不同采样点对透析用水微生物监测结果的影响

 目的 观察不同采样点透析用水微生物监测结果的差异，探讨供水管路微生物污染高风险环节。方法 依据YY 0572—2015《血液透析及相关治疗用水》要求，对57所透析中心进行多点采样，包括水处理系统出水口、回水口、进水软管与透析机连接处等，检测透析用水菌落总数和内毒素指标。结果 透析用水菌落总数和内毒素合格率，以水处理系统出水口处最高，均为100%；其次为回水口处，分别为96.88%、95.31%，进水软管与透析机连接处分别为80.86%、77.03%；储水罐、配液桶等处两项合格率最低，分别为66.67%、83.33%。结论 透析机连接软管、储水罐、配液桶等处是透析用水污染的主要环节，临床消毒应关注到此类消毒盲区，日常监测应强化对透析机连接软管等高风险点的采样。

Effect of different sampling points on microbial monitoring results of dialysis water

Objective To observe the difference in microbial monitoring results of dialysis water in different sampling points, and explore high-risk links of microbial contamination in water supply pipeline. Methods According to the requirements of YY 0572—2015 "Water for hemodialysis and related therapies", 57 dialysis centers were sampled at multiple points, including water treatment system water outlet, water return outlet, connection of water inlet hose and dialysis machine, the total number of bacterial colonies and endotoxin index of dialysis water were detected. Results The qualified rates of total bacterial colonies and endotoxin in dialysis water at water outlet of water treatment system were the highest, both were 100%, followed by 96.88% and 95.31% at the water return outlet, qualified rate at the connection of water inlet hose and dialysis machine were 80.86% and 77.03% respectively, qualified rate of total bacterial colonies and endotoxin in water storage tank and liquid preparation barrel were the lowest, which were 66.67% and 83.33% respectively. Conclusion Connection of hose and dialysis machine, water storage tank and liquid preparation barrel are the main links of contamination of dialysis water, clinical disinfection should pay attention to these disinfection blind area, sampling of connection at hose and dialysis machine and other high-risk points in daily monitoring should be strengthened.