厌氧培养在单采血小板细菌筛查中的作用  

Evaluation of the value of anaerobic culture in bacterial contamination forapheresis platelets

作　　者：朱立苇[1] 徐健[1] 

机构地区：[1]浙江省血液中心,浙江杭州310052

出　　处：《中国输血杂志》2017年第7期826-828,共3页Chinese Journal of Blood Transfusion

摘　　要：目的分析增加厌氧培养是否降低血小板细菌污染引起的临床输血不良反应。方法采用全自动微生物培养检测系统对9 758份单采血小板进行需氧、厌氧培养,调查单采血小板厌氧培养的细菌检出率、检出时间、检出细菌的种类以及临床输注后的反应。结果需氧培养和厌氧培养的阳性率分别为0.06%(6/9 758)和0.16%(16/9 758),增加厌氧培养使细菌污染检出率从0.06%增加到0.16%,提高了2.6倍。其中有10份血小板样本仅在厌氧培养中检出的细菌,检出的细菌以疮疱丙酸杆菌等厌氧菌为主,检出时间为(96.8±18.21)h,检出时均已临床输注,未出现不良反应。结论增加厌氧培养可提高血小板细菌污染的检出率,但是本研究中厌氧瓶未在血小板发放使用前出现阳性信号。在目前我国逐步开展血小板细菌检测的情况下,可参考北美洲和中国香港的模式首先开展需氧培养以减少血小板细菌污染引起的临床输血不良反应。Objective To determine the potential deficiency due to lack of anaerobic culture and evaluate the effect to reduce adverse reaction associated to transfusion-translated bacterial infection. Methods The result of 9 758 units of apher- esis platelet concentrates （PCs）detected with automated microbial detection system were reviewed and the medical records of the patients that received the contaminated PCs were followed. Results The confirmed positive rates by aerobic and anaero- bic cultures were 0.06% （6/9 758）and 0. 16% （ 16/9 758） , respectively. In 10 of t6 yield cases, only the anaerobic culture was positive. The most of the bacterial detected by anaerobic culture only were Propionibacterium aches. Their mean detection time from inoculation was 96. 8±18.21 hours. Conclusion Ad-dition of anaerobic culture would enhance the detection of bacterial contamination in PCs. However, since only slow-growing bacteria were detected, and because their clinical significance was debatable, blood service should select feasible and costeffective projects using only aerobic bottle for bacterial screening, like the majority of licensed blood centers in North America and Hong Kong, China.

关 键 词：血小板 无菌试验 细菌检测 厌氧培养 

分 类 号：R457.1[医药卫生—治疗学] R331.143[医药卫生—临床医学]