17/5/2016

Snhimvisinhvttrongkhngkh,phngphpkimtravtiuchunnhgi

Mitrnglaong

Snhimvisinhvttrongkhngkh,phngphpkimtravtiuchun
nhgi
TmttSnhimvisinhvttrongkhngkhlmttrongnhngvncncquantmkhinhgichtlngmi
trng khng kh ti ni lm vic. Vic chun ha cc phng php ly mu vi sinh trong khng kh cng nh phng
phpnhgicccnhkhoahc,cctchccuytntrnthgiinghincuvbanhnhtuynhinvnchacs
thngnht.Bivitnynhmtngquanliccvnccphngphpkimtra,nhgisnhimvisinhtrongkhng
khtrncscctiuchuncbanhnhvsai,davomcccssnxutcththamkhonhgi
chtiuvisinhtrongkhngkhkhiVitNamvnchacnhngnghincuybanhnhtiuchunny.

1.Mu
Visinhvttimntrongmitrngkhngkhnidinracchotngcaconngivtrthnhmtyut
nguyc,cbitltrongbnhvin,trongcngnghipnichungvtrongnngnghip.Nhngnmgnyc
nhiunghincutinhnhthchinvickhostsnhimbncavisinhvttrongkhngkhtrongmitrnglm
vicvvicnhgimcnhimbncavisinhvttrongkhngkhmtkhuvcnguycnocxemnh
lmtbccbncacngtcphngnga.Tuynhin,nhiuvnlinquannphngphplymu,khost,
dingiiccktquvtiuchunvmcnhimcchpnhnvnangtrongqutrnhnghincu.TiVit
Nam,snhimvisinhvttrongkhngkhnhiungnhnghchacchnhiuvtiuchunvisinhvttrong
khngkhvnchacbanhnh,gykhkhnchocngtckimtra,nhginguycnhimkhngkhcacc
tcnhnvisinhtinilmvic.Trongbivitny,tcgitngquanvccphngphplymuvisinhtrongkhng
kh,cccchnhginhimvisinhtrongkhngkhangcsdngtrnthgiicgithamkho.Tuy
nhin,vnbanhnhtiuchunvisinhvttrongkhngkhnilmvicvnlmtmctiuludicnhngti.
2.Cchthcthumuvisinhvttrongkhngkh.
Hin nay, cch thc hiu qu nh lng vi khun trong khng kh vn l m khun lc. m khun lc trong
khngkhkhngphilmtcngvicngincnhiuphngphpkhcnhaucsdngvchiathnh4
nhmchnh:
3

mkhunlchnhthnh(ColonyformingunitCFU)trong1m khngkh:(cfu/m ).
mskhunlchnhthnh(ColonyformingunitCFU)trncca.
3

Khostthnhphnhahccacctbovikhuntrong1m khngkh.
mvisinhvtdiknhhinvi.
Vickhostccthnhphnhahccacctbovikhun(vdnhkhostnnglngATP,khostgenhoc
ccloienzyme)vnchacxemlphngphpngtincyvctnhthctinkhisdngnghincuvi
sinhtrongkhngkh.mdikinhhinvihoclmtngtrnhthnghunhquangnhhthngflycytometry
hoclphngphplaitichinsituchunhquanghinangcngdngkhhnchvcnangtiptc
cnghincu.Phngphpmkhunlchnhthnhangcsdngphbinnht,tuynhincngcnhiu
vnchacthngnht.
Victhumukhngkhkhostvisinhvthinnaycthctinhnhtheohaicch:theophngphply
muchngvphngphplymuthng(phngphpta).Chaiphngphpnyucsdng
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rngri,tuynhinphngphpnocngcnhnguimvnhcimring.
2.1Phngphplymuchng.
3

nhimvisinhtrongkhngkhcthkhostcthngquavicmskhunlchnhthnhtrong1m khng
3

kh(cfu/m ).Ngitasdngphngphplymuchngbngcchthunhnmtthtchkhngkhnhtnh
cbittrcvthiquamitrngdinhdngbngcckthutkhcnhau.Cnhiucngclymukhng
khcbntrnthtrngmmicngccthitkkhcnhaucthtmchiathnh7nhm,baogm:(1)
nhmlymusdngccngimpinger,(2)nhmlymusdngccimpactordngkhe(slittype),(3)nhms
dngccimpactordngsng(sievetype),(4)nhmlymucmnglc,(5)nhmlymulytm,(6)nhmphng
phplngtnhin,(7)nhmphngphptnhit.Tiuchunchnhthngivikhngkhvcbncngdatrn
3

vickhostscfu/m .Tuynhin,cnhiuphnhichothyrngrtkhcthgiithchmtcchngnkt
quthuctccthitbny.
Cngmtcngclymuchoraccktqukhcnhaudmuclycngmtnivcngmtthiim,cho
thycssaikhcrtln.Ccdngclymukhcnhaulichoraccktqukhcnhau.iucnghal
khngthsosnhccdliuthuckhisdngcccngclymukhcnhau.Nhiubiboccngb
mquanhgivsosnhcchiuqucacccngclymukhcnhau.Ktqucmtimchungls
lngkhunlcmckhcnhaukhisdngcngc,thitbkhcnhau.Nhvyrrnglkhcthlachn
cthitbnolngsdng.
ChnghnnhmtsnghincuchngtrngcngclymukhngkhdngimpactornhAndersenthuc
slngccvisinhvtcaohnngknhngthitbAndersen8thtthnthitbAndersen2th[11].Ngoira,
LembkephnnnvnhngsaikhcqulnkhisthitblymuAndersen6[6].nicnngvisinhcaohn
3

1000cfu/m thimpingerAG30choktqumkhunlccaogp6lnsoviphngphpquamnglcgelatin
(Gelatin membrane filtration GMF) [10], trong khi thit b ly mu ly tm Reuter (Reuter Centrifugal Sampler
RCS) cho thy hiu qu hn thit b ly mu c ct khe hay impinger lng [1]. Khi so snh phng php RCS vi
phngphplymuSAS(surfaceairsystemSAS)thycktqutngt:thitblymuRCSchoktqum
khunlccaohngp34lnsovihthngSAS[8].KhostbngthitbSASsuper90vRCSchothythphn
hnsovisdngthitbAndersen2thhaythitbBurkard.Verhoeffvcngsctnghplinhngktqukhc
nhaukhisdngccthitblymukhcnhaukhilitkvnhdngnmmc.Vicsosnhcthchinbng
cchsoktquca5thitblymutrnthtrnghinnay(lthitblymuckhethch,N6Anderson,SAS,
RCSvthitblymulcgelatin)kthpvi4mitrngnuicy.Ktquchothyktqucssaikhcln
ttcccphngphp.KtquthngkchothythitblymuctkhevN6AndersenkthpviDG18%
(dichloran18%glycerolagar)vMEA(maltextractagar)choktqucaonht[14].

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Snhimvisinhvttrongkhngkh,phngphpkimtravtiuchunnhgi

Thitblymuchngdngimpactor

ThitblymudnglytmRCS

Thitblymukhngkhbmt

Lymusdngmnglc

Thitbthumusdngccimpinger

Hnh1:Hnhminhhamtscngclymukhngkhbngphngphpchng.
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Snhimvisinhvttrongkhngkh,phngphpkimtravtiuchunnhgi

Ngoiccnhcimkhngthngnhtvsliukhostkhisosnhktqu,thitblymuchngcnrtt
tin,nng,gytingnvkhtuyttrng.Chngthngxuynphihiuchnhvthtchcakhngkhthuc
khngtngthchvimongi.Mthnchnacalymuchnglgiihnvkchcmukhngkh.in
3

hnhlthitblymuckhethchcdungtchlymul80L/pht.Nu1m khngkhckimtrathnyu
cuthigianl15.Mcdcnhngthitblymuccholckhnnglymuvithtchlnhnnhngcn
phixemxtnhngtnhhungnhtorasnhiulonvngkhngkhcnckhosttithiim,quatora
snhiulonnhntovlmthayislngkhunlcmc.Hnna,visinhvtsngcthbthottrong
qutrnhlymudotngtcvithitbhocvimitrngnuicy.
Tuynhin,ttcccquinhchnhthngkimsotccvisinhvttrongkhngkhchyuudatrnslng
3

khunlctrong1m khngkhmkhngcphnbitloithitblymunocsdng.ylmtvnquan
trngcnchvccthitblymuchngtrnthtrngrtkhcnhauvhiusutlmvic.
TiHoaK,tiuchunutinivivickhostccthnhphnnhimtrongkhngkhcbanhnhlTiu
chunlinbang209E(FederalStandard209E).Sauny,tiuchunFS209EcthaythbngtiuchunISO
14644vinhiunidungccitin[15].
TheotiliucaCEN/TC243,viclachnthitblymucnphitnhtonncctiuchunnhsau:(a)Kh
nngphthincnhimvisinhvttrongkhngkhmcthpviktqungtincy,(b)tcdngph
hpvimctiu(a),(c)Tcdngkhngkh/tngtcphhp,(d)thtchkhngkhctrngcthlyc
(e)mitrngnuicyphhp(f)trnglng/kchthcthitbdthaotc(g)thitbdvnhnh,(h)thitbd
dngvsinh,khnglylanvkhtrngc(i)thitbphiccngnhnvvicchunha[3].
2.2Phngphplymuthng(phngphpta).
phngphpny,ccapetricchamitrngnuicyctngoikhngkhtrongmtthigiannht
nh.Ccvisinhvtcmangvomitrngnuicynhccphnttrrivobmtcaavitctrung
o

bnhkhong0,46cm/s.Saukhi361 Cthchngmcthnhkhunlctlvisnhimbnvisinhvttrong
khngkh.

aRODAC

aPetri

Hnh2:Mtsloiathytinhchuyndngsdngtrongphngphpta
Nhcimchnhcaphngphptalkhngphitonbccvisinhvtkhosturivohoclcmi
tng quan yu vi cc khun lc xc nh bi cc phng php nh lng khc v vi th tch khng kh xung
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quanhxcnh.Vvymviclymutheotrnglchocltheoqutrnhdchchuynnycxemlphng
phpthumukhngnhlngvphngphpnybnhhngbikchcvhnhdngcaphntvbisdi
chuyncakhngkhxungquanh.Thtchkhngkhtccphntbanulkhngthbittrc.Ktquthu
ctphngphplymutheotrnglckhikhngnhlngchnhxchoclkhngsosnhcvicc
phngphplymukhc.Ngoira,thigiantakodit15phtti1hhochn.Soviphngphplymu
chng,phngphplymuthng(ta)cuimlccasdngcthtuyttrng,titkimvcth
sdngnhiuln,githnhrvdsdng.Ccktquthuctccatctnhlplivngtincy.Hn
na,nhiuaimtrongmitrngcthkimtractrongcngmtthiimvdliuthuctccat
nhngvtrkhcnhaucthsosnhcvinhau.Ngoira,khuynhhngtnhincaqunthvisinhvt
trongkhngkhikhngbnhiulontrongqutrnhlymuhockhngbdngkhngkhcntr.Phngphpt
acthdngkhostccthnhphnchicavikhunritrnbmtmtthiimxcnh,doktqu
cn c th nh gi c s nhim bn b mt t khng kh. Chnh v c nhiu u im ni tri hn hn so vi
phngphplymuchngnnphngphptackhuyncosdngnhiutrongcctiuchunvvi
sinhkhngkhcbanhnh.
3.Nhngtiuchunvvisinhtrongkhngkhcxut
Friberg v cng s xut rng phng php t a c th cho cc d liu v s nhim vi sinh b mt v
phngphpnythctinvccchstngngvtlnhimbnkhngkhthcthnlphngphpm
khunlcbngphngphpchng.Trongnghincuny,nhmtcgicxuttiuchunvisinhtrongphng
3

schtiAnhqucl<10cfu/m [5].
NhmtcgiPasquarellavcngsctinhnhnghincusosnhvtincycadliuthuctphng
phptavidliuthuct2phngphplymuthnglSASSurfaceAirSystem(PoolBioanalysis
Italian)vRCSReuterCentrifugalSampler(FolexBiotest).Vickhostvisinhvttrongmitrngvimc
nhimbnkhcnhauvsmuthucnhnhaucngmtaimvcngthigianivicbaphng
php.Ktquchothyphngphptachosliuclchchunthpnhtsovihaiphngphpcnli[9].
Tuynhin,phngphptacngcnhngnhcimchacthngnhtvphngphpnyangc
sdngvinhiucchthcrtkhcnhau.apetrisdngvingknhkhcnhau,thigiantakhcnhau,
mitrngnuicykhcnhau,thmchthigianvnhitcngkhcnhaudodnnvickhsosnhcc
dliuthucdonhngcchthckhcnhauny.
TiuchunvisinhvtutindatrnphngphptacxutbiFishertrongnhngnm1970vsau
chnhnhmnghincucangcngtheouivicnghincuxuttiuchunvisinhvcngbccbibo
vtiuchunnyvonhngnmsau.Trongnghincuutin,nhmnghincuthchinnhmmcchxc
o

nh cc thng s v phng php ly mu tt nht. S dng a petri 9cm v thch mu, sau 24h 37 C v
2

chuynktqutheonvtnhlcfu/dm ,ktqunghincucangchothysnhiuloncakhngkhkhng
lmnhhngtiktqumkhunlctrna.Vicchtatrongmitrngkhngkhtrongvng1hv
chngcchnntt80100cm,cchtng100150cm,nhmnghincuthucccgitrtrungbnhrt
huchnhgicsnhimvisinhvttrongmitrngkhngkh.Sau,tnghincunymquitrnh
1/1/1/cxutltiuchunkhostsnhimvisinhtrongkhngkhtrongbnhvin:apetrittrong
mitrngkhngkhtrong1h,cchsn1mvcchtng1m.Sau,ngccngbvccmcnhimvisinh
trongkhngkhcchpnhncckhuvckhcnhaucabnhvinvimcnhginguycvvisinhkhc
nhaunhsau[9]:
Bng1:mtngvisinhvttrongkhngkhtheoFisherticckhuvckhcnhaucabnhvin(sCFUtrna
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petringknh9cm,thchmy,ttrongmitrngkhngkhtheoquitrnh1/1/1).

Tuynhin,theotiuchuncaNASAsdngiviphngschvkhuvclmvickimsotvisinhvttrong
3

mitrngthvicmkhunlclictnhtheonvlcfu/m .ViclymulisdngccaPetrikch
2

thc73,5cm ttrongkhngkhtrong1hv2h,vtrttrong1m trongthigian1tun[7].Ngoira,theotiu

chun CEN/ISO ca Chu u v hng dn thc hin sn xut sch GMP (EU Guide to Good Manufacturing
Practice)thcnphitnhticvisinhvttrntay,trnccbmtvtrongkhngkh.Domaraccmc
schtnggimtheoccmcA,B,C,Dtngngvimimcthtiuchunctnhtheonvlsphn
3

t/m khngkh,scfu/m khngkh,scfu/a9cmtrongkhngkhtrong4h,scfu/aRODACvscfu/gng

tay,theobngnhsau:
Bng2:GiihnnhimvisinhtrongkhngkhtheotiuchunGMPcaChuu[4]

Ghich:
1

ta9cmtrongkhngkhtrong4h
ivibmtthdngatipxcRODAC,55cm
Scfutrntayceogngkhtrng.

Nhvy,rrnglvnchacsthngnhtvphngphpta.DovymccnhkhoahcthucphngV
sinhcatrngihcPerugiacngbvphngphpgimstvisinhtrongmitrngkhngkh(Microbial
environmentalmonitoring)mhnghincu.lmththnggimstvisinhbtkkhuvclmvicnoc
nguycbphinhimvivisinhvt.Phncbncahthngnyllpkhochgimstvisinhkhngkhmqua
cththitlpcchsphinhimvisinh(TheIndexofMicrobialAircontaminationIMA)thngquachsny,
ccnhnghincuhyvngcththngnhtcphngcchthclymuvtnhtonktqutheodatheo
phngphpta.
PhngphpkhostIMAngin,sdngapetri9cmvmitrngnuicyPCA(platecountagar)tngoi
o

khngkhtheoquitrnh1/1/1.Sauthigian48h361 Cthtinhnhnkhunlc,skhunlcchnhlsIMA.
ChsIMActhsdngkhostvisinhkhngkhnhiumitrngkhcnhaunhtrongbnhvin,trongnh,
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cctrnghc,vinnghincu,ccxngcngnghip,ngoitri,botng,thvin[9].Nucnctheochs
IMAthc5mcnhgiivivisinhtrongkhngkhnhbngsau:
Bng3:CcmccachsIMAvcchpdng

TiVitNam,vicnghincusnhimvisinhvttrongkhngkhhinnaychyudnglimckhost
nmcthctrngvvcbnphngphpcsdnglphngphplngbicaKock(phngphpt
a)[2],[12],[13].Phngphpnyvnhnchmcnhgivisinhkhngkhphngsch(cyucunghim
ngtvgiihnvisinhmcthpnhphngxtnghim,bnhvin)[2],dovicpdngkhostvisinh
khngkhnhiumitrngkhcnhaunhtrongnh,xngcngnghip,..vngoitrinuchdatrntiuchun
nhgicaKockscnhngbtcpchnghnnhmitrngtrongnhxngvithngthonghnch,
(cbitlcccssnxutlngthc,thcphm)thmcnhimvisinhcthsthn,tiuchunphi
nghimngthnnhngcngngoitrivithngthonghn,mtvisinhcthcaohnnhngtiuchunnh
gicthscphntnghimngthn.Tuynhin,hnchhintilchngtavnchacnhiunghincuvs
nhimvisinhtrongnhxng,domchacythngtinctharanhngxutvtiuchunvi
sinhkhngkhphhp.
4.Ktlun
Nhvy,trnthgiicnhiunlctiuchunhavicnhgivisinhvttrongkhngkhvnglmvic,
iunyquantrngvkhngnhnglmttrongnhngtiuchunnhgichtlngmitrngkhngkhtronglao
ngmcnlmttiuchkimsotchtlngsnphm.Tuynhin,tiVitNam,hinnaychngtachabanhnh
ctiuchunvisinhvttrongkhngkhccngnhngh.Vicchabanhnhctiuchunvisinhvttrong
khngkhgykhkhnchovickimsotchtlngkhngkh,cbitlchtlngkhngkhtrongmitrng
lmvic,dortkhcthcnhngphngnphngngaslylancavisinhvtchitrongkhngkh,nh
hngtichtlngsnphm,tiqutrnhsnxutvsckhecangilaong.Nhvy,trncstham
khonhngtiuchunvisinhkhngkhcbanhnhmtsqucgia,chngtacnsmcnhngnghin
cubanhnhnhngtiuchunvisinhkhngkh(cvphngphpvtiuchunpdng)ddnghntrong
vicnhgichtlngmitrngkhngkhnilmvic.
TILIUTHAMKHO
1. AMPlacencia,JTPeeler,GSOxborrow,andJWDanielson."ComparisonofbacterialrecoverybyReuter
centrifugalairsamplerandslittoagarsampler."ApplEnvironMicrobiol44,no.2(1982):512513.
2. B,yt.ThngquykthutYhclaongvVsinhmitrng,Sckhetrnghc.VinYhclaong
vvsinhmitrng,2002.
3. CEN/TC243/WG2N52E.CleanRoomTechnology.MethodsofAnalyzingandMeasuringAerobicContamination
inAreasatRisk.
4. EuropeanGoodManufacturingPractices(EUGMP).GuidetoManufactureofSterileMedicinalProducts,1997.
5. FribergB,FribergS,BurmanLG.Inconsistentcorrelationbetweenaerobicbacterialsurfaceandaircountsin
operatingroomswithultracleanlaminarairflows:proposalofanewbacteriologicalstandardsurface
contamination.JHospInfect.42(1999):287293.
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6. LLLembke,RNKniseley,RCvanNostrand,andMDHale."Precisionoftheallglassimpingerandthe
andersenmicrobialimpactorforairsamplinginsolidwastehandlingfacilities."ApplEnvironMicrobiol.1981Aug
42(2):222225.42,no.2(1981):222225.
7. NationalAeronauticsandSpaceAdministration.NASAStandardsforCleanRoomsandWorkStationsforthe
MicrobiallyControlledEnvironment.NHB5340.2.Washington,DC20546,1967
8. MehtaSK,MishraSK,PiersonDL."Evaluationofthreeportablesamplersformonitoringairbornefungi."Appl
EnvironMicrobiol62,no.5(1996):18351838.
9. PasquarellaC,PitzurraO,SavinoA."Theindexofmicrobialaircontamination."JHospInfect46,no.4(2000):
241246.
10. Radmore,K,Luck,H."Microbialcontaminationofdairyfactoryair."SouthAfricanjournalofdairytechnology16,
no.3(1984).
11. S.E.Curtis,R.K.Balsbaugh,andJ.G.Drummond."ComparisonofAndersenEightStageandTwoStageViable
AirSamplers."ApplEnvironMicrobiol35(1978):208209.
12. TCVN,53761991.Trichnnui,phngphpkimtravsinh.
13. Tun,NguynQuc."Khostnhimvisinhvttrongkhngkhtiphngphuthut,phnghiscmts
bnhvintiTp.HChMinh."TpchYhcTp.HChMinh14,no.2(2010):173179.
14. VerhoeffAP,vanWijnenJH,BoleijJS,BrunekreefB,vanReenenHoekstraES,SamsonRA."Enumerationand
identificationofairborneviablemouldpropagulesinhouses.Afieldcomparisonofselectedtechniques."Allergy
45,no.4(1990):275284.
15. http://www.iest.org/StandardsRPs/ISOStandards/ISO14644Standards#ISO%2014644%20Standards

NgThMai
PhnVinBohlaongvbovmitrngminNam
(Nguntin:Nilp.vn)
Tags:nhim,visinhvt,khngkh,kimtra
Tinkhc

ThitblcncsinhhotvngnngthnVitNamsdngvtliulclisxpvthanhottnhttru
Nghincuhonnguynblcxctcquangcathitblmschkhngkh
Nghincuxydngquytrnhquantrctngvikhunhiukhvtngnmtrongkhngkhmitrnglaong

Tipxcnghnghipvisngdukhongtrongluynkim:Xydngphngphplymuvphntchmi.Sosnhktqugiaccph
ThctrngthchinphplutbovngunnctrongmitrnglngnghcctnhngbngsngHng.

nhhngcamitrngnhitkhimcqunobohlaongquathangnhgicmgicnhitchquantiphngthnghimnhit
Nhndngcctcnhngybinikhhuphtsinhtcchotngsnxutcngnghip.
xutmtsgiiphpkhoahccngnghgimthiucctcnhngybinikhhuphtsinhtcchotngsnxutcngnghp

Nghincunhgihintrngantonlaongtrongsdngmy,thitbcinnngnghipcctnhphanam,xutmtsgiiph
Nghincuchtothitbxlnhimkhngkhtrncsxctcquangha

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Nghincuthcnghimnngcaohiuqulcbicaxiclon

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