摘要
目的观察执行血液透析及相关治疗用水(YY0572-2015)标准后,透析用水微生物培养结果的变化,分析水路污染的风险因素。方法依照YY0572-2015要求,采集2017年1月-6月供水回路反渗水回水口、出水口的透析用水各10份,同时采集透析机与供水回路软管连接处的透析用水128份,薄膜过滤法富集后,用TGEA培养皿进行微生物培养,取不同使用年限软管内壁行电镜扫描。结果供水回路反渗水回水口、出水口的透析用水微生物培养结果均为阴性;透析机与供水回路软管连接处的透析用水128份均有菌落生长,其中革兰阴性菌较多占60.16%;4组使用不同年限软管的透析用水细菌数量构成不同,并且电镜下软管内壁存在生物膜结构。结论透析机与供水回路间连接软管检出微生物以革兰阴性菌为主,随着软管使用时间的延长,细菌菌落呈现增长趋势,软管内壁产生生物膜,是污染透析用水的主要因素,可采用U型回路连接管或者定期维护更换软管等措施消除风险。
OBJECTIVE To observe the change of result of microbial culture of dialysis water after the standards for hemodialysis and related treatment water（YY0572-2015）were implemented and analyze the risk factors for the waterline contamination.METHODS According to YY0572-2015 requirements,10 dialysis water samples were respectively collected from reverse osmosis water outlet and input from Jan 2017 to Jun 2017,meanwhile 128 dialysis water samples were collected from flexible pipes which connected water supply circuits and dialysis devices.The microbial culture was carried out by using TGEA culture dish after the samples were gathered by membrane filtration method,and the internal walls of the flexible pipes with different service years were scanned with the use of electron microscopes.RESULTS The microbial culture was negative for the dialysis water in both reverse osmosis water outlet and input.There was bacterial growth in 128 samples of dialysis water in flexible pipes connected water supply circuits and dialysis devices,the gram-negative bacteria were dominant and accounted for 60.16% .The bacterial colony counts in the dialysis water varied among the 4 groups of flexible pipes with different service years,and the biofilm structure could be displayed under the electron microscope.CONCLUSION The gram-negative bacteria are dominant among the microorganisms isolated from flexible pipes connected water supply circuits and dialysis devices.The bacterial colony counts show upward trend with the extension of use of the flexible pipes,the growth of biofilm on inner walls of flexible pipes is the leading cause of contamination of dialysis water,and the U-shaped connection hose or regular maintenance or replacement of flexible pipes may reduce the risk of contamination of the dialysis water.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第18期4171-4174,共4页
Chinese Journal of Nosocomiology
