey ayaa si isdaba joog ah loogu qasi jiray 10 jeer iyada oo leh salin nadiif ah, ka dib tirada bakteeriyada la qasi karo ayaa lagu go'aamiyay taarikada agar ee dhiigga (bakteeriyada aerobic) ama taarikada agar ee dhiigga anaerobic ee Brucella (loogu talagalay Clostridium difficile) waxaana lagu dhajiyay 37 ° C 24 saacadood.ama xaaladaha anaerobic ee 48 saacadood oo ah 37 ° C oo nuqul ah si loo go'aamiyo diiradda bilowga ah ee tallaalka.Farqiga u dhexeeya tirada bakteeriyada ee u dhaxaysa kontaroolada aan la soo bandhigin iyo shaybaarada qaawan ayaa la xisaabiyay si loo dhimo tirada bakteeriyada (sida, waxtarka jeermiska) ee xaaladaha tijaabada.
Unugyada bayooloji waa inay ku dhaqaaqaan saxan sawirka AFM;Sidaa darteed, saxan mica ah oo fidsan oo isku mid ah oo leh miisaan qallafsan oo ka yar cabbirka unugga ayaa loo isticmaalaa substrate ahaan.Dhexroorka iyo dhumucdiisuna waxay ahaayeen 20 mm iyo 0.21 mm, siday u kala horreeyaan.Si unugyadu si adag loogu xidho dusha sare, dusha sare ee miika waxa lagu dahaadhay poly-L-lysine (200 µl), taas oo ka dhigaysa mid si togan loo dallacay iyo xuubka unugga oo si xun loo dallacay.Ka dib markii lagu dahaadhay poly-L-lysine, saxanka mica waxaa lagu maydhay 3 jeer biyo 1 ml deionized (DI) iyo hawo la qalajiyey habeenkii.Kadibna, unugyada bakteeriyada ayaa lagu dabaqay dusha sare ee mica ah oo lagu daboolay poly-L-lysine iyadoo la eegayo xal bakteeriyada dilute, oo ka tagay 30 min, ka dibna dusha sare ee mica waxaa lagu maydhay 1 ml oo biyo ah.
Kala badh shaybaarada waxaa lagu daaweeyay ozone iyo qaabka dusha sare ee taarikada mica ah ee ay ku raran yihiin VRE, CRAB iyo C. kudka adag ayaa la arkay iyadoo la isticmaalayo AFM (XE-7, nidaamka park).Habka AFM ee hawlgalka ayaa lagu dejiyay habka garaacista, taas oo ah habka caadiga ah ee sawirada unugyada noolaha.Tijaabooyinku, microcantilever oo loogu talagalay qaabka aan xidhiidhka ahayn (OMCL-AC160TS, OLYMPUS Microscope) ayaa la isticmaalay.Sawirada AFM ayaa la duubay iyadoo lagu salaynayo heerka iskaanka baadhista ee 0.5 Hz taasoo keentay in sawir laga qaado 2048 × 2048 pixels.
Si loo go'aamiyo xaaladaha ay reactors Plasma DBD waxtar u yihiin jeermiska, waxaan samaynay tijaabo taxane ah oo isticmaalaya MDRO (VRE, CRE, CRPA, iyo CRAB) iyo C. adag tahay in la beddelo fiirsashada ozone iyo wakhtiga soo-gaadhista.On berde.1b waxay tusinaysaa qalooca wakhtiga ozone ee xaalad kasta oo tijaabo ah kadib marka la shido aaladda balasmaha.Feejignaanta waxay u korodhay logarithmically, iyadoo gaadhay 300 iyo 500 ppm ka dib 1.5 iyo 2.5 daqiiqo, siday u kala horreeyaan.Tijaabooyin horudhac ah oo lagu sameeyay VRE ayaa muujiyay in ugu yar ee loo baahan yahay in si wax ku ool ah bakteeriyada looga saaro ay tahay 300 ppm ozone 10 daqiiqo.Sidaa darteed, tijaabooyinka soo socda, MDRO iyo C. difficile ayaa lagu soo bandhigay ozone laba qaybood oo kala duwan (300 iyo 500 ppm) iyo laba jeer oo kala duwan (10 iyo 15 daqiiqo).Waxtarka nadiifinta ee qiyaasta ozone kasta iyo goobta wakhtiga soo-gaadhista ayaa la xisaabiyay waxaana lagu muujiyay shaxda 1. Soo-gaadhista 300 ama 500 ppm ozone 10-15 daqiiqo waxay keentay hoos u dhaca guud ee VRE ee 2 ama ka badan log10.Heerkan sare ee bakteeriyada dilaaga ah ee CRE waxa lagu gaadhay 15 daqiiqo oo gaadhista 300 ama 500 ppm ozone. Hoos-u-dhac sare oo CRPA ah (> 7 log10) ayaa lagu gaadhay soo-gaadhista 500 ppm ozone 15 min. Hoos-u-dhac sare oo CRPA ah (> 7 log10) ayaa lagu gaadhay soo-gaadhista 500 ppm ozone 15 min. CRPA (> 7 log10) было достигнуто при воздействии 500 частей Hoos-u-dhac sare oo CRPA ah (> 7 log10) ayaa lagu gaadhay soo-gaadhista 500 ppm ozone muddo 15 daqiiqo ah.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. Hoos u dhac weyn oo ku yimid CRPA (> 7 log10) 15 daqiiqo ka dib soo-gaadhista 500 ppm ozone.Dilalka aan fiicnayn ee bakteeriyada CRAB ee 300 ppm ozone; si kastaba ha ahaatee, 500 ppm ozone, waxaa jiray hoos u dhac > 1.5 log10 ah. si kastaba ha ahaatee, 500 ppm ozone, waxaa jiray hoos u dhac > 1.5 log10 ah. однако при концентрации озона 500 частей на миллион наблюдалось снижение > 1,5 log10. si kastaba ha ahaatee, qiyaasta ozone ee 500 ppm, hoos u dhac>1.5 log10 ayaa la arkay.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. Si kastaba ha ahaatee, marka la eego qiyaasta ozone ee 500 ppm, hoos u dhac> 1.5 log10 ayaa la arkay. Soo bandhigida xadhkaha adag ee C. 300 ama 500 ppm ozone waxay keentay hoos u dhac> 2.5 log10 ah. Soo bandhigida xadhkaha adag ee C. 300 ama 500 ppm ozone waxay keentay hoos u dhac> 2.5 log10 ah. Воздействие на споры C. difficile озона с концентрацией 300 или 500 частей на миллион приводило к снижению 1,5. Soo bandhigida xadhkaha adag ee C. 300 ama 500 ppm ozone waxay keentay> 2.5 log10 hoos u dhac.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 снижению >2,5. Soo bandhigida xadhkaha adag ee C. 300 ama 500 ppm ozone waxay keentay> 2.5 log10 hoos u dhac.
Iyada oo ku saleysan tijaabooyinkii sare, shuruud ku filan ayaa la ogaaday in ay bakteeriyadu hawlgeliso qiyaasta 500 ppm ozone muddo 15 daqiiqo ah.VRE, CAB iyo C. kudka adag ayaa lagu tijaabiyay saamaynta jeermiska ee ozone ee agabyo kala duwan oo ay ka mid yihiin birta aan-daawaha lahayn, dharka, dhalooyinka, balaastiigga iyo alwaaxyada sida caadiga ah loo isticmaalo isbitaallada.Waxtarkooda jeermiska ayaa lagu muujiyay shaxda 2. noolaha tijaabada ah ayaa la qiimeeyay laba jeer.VRE iyo CRAB, ozone waxtar yar ayuu ku lahaa dusha dhalada iyo bacaha, inkastoo log10 dhimis qiyaastii ah 2 ama in ka badan lagu arkay birta, dharka iyo sagxadaha alwaax.C. Kudka adag ayaa la ogaaday in ay aad ugu adkeysanayaan daaweynta ozone marka loo eego dhammaan noolaha kale ee la tijaabiyay.Si loo xisaabiyo saameynta ozone ee saameynta dilka ee walxaha kala duwan ee ka soo horjeeda VRE, CRAB, iyo C. adag, t-tijaabooyin ayaa loo isticmaalay in lagu barbardhigo farqiga u dhexeeya tirada CFU halkii millilitir ee xakamaynta iyo kooxaha tijaabada ah ee alaabta kala duwan (Jaantus 2).Noocyada ayaa muujiyay kala duwanaansho muhiim ah, laakiin kala duwanaansho aad u weyn ayaa lagu arkay VRE iyo CRAB spores marka loo eego C. kudka adag.
Kala firdhiso saamaynta ozone ee dilka bakteeriyada ee agabyada kala duwan (a) VRE, (b) CRAB, iyo (c) C. difficile.
Sawirka AFM waxaa lagu sameeyay ozone-la daweeyay oo aan la daawayn VRE, CRAB, iyo C. kudka adag si loo barto si faahfaahsan habka jeermiska gaaska ozone.On berde.3a, c iyo e waxay muujinayaan sawirada AFM ee VRE, CAB iyo C. kudka adag ee aan la daawayn, siday u kala horreeyaan.Sida lagu arkay sawirada 3D, unugyadu waa siman yihiin oo dhawrsan yihiin.Jaantusyada 3b, d iyo f waxay muujinayaan VRE, CRAB iyo C. kudka adag ka dib daawaynta ozone.Ma aha oo kaliya inay hoos u dhigeen cabbirka guud ee dhammaan unugyada la tijaabiyay, laakiin korkooda ayaa noqday mid si muuqata u qallafsan ka dib soo-gaadhista ozone.
Sawirada AFM ee VRE, MRAB iyo C. kudka adag (a, c, e) iyo (b, d, f) oo lagu daaweeyay 500 ppm ozone 15 daqiiqo.Sawirada waxaa lagu sawiray Park Systems XEI nooca 5.1.6 (XEI Software, Suwon, Korea; https://www.parksystems.com/102-products/park-xe-bio).
Cilmi-baadhisteenu waxay muujinaysaa in ozone-ka ay soo saartay qalabka balasmaha ee DBD ay muujinayso awoodda ay si wax ku ool ah u wasakhayso MDRO iyo C. kudka adag, kuwaas oo la og yahay inay yihiin sababaha ugu waaweyn ee caabuqyada la xiriira daryeelka caafimaadka.Intaa waxaa dheer, daraasaddeena, marka la eego in wasakheynta deegaanka ee MDRO iyo C. kudka adag ay noqon karaan isha caabuqyada la xiriira daryeelka caafimaadka, saameynta jeermiska ee ozone waxaa lagu ogaaday in lagu guuleysto alaabta ugu horrayn loo isticmaalo goobaha isbitaalka.Tijaabooyin sun-saarid ah ayaa la sameeyay iyadoo la adeegsanayo qalabka balaasmaha ee DBD ka dib wasakhaynta macmalka ah ee alaabta sida birta aan la soo koobi karin, maro, dhalo, caag iyo alwaax leh MDRO iyo C. kudka adag.Natiijo ahaan, in kasta oo saameynta sun-saariddu ay kala duwan tahay iyadoo ku xiran walxaha, awoodda wasakheynta ee ozone waa mid cajiib ah.
Walxaha sida badan loo taabto ee qolalka cisbitaalku waxay u baahan yihiin jeermis-dile oo heer hoose ah oo joogto ah.Habka caadiga ah ee wasakheynta walxahan oo kale waa nadiifinta gacanta ee jeermiska dareeraha ah sida xarun ammonium quaternary 13. Xitaa iyada oo si adag loogu hoggaansamo talooyinka isticmaalka jeermiska, MPO way adagtahay in laga saaro nadiifinta deegaanka ee dhaqameed (sida caadiga ah nadiifinta gacanta)14.Sidaa darteed, tignoolajiyada cusub ayaa loo baahan yahay, sida hababka aan xiriirka ahayn.Sidaa darteed, waxaa jiray xiiso loo qabo jeermiska gaaska, oo ay ku jiraan hydrogen peroxide iyo ozone10.Faa'iidada jeermis-dileyaasha gaaska ayaa ah inay gaari karaan meelo iyo walxo aysan hababka dhaqanka ee buuggu gaari karin.Hydrogen peroxide ayaa dhawaan loo isticmaalay goobaha caafimaadka, si kastaba ha ahaatee hydrogen peroxide lafteedu waa sun waana in loo maareeyaa habraacyo adag oo maarayn.Nadiifinta balaasmaha leh hydrogen peroxide waxay u baahan tahay waqti nadiifin ah oo aad u dheer kahor wareegga xiga ee jeermiska.Taas bedelkeeda, ozone waxay u shaqeysaa sidii wakiilka bakteeriyada ballaaran, wax ku ool ah bakteeriyada iyo fayrasyada u adkaysta jeermiska kale8,11,15.Intaa waxaa dheer, ozone waxaa laga soo saari karaa si raqiis ah hawada atmospheric oo aan u baahnayn kiimikooyin sun ah oo dheeraad ah oo ka tagi kara raad waxyeello leh deegaanka, maadaama ay ugu dambeyntii u jajabiso oksijiinta.Si kastaba ha ahaatee, sababta ozone aan si weyn loogu isticmaalin jeermis-dile ahaan waa sidan soo socota.Ozone waxay sun u tahay caafimaadka bini'aadamka, sidaa awgeed xoogasaarkeedu kama badna 0.07 ppm celcelis ahaan in ka badan 8 saacadood16Waxa kale oo suurtogal ah in la neefsado gaaska oo la soo saaro ur aan fiicnayn ka dib marka la nadiifiyo5,8.Ozone si firfircoon looguma isticmaalin xarumaha caafimaadka.Si kastaba ha ahaatee, ozone waxaa si badbaado leh loogu isticmaali karaa qolalka jeermis-dilista iyo hababka hawo-qaadista ee habboon, ka saaristiisana si weyn ayaa loo dedejin karaa iyadoo la adeegsanayo beddele katalytik ah.Daraasaddan, waxaan ku tusineynaa in nadiifiyaha ozone ee plasma loo isticmaali karo jeermi-dilista goobaha daryeelka caafimaadka.Waxaan soo saarnay qalab leh awood nadiifin sare, qalliin fudud iyo adeeg degdeg ah oo loogu talagalay bukaannada isbitaallada jiifa.Intaa waxa dheer, waxaanu samaynay unug nadiifin fudud oo isticmaala hawada agagaaraha iyada oo aan kharash dheeraad ah lahayn.Ilaa hadda, waxaa jira macluumaad ku filan oo ku saabsan shuruudaha ozone ee ugu yar ee hawl-qabad la'aanta MDRO.Qalabka loo isticmaalo daraasaddeena waa sahlan tahay in la dejiyo oo leh wakhti gaaban oo gaaban waxaana la filayaa inuu waxtar u leeyahay jeermiska qalabka.
Habka ficilka bakteeriyada ee ozone si buuxda uma cadda.Daraasado dhowr ah ayaa muujiyay in ozone ay waxyeelo u geysato xuubka unugyada bakteeriyada, taasoo keenta dheecaanka unugyada iyo ugu dambeyntii lysis unug17,18.Ozone waxay faragelin kartaa dhaqdhaqaaqa enzymatic-ka gacanta iyada oo la falgasha kooxaha thiol waxayna wax ka beddeli kartaa purine iyo pyrimidine saldhigyada nucleic acids.Daraasadani waxay soo bandhigtay qaab-dhismeedka VRE, CRAB, iyo C. kudka adag ka hor iyo ka dib daaweynta ozone waxaana lagu ogaaday in aysan hoos u dhicin xajmiga, laakiin sidoo kale waxay noqdeen kuwo si weyn u qallafsan dusha sare, taas oo muujinaysa dhaawaca ama daxalka xuubka sare.iyo walxaha gudaha oo ay ugu wacan tahay gaaska ozone waxay leeyihiin awood oksaydheyn oo xooggan.Waxyeelladani waxay u horseedi kartaa hawl-qabad la'aanta unugga, iyadoo ku xiran darnaanta isbeddellada gacanta.
C. kudka dhibka leh way adagtahay in laga saaro qolalka isbitaalka.Kutooyinku waxay ku haraan meelaha ay ku daadiyeen 10,20.Intaa waxaa dheer, in daraasaddan, inkastoo logarithmic ugu badnaan 10-laab dhimista tirada bakteeriyada ee taarikada agar ee 500 ppm ozone 15 daqiiqo ay ahayd 2.73, saamaynta bakteeriyada ee ozone on alaabta kala duwan oo ay ku jiraan C spores. adag ayaa la dhimay.Sidaa darteed, xeelado kala duwan ayaa loo tixgelin karaa si loo yareeyo caabuqa C. difficile ee goobaha daryeelka caafimaadka.Si loogu isticmaalo qolalka adag ee C. ee go'doonsan, waxa kale oo laga yaabaa inay faa'iido u leedahay in la hagaajiyo wakhtiga soo-gaadhista iyo xoojinta daaweynta ozone.Intaa waxaa dheer, waa in aan maskaxda ku haynaa in habka wasakheynta ozone uusan si buuxda u bedeli karin nadiifinta buug-gacmeedka caadiga ah jeermiska iyo xeeladaha ka hortagga jeermiska, iyo sidoo kale waxay noqon kartaa mid aad waxtar u leh xakamaynta C. Difficile 5.Daraasaddan, waxtarka ozone sida jeermiska dile ayaa ku kala duwanaatay noocyada kala duwan ee MPO.Waxtarka waxay ku xirnaan kartaa dhowr arrimood sida heerka korriinka, gidaarka unugga, iyo hufnaanta hababka dayactirka21,22.Sababta saamaynta jeermiska ee kala duwan ee ozone ee dusha sare ee shay kasta waxaa laga yaabaa inay sabab u tahay samaynta biofilm.Daraasado hore ayaa muujiyay in E. faecium iyo E. faecium ay kordhiyaan iska caabbinta deegaanka marka ay joogaan biofilms23, 24, 25. Si kastaba ha ahaatee, daraasaddan ayaa muujinaysa in ozone ay saameyn weyn ku leedahay bakteeriyada MDRO iyo C. kudka adag.
Xaddidaadda daraasaddeena ayaa ah in aan qiimeynay saameynta haynta ozone ka dib hagaajinta.Tani waxay keeni kartaa in la qiimeeyo tirada unugyada bakteeriyada ee shaqayn kara.
Inkasta oo daraasaddan loo sameeyay si loo qiimeeyo waxtarka ozone sida jeermiska dile ee goobta isbitaalka, way adagtahay in natiijadeena lagu soo koobo dhammaan goobaha isbitaalka.Haddaba, cilmi-baaris dheeraad ah ayaa loo baahan yahay si loo baaro ku-dhaqanka iyo ku-habboonaanta DBD ozone sterilizer-ka deegaanka cisbitaalka dhabta ah.
Ozone-ka ay soo saarto reactors plasma ee DBD waxay u noqon kartaa walax nadiif ah oo fudud oo qiimo leh MDRO iyo C. difficile.Haddaba, daawaynta ozone waxaa loo qaadan karaa beddel wax ku ool ah oo ka baxsan jeermiska deegaanka isbitaalka.
Xogta la isticmaalay iyo/ama lagu falanqeeyay daraasadda hadda jirta waxa laga heli karaa qorayaasha kala duwan marka la eego codsi macquul ah.
Istaraatiijiyada caalamiga ah ee WHO si loo xakameeyo caabbinta ka hortagga jeermiska.https://www.who.int/drugresistance/WHO_Global_Strategy.htm/en/ La heli karo.
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