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中国某血液中心单采血小板细菌污染情况的检测

Detection of bacterial contamination of apheresis platelets in a Chinese Blood Center.

作者信息

Zhu L, Xu J, Yang X, Shen Z, Wang Y, Zhu F, Lv H, Yan L

机构信息

Blood Center of Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China.

出版信息

Transfus Med. 2009 Dec;19(6):357-62. doi: 10.1111/j.1365-3148.2009.00948.x. Epub 2009 Aug 28.

Abstract

Bacterial contamination of platelets is considered as the most frequent infectious risk of transfusion. The prevalence of bacterial contamination has been reported and varied considerably in different countries, but the data for bacterial contamination of platelets in China are rarely reported. Eight thousand apheresis platelet concentrates (PCs) were analysed by aerobic and anaerobic cultures. Ten millilitres of PCs were inoculated into aerobic and anaerobic bottles (5 mL each), followed by the incubation for a maximum of 7 days. A new sample was taken from the unit for reculturing in order to confirm the initial positive reaction. All positive culture bottles were referred for bacterial isolation and identification. Twenty one cultures (0.26%) were flagged as positive in initial culture. Five cultures (0.06%) were confirmed as true positive and nine cultures (0.11%) were confirmed as indeterminate in reculture. A bacterium from skin flora (Propionibacterium spp.) was the most prevalent contaminant. Mean time to initial positive culture from start of incubation was 22.1 h for confirmed positive units and 97.3 h for indeterminate units. Most PC units had already been issued by the time of initial positive culture with a 'negative-to-date' issued strategy. There is a risk of bacterial contamination of PCs in China. Implementing bacterial screening of platelets could reduce the risk of septic reaction and fatalities due to transfusion of bacterially contaminated platelets. However, bacterial contamination PCs can still be transfused due to the delay until a positive signal in the culture system.

摘要

血小板的细菌污染被认为是输血中最常见的感染风险。不同国家已报道的细菌污染发生率差异很大,但中国血小板细菌污染的数据鲜有报道。通过需氧和厌氧培养对8000份单采血小板浓缩液(PCs)进行了分析。将10毫升PCs接种到需氧瓶和厌氧瓶中(各5毫升),然后培养最长7天。从该单位采集新样本进行再次培养,以确认最初的阳性反应。所有阳性培养瓶都送去进行细菌分离和鉴定。21份培养物(0.26%)在初次培养时被标记为阳性。5份培养物(0.06%)被确认为真阳性,9份培养物(0.11%)在再次培养时被确认为不确定。来自皮肤菌群的一种细菌(丙酸杆菌属)是最常见的污染物。对于确认阳性的单位,从开始培养到初次阳性培养的平均时间为22.1小时,对于不确定的单位为97.3小时。在初次阳性培养时,大多数PC单位已经按照“截至目前为阴性”的发放策略发放。中国存在PCs细菌污染的风险。实施血小板细菌筛查可降低因输注细菌污染的血小板而导致败血症反应和死亡的风险。然而,由于培养系统中出现阳性信号存在延迟,细菌污染的PCs仍可能被输注。

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