血液透析用水及透析液细菌污染情况监测分析

目的: 调查血液透析用水及透析液细菌污染和内毒素产生情况。方法: 倾注法检测细菌含量,常规方法分离鉴定细菌,鲎试剂定性凝胶法检测内毒素含量。结果: 透析用水(反渗水)平均菌落数130 CFU/ml,内毒素检测阳性率5.8%,透析器入口处透析液平均菌落数259 CFU/ml,出口处透析液平均菌落数644 CFU/ml,A液和B液平均菌落数分别为13 CFU/ml和268CFU/ml。常见细菌为革兰阴性杆菌(非发酵菌为主)、革兰阳性杆菌及球菌。4~10月份细菌含量超过同年同类标本平均菌落数。结论: 血液透析用水在其生产、运输、循环使用及透析液在配制、储存等多个环节中可能造成污染,并与季节有一定的相关性。应加强透析用水及透析液的监测工作。

Monitoring and analysis of bacterial contamination of hemodialysis fluid

Objective:To investigate the bacterial contamination and endotoxin in hemodialysis fluid.Methods:The levels of bacterial contamination were detected by pour plate method.The species of bacteria were evaluated by routine method and the endotoxin was detected by gel-colt assay with limulus reagents.Results:The average bacteria colony forming unit per milliliter in reverse osmosis and dialysis fluid from the dialyzer inlet,outlet,fluid A,and fluid B was 130 CFU/ml,259 CFU/ml,644 CFU/ml,13 CFU/ml,and 268 CFU/ml,respectively.The positive rate of endotoxin was 5.8 in reverse osmosis.The common isolated bacteria were Gram-negative bacilli(nonferments was main),Gram-positive bacilli and coccus.From April to October,the average number of colony exceeded the same kind of sample in the same year.Conclusions:Many factors such as the process of production,transportation and recycling use of reverse osmosis and the process of preparation and reservation of dialysis fluid may cause bacterial contamination,and is related to the seasons.Strict monitoring of dialysis fluid should be emphasized.