不同培养基对血液透析用水细菌菌落检测比较  

Comparison of different culture media on bacterial colony count in hemodialysis water

作　　者：蔡宏[1] 张伟明[1] 杨海慧[2] 王咏梅[1] 张斌[1] 蒋蓉[1] 应春妹[2] 严玉澄[1] 倪兆慧[1] 钱家麒[1] 

机构地区：[1]上海交通大学医学院附属仁济医院肾脏科分子细胞(肾病)实验室,上海200127 [2]上海交通大学医学院附属仁济医院检验科,上海200127

出　　处：《上海交通大学学报（医学版）》2014年第1期56-59,87,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市卫生局基金(2010120)~~

摘　　要：目的比较各种培养基在不同培养温度和时间条件下对血液透析用水的细菌检出率，探索临床上合适的透析用水细菌菌落检测方法。方法2012年1—12月随机采集上海交通大学医学院附属仁济医院血液净化中心透析用水样本共152份。分别接种在血培养基、胰蛋白酶大豆琼脂（TSA）、Reasoner’2A琼脂（R2A）和胰蛋白胨葡萄糖浸膏琼脂（TGEA）的4种培养基，分别在20℃、30℃和35℃培养48～168h。培养结束时对每个培养皿进行细菌菌落计数。结果血培养基组透析用水细菌菌落计数和细菌检出率最低，与TGEA和R2A相比差异具有统计学意义（P〈0．05和P〈0．01）。R2A在20℃环境下培养168h，细菌检出率较血培养35℃培养48h显著增加（67．1％vs43．4％，P〈0．01）。Bland．Ahman分析显示，R2A培养基20℃培养168h与TGEA培养基30℃培养120h两组细菌检出率具有较好的一致性。结论使用R2A或TGEA培养基较血培养基显著提高透析用水细菌菌落计数和细菌检出率。临床上适合选用R2A培养基20℃、168h或TGEA培养基30℃、120h方法对血液透析用水进行细菌菌落检测。Objective To compare detection ratio of bacterial colony count in dialysis water with different media and different incubation conditions, and to search for suitable method to detect bacteria from dialysis water. Methods Between January and December of 2012, 152 samples of hemodialysis water from Hemodialysis Center of Renji Hospital were randomly collected. The samples were cultured in duplicate on spread plates with blood agar, tryptic soy agar （TSA）, Reasoner＇s 2A （R2A）, and tryptone glucose extract agar （TGEA）, respectively, at 20, 30, and 35 ℃ for 48 - 168 h. After incubation, the numbers of colonies were quantified. Results In blood agar, the bacterial colony counts of dialysis water were the lowest with significant differences compared to TGEA and R2A culture media （P 〈0.05, P 〈0.01）. In R2A agar, the detection rate of bacteria at 20 ℃ for 168 h was significantly higher than that in blood agar at 35 % for 48 h （67. 1% vs 43.4%, P 〈0.01）. Bland-Altman analysis showed that there was close consistence between the detection rates of bacteria in R2A agar at 20 ℃ for 168 h and in TGEA agar at 30 % for 120 h. Conclusion The method of R2A or TGEA agar culture could improve the detection rate of bacterial colony count in dialysis water in comparing to the method of blood culture. The method of R2A at 20 ℃ for 168 h or TGEA at 30 ℃ for 120 h is the suitable method for bacteria detection in dialysis water.

关 键 词：细菌培养 血液透析 培养基 透析用水 

分 类 号：R446.5[医药卫生—诊断学]