无偿献血中采集的手工血小板细菌污染原因分析及对策

目的探讨无偿献血手工血小板细菌污染的原因，以减少细菌污染手工血小板。方法选择经体检合格的无偿献血者1313例，其中应急献血者663例，自愿无偿献血者650例，将两类人群最初采集的10ml血液分别收集于样品采集袋进行细菌培养；选择体检合格的无偿献血者4224例，采血时弃去和不弃去最初的10ml血液，各制备手工血小板2112袋，每袋血小板均留血样做细菌培养。结果自愿无偿献血者和应急献血者采集的最初10ml血液样本细菌培养阳性率分别是0和3．0％，弃去和不弃去采血最初10ml血液后制备的手工血小板细菌培养阳性率分别是0．09％和0．57％，差异均有统计学意义（P〈0．01）。结论血小板制品的细菌污染率与献血人群和采血最初采集的10ml血液密切相关，加强无偿献血者选择，做好采血前皮肤清洁消毒工作，并去除最初采集的小部分血液能有效地降低手工血小板细菌污染率。

The Causes of Bacteria Contamination of Platelets from Manual Manipulation during Voluntary Blood Donation and the Countermeasures

Objective To explore the causes of bacteria contamination of platelets by manual manipulation during voluntary blood do- nation to reduce chances of bacteria＇s contaminating platelets. Methods The 10 ml blood samples were collected into the sample collection bags at first trial from 1 313 qualified voluntary blood donators including 663 emergency donators and 650 routine volun- tary ones, and cultured. The blood from another 4 224 qualified voluntary donators was collected into anther 4 224 bags： 2 112 ones containing the first 10 ml blood and the other 2 112 ones did not. The samples from these 4 224 bags were collected for bacterial culture. Results The positive rates from the first 10 ml blood culture of routine voluntary donators and emergency .donators were 0 and 3.0%, while the positive rates for those containing the first 10 ml blood and those not were 0.09% and 0.57%. The differences were significant statistically （P〈0.01）. Conclusion The contamination rates of donated blood are closely related to population of do- nators and the first 10 ml collected blood. Careful selection of donators, skin strict sterilization before collection, removal of first 10 ml blood can lower the contamination of donated platelets effectively.