血小板制品细菌污染风险的研究  

Study on risk in bacterial contamination of platelet concentrates

作　　者：刘仁强[1] 秦艳兰[1] 梁兵[1] 王德文[1] 叶柱江[1] 刘赴平[1] 邹文涛[1] 何子毅[1] 

机构地区：[1]东莞市中心血站,广东东莞523930

出　　处：《临床血液学杂志（输血与检验）》2010年第2期210-213,共4页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

基　　金：广东省东莞市科技基金项目(No:2005454)

摘　　要：目的:研究血小板在采集制备过程中细菌污染的风险,为减少血小板细菌污染,提高输血安全性并制定预防措施提供依据。方法:采用生物梅里埃公司BacT/Alert120全自动细菌培养仪及需氧瓶(BPA Culture Bottle)、厌氧瓶(BPN Culture Bottle)对10949例血小板进行细菌培养,细菌培养阳性者转种,转种阳性者进行细菌鉴定。结果:2003年3月-2005年12月共培养血小板3073例,其中19例阳性,阳性率为0.62%(手工混合血小板0.72%,单采血小板0.47%);2006年1月-2009年5月采取预防措施后培养7876例,共发现17例细菌培养阳性,阳性率为0.22%(手工混合血小板0.24%,单采血小板0.21%)。采取预防措施后总体血小板阳性率、手工混合血小板阳性率显著低于采取预防措施前(分别为χ2=10.92,P<0.05;χ2=4.98,P<0.05),而单采血小板阳性率则差异无统计学意义(χ2=2.81,P>0.05)。结论:采取预防措施可有效减少血小板细菌污染的发生,尤其对手工混合血小板效果显著,对单采血小板效果不明显。由于血小板采集后在(22±2)℃振荡条件下保存,细菌容易生长繁殖,因此输注血小板仍存在极高的细菌污染风险,预防措施仍需持续改进。Objective：To investigate the risk in bacterial contamination of platelet concentrates during collection and preparation in order to provide basis for reducing bacterial contamination in platelet concentrates,improving safety of blood transfusion and developing preventive measures.Method：10 949 units platelet concentrates were cultured for bacteria screening by Bact/Alert 120 automated blood culture system（bioMérieux） and aerobic culture bottles（BPA Culture Bottle）,anaerobic culture bottles（BPN Culture Bottle）.Unites which were cultured-positive were recultured,and units which were recultured-positive were under bacterial identification.Result：3073 units were cultured from March 2003 to December 2005,19 units of which were cultured-positive and the positive rate was 0.62% （manual pooled platelet 0.72%;apheresis platelet 0.47%,respectively）.7 876 units were cultured after taking preventive measures from January 2006 to May 2009,17 units of which were cultured-positive and the positive rate was 0.22% （manual pooled platelet 0.24%;apheresis platelet 0.21%,respectively）.The positive rate of bacterial contamination in total platelet concentrates as well as manual pooled platelet after taking preventive measures was significantly lower than that in platelet concentrates prior to taking preventive measures（χ2=10.92,P0.05;χ2= 4.98,P0.05,respectively ）,while there was no significant difference in the positive rate of apheresis platelet（χ2= 2.81,P0.05）.Conclusion：Taking preventive measures could reduce bacterial contamination in platelet concentrates effectively,especially to manual pooled platelet.But it had no apparent impact on apheresis platelet.Platelet concentrates are stored in the condition of （22±2）℃ and oscillation,which provides a good medium for bacteria growth.Therefore great risk of bacterial contamination still lies in platelet concentrates transfusion,and the preventive measures still need improving.

关 键 词：血小板 细菌培养 污染 输血风险 

分 类 号：R558[医药卫生—血液循环系统疾病]