血液透析用水及透析液细菌污染情况监测分析  

Monitoring and analysis of bacterial contamination of hemodialysis fluid

作　　者：朱雪峰[1] 蒋惠云[2] 张德力[3] 张梦兰[3] 

机构地区：[1]安徽省蚌埠市第一人民医院感染管理科,233000 [2]安徽省蚌埠市第一人民医院血液透析室,233000 [3]安徽省蚌埠市第一人民医院检验科,233000

出　　处：《蚌埠医学院学报》2006年第6期660-662,共3页Journal of Bengbu Medical College

摘　　要：目的：调查血液透析用水及透析液细菌污染和内毒素产生情况。方法：倾注法检测细菌含量，常规方法分离鉴定细菌，鲎试剂定性凝胶法检测内毒素含量。结果：透析用水（反渗水）平均菌落数130CFU／ml，内毒素检测阳性率5．8％，透析器人口处透析液平均菌落数259CFU／ml，出口处透析液平均菌落数644CFU／ml，A液和B液平均菌落数分别为13CFU／ml和268CFU／ml。常见细菌为革兰阴性杆菌（非发酵菌为主）、革兰阳性杆菌及球菌。4—10月份细菌含量超过同年同类标本平均菌落数。结论：血液透析用水在其生产、运输、循环使用及透析液在配制、储存等多个环节中可能造成污染，并与季节有一定的相关性。应加强透析用水及透析液的监测工作。Objective ：To investigate the bacterial contamination and endotoxin in hemodialysis fluid. Methods ：The levels of bacterial contamination were detected by pour plate method. The species of bacteria were evaluated by routine method and the endotoxin was detected by gel-coh assay with limulus reagents. Results ：The average bacteria colony forming unit per milliliter in reverse osmosis and dialysis fluid from the dialyzer inlet, outlet, fluid A, and fluid B was 130 CFU/ml, 259 CFU/ml,644 CFU/ml, 13 CFU/ml, and 268 CFU/ml, respectively. The positive rate of endotoxin was 5.8% in reverse osmosis. The common isolated bacteria were Gram-negative bacilli（ nonferments was main） , Gram-posltive bacilli and coccus. From April to October, the average number of colony exceeded the same kind of sample in the same year. Conclusions：Many factors such as the process of production, transportation and recycling use of reverse osmosis and the process of preparmion and reservation of dialysis fluid may cause bacterial contamination,and is related to the seasons. Strict monitoring of dialysis fluid should be emphasized.

关 键 词：血液透析液 微生物学技术 细菌污染/预防和控制 内毒素 

分 类 号：R944.1[医药卫生—药剂学] R446.5[医药卫生—药学]