Ishida T, Nakano S, Nakatani H, Gomi A, Sato T, Saegusa N, Ito A, Okada A, Tazawa Y
Department of Cardiovascular Surgery, Kanto Medical Center NTT EC, Tokyo, Japan.
Kyobu Geka. 2001 Aug;54(9):753-7.
We investigated sources of bacterial contamination of intraoperative salvaged blood producted by autologous transfusions device (CS; CELL SAVER 5, Heamonetics Corp., Braintree, MA). Eleven patients undergone open heart surgeries including 2 emergency operations with a median sternotomy enrolled in this study. Blood samples were drawn from salvaged blood bags. Airborne contaminants (AB) were collected by a blood agar plate put besides the operation bed for 30 minutes. The median wounds samples were collected by a swab. Bacterial growth was detected in 81.8% of salvaged blood samples. Twenty-nine bacterium were isolated from CS, 72.4% of those were Staphylococci. 9.1% of sample was positive in wound swabs. Forty bacterium were isolated from plate cultures. 65% of them were Staphylococci. Staphylococcus epidermidis and coagulase negative Staphylococcus isolated both CS and AB in the 2 cases had the same identify codes, and incubated from several AB cultures. Corynebacterium sp. is also isolated from both CS and AB cultures in other 2 same cases. In 7 out of 8 cases (87.5%), from which Staphylococci isolated in CS, the Staphylococci were cultured from AB in not the same but the other cases. In conclusion, highly incidence of the identification in identical code of Staphylococci indicated that the main source of CS contamination was highly suspected to AB.
我们调查了自体输血设备（CS；CELL SAVER 5，海莫奈蒂克斯公司，马萨诸塞州布伦特里）术中回收血液制品的细菌污染来源。11例接受心脏直视手术的患者，包括2例急诊手术，均采用正中胸骨切开术，纳入本研究。从回收血袋中采集血样。通过将血琼脂平板放置在手术床边30分钟来收集空气传播污染物（AB）。通过拭子采集伤口样本。在81.8%的回收血样中检测到细菌生长。从CS中分离出29种细菌，其中72.4%为葡萄球菌。伤口拭子样本中有9.1%呈阳性。从平板培养物中分离出40种细菌。其中65%为葡萄球菌。在2例病例中，从CS和AB中分离出的表皮葡萄球菌和凝固酶阴性葡萄球菌具有相同的识别编码，且均从几种AB培养物中培养而来。在另外2例相同病例中，也从CS和AB培养物中分离出棒状杆菌属。在CS中分离出葡萄球菌的8例病例中，有7例（87.5%），葡萄球菌不是从同一病例而是从其他病例的AB中培养出来的。总之，葡萄球菌识别编码相同的高发生率表明，CS污染的主要来源高度怀疑是AB。
