Bland L A
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Adv Ren Replace Ther. 1995 Jan;2(1):70-9. doi: 10.1016/s1073-4449(12)80073-2.
The potential for exposure of dialysis patients to greater levels of microbial and endotoxin contamination has increased dramatically during the last decade with the increase in reuse of hemodialyzers, and the use of bicarbonate dialysate and high flux dialysis. To help prevent pyrogenic reactions and bacteremia in hemodialysis patients caused by microbial and endotoxin contamination of hemodialysis fluids, the Association for the Advancement of Medical Instrumentation (AAMI) has promulgated standards for maximum allowable concentrations of bacteria and endotoxin in these fluids. Each dialysis center should develop microbiological and endotoxin surveillance policies and procedures for the types of hemodialysis fluids to assay, frequency and manner of sample collection, assay techniques, and methods for recording and interpreting results to ensure compliance with the AAMI standards. These necessary components of a comprehensive surveillance program are discussed in depth in this article. A safer environment will be provided for each dialysis patient if appropriate microbiological assay procedures are followed and the results are consistently within the AAMI microbiological and endotoxin standards.
在过去十年中，随着血液透析器复用的增加以及碳酸氢盐透析液和高通量透析技术的应用，透析患者接触更高水平微生物和内毒素污染的可能性急剧增加。为了帮助预防因血液透析液的微生物和内毒素污染导致的血液透析患者发热反应和菌血症，医疗仪器促进协会（AAMI）已经颁布了这些液体中细菌和内毒素最大允许浓度的标准。每个透析中心都应制定针对要检测的血液透析液类型、样本采集频率和方式、检测技术以及结果记录与解释方法的微生物学和内毒素监测政策及程序，以确保符合AAMI标准。本文将深入讨论全面监测计划的这些必要组成部分。如果遵循适当的微生物检测程序且结果始终符合AAMI微生物学和内毒素标准，将为每位透析患者提供更安全的环境。
