Cao Xiongjing, Xiong Huangguo, Fan Yunzhou, Xiong Lijuan
Department of Hospital Infection Management, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Ave, Wuhan, 430022, China.
J Epidemiol Glob Health. 2024 Mar;14(1):184-192. doi: 10.1007/s44197-023-00186-1. Epub 2024 Feb 15.
Accurately detecting the quantity of microorganisms in hospital purified water is of significant importance for early identification of microbial contamination and reducing the occurrence of water-borne hospital infections. The choice of detection method is a prerequisite for ensuring accurate results. Traditional Plate Count Agar (PCA) belongs to a high-nutrient medium, and there may be limitations in terms of accuracy or sensitivity in detecting microorganisms in hospital purified water. On the other hand, Reasoner's 2A agar (R2A) has characteristics, such as low-nutrient levels, low cultivation temperature, and extended incubation time, providing advantages in promoting the growth of aquatic microorganisms. This study, through comparing the differences in total colony counts between two detection methods, aims to select the method more suitable for the growth of aquatic microorganisms, offering new practical insights for accurately detecting the total count of heterotrophic bacteria in hospital purified water.
The most commonly used plate count agar (PCA) method, and the R2A agar culture were adopted to detect microorganisms and determine the total number of bacterial colonies in the water for oral diagnosis and treatment water and terminal rinse water for endoscopes in medical institutions. The two water samples were inoculated by pour plate and membrane filtration methods, respectively. Using statistical methods including Spearman and Pearson correlation, Wilcoxon signed-rank sum test, paired-Chi-square test, and linear regression, we analyze the differences and associations in the bacterial counts cultivated through two different methods.
In 142 specimens of the water, the median and interquartile range of the heterotrophic bacterial colony number under the R2A culture method and under the PCA culture method were 200 (Q1-Q3: 25-18,000) and 6 (Q1-Q3: 0-3700). The total number of heterotrophic bacteria colonies cultured in R2A medium for 7 days was more than that cultured in PCA medium for 2 days (P < 0.05). The linear regression results showed a relatively strong linear correlation between the number of colonies cultured by the R2A method and that cultured by the PCA method (R = 0.7264). The number of bacterial species detected on R2A agar medium is greater than that on PCA agar medium.
The R2A culture method can better reflect the actual number of heterotrophic bacterial colonies in hospital purified water. After logarithmic transformation, the number of colonies cultured by the two methods showed a linear correlation.
准确检测医院纯化水中的微生物数量对于早期识别微生物污染和减少医院水传播感染的发生具有重要意义。检测方法的选择是确保结果准确的前提。传统的平板计数琼脂(PCA)属于高营养培养基,在检测医院纯化水中的微生物时,在准确性或灵敏度方面可能存在局限性。另一方面,Reasoner's 2A琼脂(R2A)具有营养水平低、培养温度低和孵育时间长等特点,在促进水生微生物生长方面具有优势。本研究通过比较两种检测方法在总菌落数上的差异,旨在选择更适合水生微生物生长的方法,为准确检测医院纯化水中异养细菌总数提供新的实践见解。
采用最常用的平板计数琼脂(PCA)法和R2A琼脂培养法检测医疗机构中用于口腔诊疗用水和内镜终端冲洗用水中的微生物并测定细菌菌落总数。两种水样分别采用倾注平板法和膜过滤法接种。使用Spearman和Pearson相关性、Wilcoxon符号秩和检验、配对卡方检验和线性回归等统计方法,分析两种不同方法培养的细菌计数的差异和相关性。
在142份水样中,R2A培养法和PCA培养法下异养细菌菌落数的中位数和四分位数间距分别为200(Q1-Q3:25-18,000)和6(Q1-Q3:0-3700)。R2A培养基培养7天的异养细菌菌落总数多于PCA培养基培养2天的菌落总数(P<0.05)。线性回归结果显示,R2A法培养的菌落数与PCA法培养的菌落数之间存在较强的线性相关性(R=0.7264)。R2A琼脂培养基上检测到的细菌种类数多于PCA琼脂培养基上的。
R2A培养法能更好地反映医院纯化水中异养细菌菌落的实际数量。对数转换后,两种方法培养的菌落数呈线性相关。