2022年江苏省盐城市医疗机构血液透析液及透析用水质量监测  

Quality monitoring of Hemodialysis solution and Dialysis water in medical institutions in Yancheng of Jiangsu in 2022

作　　者：殷俊[1] 张海燕 孙雅雯 YIN Jun;ZHANG Haiyan;SUN Yawen(Yancheng Center for Disease Control and Prevention,Yancheng,Jiangsu 224001,China)

机构地区：[1]盐城市疾病预防控制中心,江苏盐城224001

出　　处：《现代疾病预防控制》2023年第12期950-953,共4页MODERN DISEASE CONTROL AND PREVENTION

摘　　要：目的了解盐城市医疗机构血液透析液及透析用水微生物污染状况,分析污染原因并提出针对性的预防对策。方法对2022年盐城市开展血液透析的28家医院透析液和透析用水分别采用鲎试剂凝胶法和营养琼脂平板倾注法检测内毒素和细菌总数,并对结果进行统计分析。结果共检测透析液及透析用水691份样品,整体合格率为92.9%;其中一季度、二季度、三季度和四季度合格率分别为87.8%、93.1%、94.9%和98.6%,差异有统计学意义(χ^(2)=10.359,P<0.05);三甲医院、二甲医院、二乙医院合格率分别为97.8%、95.4%和83.5%,差异有统计学意义(χ^(2)=30.986,P<0.05);抽检样品、委托样品合格率分别为95.3%和86.4%,差异有统计学意义(χ^(2)=16.061,P<0.05);透析器入口处、出口处透析液合格率分别为94.0%和90.7%,差异无统计学意义(χ^(2)=2.318,P>0.05)。结论盐城市医疗机构血液透析液及透析用水质量总体较好,但仍然存在一定程度的污染,季节因素、医院等级及样品来源对细菌总数和内毒素合格率有一定影响,需加强消毒监督与监测,进一步提高消毒质量,减少医源性感染的发生。Objective To understand the microbial contamination of hemodialysis solution and dialysis water in medical institutions of Yancheng city,analyze the causes of contamination,and put forward targeted preventive measures.Methods The hemodialysis solution and dialysis water from 28 hospitals in Yancheng city in 2022 were measured for endotoxin by horseshoe crab reagent gel method and total bacterial counts by nutrient agar plate decantation method,and the results were statistically analyzed.Results A total of 691 samples of hemodialysis solution and dialysis water were tested,and the overall passing rate was 92.9%;among them,the passing rates in the first quarter,second quarter,third quarter,and fourth quarter were 87.8%,93.1%,94.9%and 98.6%,respectively,with statistically significant difference(χ^(2)=10.359,P<0.05).The passing rates in the level-A tertiary hospitals,level-A secondary hospitals and level-B secondary hospitals were 97.8%,95.4%,and 83.5%,respectively and the difference was statistically significant(χ^(2)=30.986,P<0.05).The pass rates for sampled samples and commissioned samples were 95.3%and 86.4%,respectively,and the differences were statistically significant(χ^(2)=16.061,P<0.05).The pass rates of dialysate at the dialyzer inlet and outlet were 94.0%and 90.7%,respectively,and the difference was not statistically significant.Conclusions The quality of hemodialysis solutions and dialysis water in medical institutions in Yancheng city is generally good,but there is still a certain degree of contamination.Seasonal factors,hospital grade,and sample source have some influence on the total bacterial count and endotoxin pass rate.It is necessary to strengthen the disinfection supervision and testing to further improve the quality of disinfection and reduce the occurrence of healthcare-acquired infections.

关 键 词：透析液 透析用水 内毒素 细菌总数 

分 类 号：R197.2[医药卫生—卫生事业管理]