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背景 细菌污染的浓缩血小板成分是输血相关的脓毒血症的重要原因。已有几份研究报告指出浓缩血小板制剂的细菌污染发生率范围较宽(0-10％)。本研究的目的是评估卡萨布兰卡(摩洛哥西北部城市)地区输血中心的标准血小板单位的细菌污染发生情况。研究设计和方法 在15个半月时间内对3,458份浓缩血小板单位进行了检测。取自血袋和采输血管的血浆样品被混匀。每天将所取血浆样品的1/5分开接种到2支含胰蛋白大豆的肉汤培养基中,连续进行5天。一支试管放置室温;另一支被置37℃,培养24小时,按标准操作程序对培养物进行细菌鉴定。结果 3,458袋血小板中有25份(0.72％)被细菌污染。22份细菌(88％)是从贮存3天或3天以上的血小板成分培养出来的。其中14份(56％)为凝固酶阴性葡萄球菌,2份为金黄色葡萄球菌,1份为α-溶血性链球菌,4份为芽胞杆菌,1份为肠道杆菌,1份为肠道埃希氏菌,2份为黄杆菌属菌。结论本文报告血小板制剂的细菌污染发生率高于大多数研究者的报导。
BACKGROUND Bacterial contamination of concentrated platelet components is an important cause of transfusion-related sepsis. Several studies have reported that concentrated platelet preparations have a wide range of bacterial contamination rates (0-10%). The purpose of this study was to assess the incidence of bacterial contamination of standard platelet units in the transfusion center in Casablanca (north-western Morocco). The study design and methodology tested 3,458 platelet-rich units in 15 and a half months. Blood samples taken from blood bags and blood transfusions were mixed. One-fifth of the plasma samples taken each day were inoculated into 2 tryptic soy broths continuously for 5 days. One tube was placed at room temperature; the other was set at 37 ° C and incubated for 24 hours. Bacterial identification of the cultures was carried out according to standard operating procedures. Results Of the 3,458 platelets, 25 (0.72%) were contaminated with bacteria. 22 bacteria (88%) were cultured from platelet components stored for 3 days or more. Among them, 14 (56%) were coagulase-negative staphylococci, 2 were Staphylococcus aureus, 1 was α-hemolytic streptococcus, 4 were Bacillus, 1 was enterobacter and 1 was intestinal Escherichia coli, 2 copies of the genus Flavobacterium. Conclusion This report reports that the incidence of bacterial contamination of platelet preparations is higher than most researchers report.