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使用不同无菌溶液清洁献血者手臂对预防血袋污染的影响。

Impact of donor arm cleaning with different aseptic solutions for prevention of contamination in blood bags.

作者信息

Patel Tanvi G, Shukla Rinku V, Gupte Snehalata C

机构信息

Surat Raktadan Kendra & Research Centre, 1st Floor, Khatodara Health Centre, Besides Chosath Joganiyo Mata's Temple, Udhana Magdalla Road, Khatodara, Surat, 394 210 India.

出版信息

Indian J Hematol Blood Transfus. 2013 Mar;29(1):17-20. doi: 10.1007/s12288-011-0138-3. Epub 2012 Jan 31.

Abstract

Transfusion associated sepsis cases are encountered occasionally and bacterial transmission remains the major cause. The goal of our study was to compare the efficacy of disinfectants in phlebotomy site preparation. After selection of donor the antecubital fossa area of the arm was disinfected with different types of disinfectants namely sprit (70% isopropyl alcohol), povidone iodine (0.5% w/v available iodine in distilled water), savlon (1.5% v/v chlorhexidine gluconate solution and 3.0% cetrimide solution) and combination of sprit and povidone iodine. Swabs were collected from 20 donors using a sterile forceps, after cleaning with different antiseptic solutions. Swab was streaked on blood agar plate aseptically and the plate was incubated at 37°C for 24 h. Colonies were counted and a single colony was re-cultured by growing on nutrient and Mac-Conkey agar. The biochemical characteristics were determined by performing Gram staining, Motility, Catalase and Oxidase tests. The mean values of colonies were significantly higher with savlon compared to other three solutions. The difference was statistically significant by "t" test (t values 1.7-3.0; P < 0.05). Staphylococcus epidermidis, Staphylococcus sp., Streptococcus sp., Micrococcus sp., Bacillus megaterium and Bacillus cereus were the organisms identified. After completion of bleeding, samples from the bag were aseptically inoculated in aerobic and anaerobic culture bottles to be tested on BacT/Alert system. The bag containing donor's blood did not show any contamination when three cleanings were carried out using sprit, povidone iodine and spirit respectively.

摘要

偶尔会遇到输血相关败血症病例,细菌传播仍是主要原因。我们研究的目的是比较消毒剂在静脉穿刺部位准备中的效果。选择献血者后,用不同类型的消毒剂对其手臂肘前窝区域进行消毒,即酒精(70%异丙醇)、聚维酮碘(蒸馏水中有效碘含量为0.5% w/v)、洗必泰醇(1.5% v/v葡萄糖酸洗必泰溶液和3.0%溴化十六烷基三甲铵溶液)以及酒精和聚维酮碘的组合。在用不同消毒溶液清洁后,使用无菌镊子从20名献血者身上采集拭子。将拭子无菌划线接种在血琼脂平板上,平板在37°C下培养24小时。计数菌落,并将单个菌落接种在营养琼脂和麦康凯琼脂上进行再培养。通过革兰氏染色、动力试验、过氧化氢酶试验和氧化酶试验确定生化特性。与其他三种溶液相比,洗必泰醇处理后的菌落平均值显著更高。通过“t”检验,差异具有统计学意义(t值为1.7 - 3.0;P < 0.05)。鉴定出的微生物有表皮葡萄球菌、葡萄球菌属、链球菌属、微球菌属、巨大芽孢杆菌和蜡样芽孢杆菌。采血结束后,将血袋中的样本无菌接种到需氧和厌氧培养瓶中,在BacT/Alert系统上进行检测。当分别使用酒精、聚维酮碘和酒精进行三次清洁时,装有献血者血液的血袋未显示任何污染。

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本文引用的文献

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Evaluation of donor arm disinfection techniques.供体手臂消毒技术的评估。
Vox Sang. 2001 Apr;80(3):135-41. doi: 10.1046/j.1423-0410.2001.00029.x.
9
Evaluation of donor skin disinfection methods.供体皮肤消毒方法的评估。
Transfusion. 1997 Mar;37(3):309-12. doi: 10.1046/j.1537-2995.1997.37397240214.x.
10
Skin antisepsis at the donor site: is there room for improvement?供皮区的皮肤消毒:是否有改进空间?
Transfusion. 1997 Mar;37(3):249-50. doi: 10.1046/j.1537-2995.1997.37397240203.x.

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