UV-C LED对柔性鼻咽喉镜的消毒：微生物学、经济学、环境与立法评估

文献信息

中文摘要

目的： 评估Ray-Two紫外-C（UV-C）发光二极管（LED）消毒舱在耳鼻咽喉科（ORL）实践中对柔性鼻咽喉镜再处理的微生物学效能，并将其经济与生态影响与使用Tristel Trio Wipes System（TTWS）的化学高水平消毒进行比较。
方法： 在一项于三级ORL中心开展的前瞻性研究中，对20条柔性鼻咽喉镜在常规后鼻镜检查和/或喉镜检查后立即评估细菌污染。从远端10-12 cm镜杆在再处理前后采集配对拭子样本：先以自来水手动预清洗，随后进行4分钟UV-C LED循环。样本在TSA-5%绵羊血琼脂上于35°C-37°C培养36小时，并计数菌落形成单位（CFU）。基于每年5000例操作，通过生命周期评估（ISO 14040/14044）计算每循环成本与碳足迹，并与TTWS进行比较。
结果： 再处理前CFU中位数（IQR；范围）为15（3-27；2至>200），UV-C后降至0（0-0；0-1）（p < 0.001；减少>99%；19/20样本无菌）。UV-C每循环成本为€0.56（TTWS为€8.32；节省93%），碳足迹为6.81 g CO2e（TTWS为115.8 g；减少94%）。年度节省：€38,800和548 kg CO2e。
结论： Ray-Two UV-C LED消毒舱在柔性鼻咽喉镜上实现近乎完全的细菌清除（19/20样本为100%；1/20样本残留1个CFU），与TTWS相比具有更优的成本效益和可持续性。这种无汞、即时护理方法在欧盟和美国各州关于含汞灯管的法规不断演变之际，支持更绿色的ORL实践，在不影响效能的情况下增强感染控制。

英文摘要

OBJECTIVE: To evaluate the microbiological efficacy of the Ray-Two ultraviolet-C (UV-C) light-emitting diode (LED) chamber for reprocessing flexible rhinolaryngoscopes in otorhinolaryngology (ORL) practice and compare its economic and ecological impacts with chemical high-level disinfection using the Tristel Trio Wipes System (TTWS).
METHODS: In a prospective study at a tertiary ORL center, bacterial contamination was assessed on 20 flexible rhinolaryngoscopes immediately after routine posterior rhinoscopy and/or laryngoscopy. Paired swab samples were collected from the distal 10-12 cm shaft pre- and post-reprocessing: manual pre-cleaning with tap water followed by a 4-min UV-C LED cycle. Samples were cultured on TSA-5% sheep blood agar for 36 h at 35°C-37°C, with colony-forming units (CFUs) enumerated. Per-cycle costs and carbon footprints were calculated via life cycle assessment (ISO 14040/14044) and compared with TTWS, based on 5000 annual procedures.
RESULTS: Pre-reprocessing median CFUs (IQR; range) were 15 (3-27; 2 to > 200), reducing to 0 (0-0; 0-1) post-UV-C (p < 0.001; > 99% reduction; 19/20 samples sterile). UV-C per-cycle cost was €0.56 (vs. €8.32 for TTWS; 93% savings), with a carbon footprint of 6.81 g CO2e (vs. 115.8 g; 94% reduction). Annual savings: €38,800 and 548 kg CO2e.
CONCLUSION: The Ray-Two UV-C LED chamber achieves near-complete bacterial elimination (100% in 19/20 samples; 1 residual CFU in 1/20 samples) on flexible rhinolaryngoscopes, with superior cost-efficiency and sustainability versus TTWS. This mercury-free, point-of-care method supports greener ORL practice amid evolving EU and US state-level regulations on mercury-containing lamps, enhancing infection control without compromising efficacy.