在牙科护理中，被Creutzfeldt_Jakob病污染的可重复使用的器械的有效灭菌是公共卫生的关键问题。本横断面研究调查了法国牙科实践在现实世界中如何实施推荐的灭菌程序。在法国Rh＆ocirc;ne-Alpes地区选择了牙科实践样本。数据是通过2016年的自我问卷收集的。灭菌程序（n=33）分为4组：（1）可重复使用器械的灭菌前清洁；（2）灭菌周期的生物学验证和mdash；监测蒸汽灭菌程序；（3）高压灭菌器性能和从业人员对高压灭菌器使用的了解；（4）灭菌程序的监测和记录；跟踪和跟踪仪器。每个程序都提供了答案，以及一组内程序的全球实施(超过80%的正确执行)。然后验证了对程序组的依从性如何随牙科实践的规模和团队中牙科助理的比例而变化。在可用于分析的179份问卷中，遵守推荐的灭菌程序明显不同的做法，从20.7%到82.6%。每次实践正确实施的程序的中位数百分比为58.1%，50.9%,69.2%和58.2%，分别在第1、2、3和4组中（该组中执行超过80％的程序的相应百分比：23.4％，6.6%,46.6%和38.6%）。牙科实践≥第2组和第4组的3个牙科单元执行的程序明显更好(>80%)(分别为p=0.01和p=0.002),而没有其他重要的关联出现。作为一项规则,实践与建议的程序不一致，尽管在更大的实践中部分改善了结果。需要进行有关灭菌程序的具体培训，并更好地了解导致其不合规的原因。
Effective sterilization of reusable instruments contaminated by Creutzfeldt⁻Jakob disease in dental care is a crucial issue for public health. The present cross-sectional study investigated how the recommended procedures for sterilization were implemented by French dental practices in real-world settings. A sample of dental practices was selected in the French Rhône-Alpes region. Data were collected by a self-questionnaire in 2016. Sterilization procedures (n = 33) were classified into 4 groups: (1) Pre-sterilization cleaning of reusable instruments; (2) Biological verification of sterilization cycles—Monitoring steam sterilization procedures; (3) Autoclave performance and practitioner knowledge of autoclave use; (4) Monitoring and documentation of sterilization procedures—Tracking and tracing the instrumentation. Answers were provided per procedure, along with the global implementation of procedures within a group (over 80% correctly performed). Then it was verified how adherence to procedure groups varied with the size of the dental practice and the proportion of dental assistants within the team. Among the 179 questionnaires available for the analyses, adherence to the recommended procedures of sterilization noticeably varied between practices, from 20.7% to 82.6%. The median percentages of procedures correctly implemented per practice were 58.1%, 50.9%, 69.2% and 58.2%, in Groups 1, 2, 3 and 4, respectively (corresponding percentages for performing over 80% of the procedures in the group: 23.4%, 6.6%, 46.6% and 38.6%). Dental practices ≥ 3 dental units performed significantly better (>80%) procedures of Groups 2 and 4 (p = 0.01 and p = 0.002, respectively), while no other significant associations emerged. As a rule, practices complied poorly with the recommended procedures, despite partially improved results in bigger practices. Specific training regarding sterilization procedures and a better understanding of the reasons leading to their non-compliance are needed.
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