Arnow P M, Houchins S G, Richards J M, Chudy R
Department of Medicine, University of Chicago Hospitals, Illinois 60637.
J Clin Microbiol. 1991 May;29(5):1038-41. doi: 10.1128/jcm.29.5.1038-1041.1991.
Lymphokine-activated killer (LAK) cells, prepared by incubating autologous lymphocytes in cell culture medium with interleukin-2, selectively lyse tumor cells and are effective immunotherapy of some cancers. During a 3-month period, two patients at our center were infused with LAK cells subsequently found to have been contaminated by Aspergillus fumigatus. Each case was investigated by obtaining environmental cultures and assessing aseptic practices during LAK cell preparation. Investigation of the first case demonstrated a malfunction of the laminar air flow hood, under which interleukin-2 and the patient's lymphocytes had been added to cell culture medium, and showed heavy A. fumigatus contamination of the hood, adjacent countertop, and cell culture incubator. Despite repair of the laminar air flow hood and cleaning of the laboratory, a second case occurred, and cultures at that time implicated the humidified cell culture incubators as the source of A. fumigatus. Following incubator sterilization and removal of the humidification apparatus from the incubators, weekly environmental cultures in the LAK cell laboratory were negative, and none of the LAK cell cultures from the 20 patients treated during the ensuing 15 months grew A. fumigatus. Our findings show that growth of fungi in humidified incubators, which previously has caused contamination problems in tissue culture and clinical microbiology laboratories, can result in patient infections when humidified incubators are used to prepare cells for reinfusion.
通过在细胞培养基中用白细胞介素-2孵育自体淋巴细胞制备的淋巴因子激活的杀伤（LAK）细胞可选择性地裂解肿瘤细胞，是某些癌症的有效免疫疗法。在3个月的时间里，我们中心的两名患者输注了后来被烟曲霉污染的LAK细胞。通过获取环境培养物并评估LAK细胞制备过程中的无菌操作对每个病例进行了调查。对第一个病例的调查表明，在将白细胞介素-2和患者的淋巴细胞添加到细胞培养基的层流通风橱出现故障，通风橱、相邻的台面和细胞培养箱均被烟曲霉严重污染。尽管对层流通风橱进行了维修并对实验室进行了清洁，但仍发生了第二例病例，当时的培养物表明加湿的细胞培养箱是烟曲霉的来源。在对培养箱进行灭菌并从培养箱中移除加湿装置后，LAK细胞实验室的每周环境培养均为阴性，在随后的15个月中接受治疗的20名患者的LAK细胞培养物均未生长出烟曲霉。我们的研究结果表明，加湿培养箱中真菌的生长，此前已在组织培养和临床微生物学实验室中引起污染问题，当使用加湿培养箱制备用于回输的细胞时，可能导致患者感染。
