بررسي احتمال آلودگي آب سردكن هاي تعدادي از بيمارستان هاي تهران با باكتري سودوموناس آئروجينوزا

Investigating the Probability of Water Coolers Contamination with Pseudomonas Aeruginosa in a number of Tehran Hospitals

زﻣﯿﻨﻪ و ﻫﺪف: ﺑﺮرﺳﯽ اﺣﺘﻤﺎل آﻟﻮدﮔﯽ آب ﺳﺮد ﮐﻦ ﻫﺎي ﺑﯿﻤﺎرﺳﺘﺎﻧﯽ ﺑﻪ ﻣﻨﻈﻮر ﺗﻌﯿـﯿﻦ ﮐﯿﻔﯿـﺖ آب ﻣﺼـﺮﻓﯽ اﻫﻤﯿـﺖ وﯾـﮋه اي در ﺳـﻼﻣﺖ ﺟﺎﻣﻌﻪ دارد. pseudomonas ﺑﻪ ﻋﻨﻮان ﯾﮏ ﭘﺎﺗﻮژن ﻓﺮﺻﺖ ﻃﻠﺐ ﻣﻮرد ﺗﻮﺟﻪ ﻣﯽ ﺑﺎﺷﺪ. از آن ﺟﺎﺋﯽ ﮐﻪ اﻣﮑـﺎن رﺷـﺪ ﺑـﺎ ﺣـﺪاﻗﻞ ﻧﯿﺎزﻫـﺎي ﻏﺬاﯾﯽ را دارد، ﻗﺎدر اﺳﺖ در آب ﺷﯿﺮ رﺷﺪ ﮐﻨﺪ. ﮐﻪ اﯾﻦ ﺗﻮاﻧﺎﯾﯽ ﺑﺎﻋﺚ ﺣﻀﻮر ﻣﺪاوم آن ﻫﺎ در ﻣﺤﯿﻂ ﻫﺎي ﺑﯿﻤﺎرﺳﺘﺎﻧﯽ ﺷﺪه اﺳﺖ. ﻫﺪف اﺻﻠﯽ اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺗﻌﯿﯿﻦ ﻣﯿﺰان آﻟﻮدﮔﯽ pseudomonas aeruginosa در آب ﺳﺮدﮐﻦ ﻫﺎي ﺗﻌﺪادي از ﺑﯿﻤﺎرﺳﺘﺎن ﻫﺎي ﺗﻬﺮان اﺳﺖ. روش ﺑﺮرﺳﯽ: ﻧﻤﻮﻧﻪ ﻫﺎي آب در 2 ﻓﺼﻞ ﭘﺎﯾﯿﺰ و زﻣﺴﺘﺎن ﺑﻪ ﺗﻌﺪاد 100ﻋﺪد ﻧﻤﻮﻧﻪ از آب ﺳﺮدﮐﻦ ﻫﺎي ﻣﺴﺘﻘﺮ از ده ﺑﯿﻤﺎرﺳـﺘﺎن در ﻧﻘـﺎط 5 ﮔﺎﻧﻪ ﺷﻬﺮ ﺗﻬﺮان ﺑﺮداﺷﺘﻪ ﺷﺪ. اﺑﺘﺪا ﻧﻤﻮﻧﻪ ﻫﺎ در ﮐﻨﺎر ژل ﯾﺦ و در دﻣﺎي 4 درﺟﻪ ﺳﺎﻧﺘﯽ ﮔﺮاد ﺑﻪ آزﻣﺎﯾﺸﮕﺎه ﻣﻨﺘﻘﻞ و ﺑﻌﺪ ﻟﻮﻟﻪ ﻫﺎي ﺣﺎوي ﻣﺤﯿﻂ ﮐﺸﺖ ﻫﺎي ﻣﺨﺘﻠﻒ ﺑﻪ ﻣﺪت 24 ﺗﺎ 48 ﺳﺎﻋﺖ در اﻧﮑﻮﺑﺎﺗﻮر ﺑﺎ دﻣﺎي 37 درﺟﻪ ﺳﺎﻧﺘﯽ ﮔﺮاد ﻧﮕﻬﺪاري ﺷﺪ. ﺳﭙﺲ ﻧﻤﻮﻧﻪ ﻫﺎ از ﻟﺤﺎظ ﻧﯿﺎز رﺷﺪ ﺑـﻪ ﻣﻮاد ﻣﻐﺬي، اﺳﺘﻔﺎده از ﮐﺮﺑﻮﻫﯿﺪرات از ﻃﺮﯾﻖ اﮐﺴﯿﺪاﺳﯿﻮن ﯾﺎ از ﻃﺮﯾﻖ ﺗﺨﻤﯿﺮ ﺻﻮرت ﮔﺮﻓﺘﻪ، ﻣﺴﯿﺮﻫﺎي ﺗﺨﻤﯿﺮ ﮔﻠﻮﮐﺰ و ﺗﻌﯿﯿﻦ ﻗﺪرت ﺑﺎﮐﺘﺮي در اﺳﺘﻔﺎده از ﺳﯿﺘﺮات وﺟﻮد آﻧﺰﯾﻢ اﮐﺴﯿﺪاز و ﮐﺎﺗﺎﻻز ﺑﺎ اﺳﺘﻔﺎده از ﻣﺤﯿﻂ ﻫﺎي ﮐﺸﺖ و ﺗﺴـﺘﻬﺎي اﺧﺘﺼﺎﺻـﯽ ﻣﺮﺑـﻮط ﺑﺮرﺳـﯽ ﺷـﺪ. ﺗﺠﺰﯾـﻪ و ﺗﺤﻠﯿﻞ داده ﻫﺎ ﺑﻪ ﺻﻮرت ﺗﻮﺻﯿﻔﯽ و ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮم اﻓﺰارﻫﺎيexcel وspss اﻧﺠﺎم ﮔﺮﻓﺖ. ﯾﺎﻓﺘﻪ ﻫﺎ: در ﻧﺘﯿﺠﻪ ﭘﮋوﻫﺶ اﻧﺠﺎم ﺷﺪه در ﻧﻤﻮﻧﻪ ﻫﺎي آزﻣﺎﯾﺸﮕﺎﻫﯽ ﺟﻨﺲ ﻫﺎي Bacillus ﺷﻨﺎﺳﺎﯾﯽ ﮔﺮدﯾﺪ. ﻫﻤﭽﻨﯿﻦ در ﻧﻤﻮﻧﻪ ﻫﺎي آزﻣﺎﯾﺶ ﺷﺪه ﺟﻨﺲ pseudomonas ﻣﺸﮑﻮك ﺑﻪ ﮔﻮﻧـﻪ aeruginosa و ﺟـﻨﺲ alcaligenes ﻣﺸـﮑﻮك ﺑـﻪ ﮔﻮﻧـﻪ Fecalis ﻧﯿـﺰ ﻣـﻮرد ﺷﻨﺎﺳﺎﯾﯽ ﻗﺮار ﮔﺮﻓﺖ. ﺑﺤﺚ و ﻧﺘﯿﺠﻪ ﮔﯿﺮي: دﻣﺎ ﺗﺎﺛﯿﺮ ﺑﻪ ﺳﺰاﯾﯽ در رﺷﺪ ﺑﺎﮐﺘﺮي pseudomonas aeruginosa دارد و دﻣﺎي ﺑﺎﻻي 37 درﺟﻪ ﺳﺎﻧﺘﯽ ﮔﺮاد ﺑﺎﻋﺚ اﻓﺰاﯾﺶ رﺷﺪ و دﻣﺎي ﭘﺎﯾﯿﻦ ﺗﺮ از 4 درﺟﻪ ﺳﺎﻧﺘﯽ ﮔﺮاد در زﻣﺎن ﺗﺎﺑﺶ ﺧﻮرﺷﯿﺪ اﻟﺒﺘﻪ در ﻫﻮاي ﺳﺮد )ﭘﺎﯾﯿﺰ و زﻣﺴـﺘﺎن( ﺑﺎﻋـﺚ ﮐـﺎﻫﺶ و ﻣﺸﺎﻫﺪه ﻧﺸﺪن ﺑﺎﮐﺘﺮي pseudomonas aeruginosa در آب ﺳﺮدﮐﻦ ﻫﺎ ﻣﯽ ﺷﻮد.

Background and Objective: Evaluation of the probability of water cooler contamination in hospitals to determine the water quality has important role in social safty. Pseudomonas Aeruginosa is considered as an opportunistic pathogen, since it is possible to grow with minimal nutritional requirements, it can grow in water bodies containing very little food such as tap water. This ability has led to their continuous presence in the hospital environment. The main objective of this study was to determine the rate of contamination in few of Tehran's hospitals water-cooling devices in terms of contamination with Pseudomonas Aeruginosa. Method: This is an experimental study and the stages of work were based on observation and test in the laboratory. Water samples were sampled in two seasons (autumn and winter) in 100 samples from five hospitals in different regions of Tehran. At first, the samples were transferred to the laboratory in a compartment filled with ice gel at 4 °C, and then the tubes containing different media were kept in an incubator at 37 °C for 24 to 48 hours. Then, the samples were examined for nutritional needs in terms of growth rate, carbohydrate usage by possible bacteria through oxidation or fermentation, glucose fermentation pathways, and determination of the bacterial power in the use of citrate, the presence of enzyme oxidase and catalase, the presence or absence of Enterobacteriaceae species and Salmonella was examined using culture media and specific tests. Data analysis was done descriptively using excel and SPSS software. Findings: As a result of the research Bacillus species were identified. Also, in the tested specimens, pseudomonas susceptible to Aeruginosa species and the suspected alcaligenes species of Faecalis were also identified. Discussion &Conclusion: The temperature has a significant effect on the growth of the Pseudomonas Aeruginosa, and a high temperature of 37 °C leads to the increase in growth rate, and in low