초음파 검사용 젤 용기의 사용빈도에 따른 오염도 조사에 관한 연구 = A Study on Investigation of Bacterial Contamination Level According to the Frequency of Use of Gel Container for Ultrasound Inspection

다국어 초록 (Multilingual Abstract)

The aim of the present study was to establish a safe examination room for ultrasonography free from infectious diseases by identifying causes of bacterial proliferation using an ultrasonographic gel after contacting an examiner’s skin for ultrasonographic examination. To examine plausible bacterial contamination during processes of manufacturing and preservation, gel products and containers of gels used for ultrasonography were obtained from three suppliers and cultured for predetermined intervals every week for four weeks.
In addition, hands of examiners for performing ultrasonographic examination were sampled to determine the degree of bacterial contamination and sources of infection of diseases before taking respective ultrasonographic examinations.
Hands of examiners, before and after washing each hand, were sampled to investigate changes in colonies. Results of this study revealed that gel products initially obtained from each supplier had no bacteria.
However, after gels products and containers were used repetitively for four weeks, bacteria such as Staphylococcus epidermidis, Micrococcus luteus, Leuconostoc mesenteroid spp cremoris, and Kocuria rhizophila were detected from hands and skin of examiners.
At the first week with the largest number of examinations, 44 bacterial colonies were identified. In the fourth week with the least number of examinations, only four bacterial colonies were found. The increase in the number of colonies was proportional to the increase in the number of examination (r = 0.994). Numbers of bacterial colonies after washing each hand of examiners were decreased by 76.1% (right hand) and 69.5% (left hand) compared to those obtained before washing hands (p value = 0.085).
Conclusively, sources of infection were identified as hands of examiners other than gel products. Opportunistic infections, particularly for patients with low levels of immunity, could be attributable to gels products or containers handled by hands of examiners contaminated with bacteria. Thus, strict sterilization of each hand is essential for the prevention of infections associated with medical interventions.

목차 (Table of Contents)

• Ⅰ. 서론 1
• 1. 연구 배경 1
• 1.1 초음파 진단장치의 이용 분야 4
• 1.2 진단 초음파 검사의 역할 7
• 1.3 진단 초음파 이용 분야 8
• 1.4 초음파 젤의 종류 18
• 1.5 국내 초음파 젤의 사용 환경 실태 19
• Ⅱ. 이론적 배경 20
• 1. 표준주의와 전파경로별주의 지침 20
• 2. 소독과 멸균 지침 23
• 2.1 의료기관의 소독과 멸균 관련 법 규정 23
• 2.2 소독 및 멸균 주요 용어 24
• 3. 기구에 따른 재처리 방법 27
• 3.1 초음파 탐촉자 27
• 3.2 초음파 젤 관리 28
• 4. 의료기기 세균 오염도와 초음파에 관한 연구 동향 29
• 5. 연구 목적 31
• Ⅲ. 연구 방법 및 재료 32
• 1. 연구 설계 32
• 2. 검체 및 배양 방법 33
• 3. 동정 35
• 4. 연구 방법 36
• 4.1 초음파 젤의 초기오염도 조사 36
• 4.2 초음파 젤 용기의 장시간 사용에 따른 오염도 조사 37
• 4.3 검사자의 손 세척 전후 비교 조사 40
• 5. 통계 분석 42
• Ⅳ. 결과 43
• 1. 초음파 젤의 초기오염도 43
• 2. 초음파 젤 용기의 장시간 사용에 따른 오염도 44
• 3. 검사자의 손 세척 전후 비교 50
• Ⅴ. 고찰 54
• Ⅵ. 결론 58
• 참고 문헌 59