血小板制品细菌污染预防措施的研究

目的 探讨减少血小板细菌污染的方法,以提高临床输注血小板的安全性.方法 首先采用血液采集前采血器材的检查、采血环境的严格消毒及献血者严格筛选,同时改进献血者进针区皮肤消毒方法和对手工血小板去除白细胞;其次去除最初采集的部分血液,再进行血小板输血前细菌培养检查三种预防措施来减少血小板污染.另采用法国生物梅里埃公司BacT/Alert 120细菌监测系统进行需氧瓶及厌氧培养瓶细菌培养,培养阳性者转种培养,转种培养阳性者进行细菌鉴定.结果 采取预防措施后,手工混合血小板细菌污染率由0.72%降低至0.45%（P＜0.01）,单采血小板细菌污染率由0.47%降至0.23%（P＜0.01）,总的细菌污染率由0.62%降至0.29%（P＜0.01）.结论 采取预防措施,可减少血小板细菌污染,对提高临床血小板输注安全具有重要意义.

Measures of preventing contamination of blood platelets with bacteria and clinical application

Objective To explore the way in reducing contamination of blood platelet with bacterium for enhancing the safety in clinical use of platelet.Methods Three precautionary measures were taken including examining blood donor equipments,sterilizing blood donation environment,screening blood donors strictly and depleting white blood cells from pooled platelets;excluding some initial collected blood,performing bacterial culture before platelets transfusion;the positive samples were subcultivated and identiufied for bacteria if it was positive in aerobic cultivation or anaerobic culture with BacT/Alert 12 monitoring system.Results The rates of bacterial contamination in pooled platelets were decreased from 0.72% to 0.45%(P<0.01),the rates of platelets pheresis were from 0.47% to 0.23%(P<0.01)and the total rates of contamination was decreased from 0.62% to 0.29%(P<0.01).Conclusion Precautionary measures can reduce bacterial contamination of blood platelet and it is of significance in enhancing the safety of clinical poleatelet transfusion.