【摘要】 目的 对上海市血液中心检测的405392袋单采血小板细菌结果进行回顾性分析，评估上海地区单采血小板细菌污染发生及控制情况，为制定细菌污染检测策略和预防措施提供依据。方法 2017年1月—2023年12月，上海市血液中心将采集至少间隔24 h的单采血小板从母袋中取样至留样袋，并接种于需氧培养瓶内，使用自动化微生物培养系统进行细菌筛查，统计分析阳性细菌数据。结果 2017年1月—2023年12月使用3种培养系统共检测到423例初始阳性标本，通过统计分析，初始阳性率为10.43×10^-4、确认阳性率为1.95×10^-4、不确定阳性率为1.33×10^-4、不一致阳性率为0.12×10^-4、取样污染引起的假阳性率为0.32×10^-4、仪器误报引起的假阳性率为6.71×10^-4,3种培养系统组间差异无统计学意义（P>0.05）。经过MALDITOFMS质谱共检测出32种，151株细菌。其中确认阳性结果中表皮葡萄球菌、头葡萄球菌、人葡萄球菌所占比例较高；在不确定结果中短芽孢杆菌、表皮葡萄球菌、头状葡萄球菌所占比例较高；在不一致阳性结果中主要是解淀粉芽孢杆菌、星座链球菌、自溶菌、坚韧类芽孢杆菌；在假阳性（取样污染）结果中短芽孢杆菌、巨大芽孢杆菌、枯草芽孢杆菌、莫哈维芽孢杆菌、人葡萄球菌所占比例较高。确认阳性结果中初始报阳时间在12h内被检出的细菌主要是蜡样芽胞杆菌、加氏乳球菌、地衣芽孢杆菌;在（12～24）h内被检出的细菌主要是表皮葡萄球菌、泛血败菌属、停乳链球菌。确认阳性细菌中，皮肤条件致病菌组的数量明显高于环境条件致病菌和常见致病菌组，差异有统计学意义（P>0.05）。结论 通过使用自动化微生物培养系统对单采血小板进行细菌筛查，能有效地控制细菌污染的发生，保障单采血小板制品输注安全，同时本研究也可为献血者皮肤消毒流程优化及有效性评估措施的标准或规程提供参考依据。更多还原

【Abstract】 Objective To retrospectively analyze the bacterial results of 405 392 bags of apheresis platelets detected by Shanghai Blood Center, evaluate the occurrence and control of bacterial contamination of apheresis platelets in Shanghai,and provide basis for formulating bacterial contamination detection strategies and preventive measures. Methods From January, 2017 to December, 2023, the apheresis platelets collected at least 24 hours apart were sampled from the mother bag to the retention bag, and inoculated in aerobic culture bottles. The automatic microbial culture system was used for bacterial screening, and the positive bacterial data were statistically analyzed. Results From January 2017 to December 2023, a total of 423 initial positive samples were detected by using three culture systems. Through statistical analysis, the initial positive rate was 10.43×10^-4, the confirmed positive rate was 1.95×10^-4, the uncertain positive rate was 1.33×10^-4, and the inconsistent positive rate was 0.12×10^-4. 32 species and 151 strains of bacteria were detected by MALDI-TOF MS Among the positive results, Staphylococcus epidermidis, Staphylococcus cephalus and Staphylococcus hominis accounted for a high proportion.Among the uncertain results, Bacillus brevis, Staphylococcus epidermidis and Staphylococcus capitis account for a high proportion. Among the inconsistent positive results, Bacillus amyloliquefaciens, Streptococcus Constellation, Autolytic bacteria and Paecilomyces fortis were the main ones. Bacillus brevis, Bacillus megaterium, Bacillus subtilis, Bacillus Mojave and Staphylococcus hominis account for a high proportion in the false positive results. Bacillus cereus, Lactococcus gasseri and Bacillus licheniformis were the main bacteria detected within 12 h after the initial positive report. The main bacteria detected within（12～24） h were Staphylococcus epidermidis, Streptococcus agalactiae. Among the confirmed positive bacteria, the number of skin conditional pathogens group was significantly higher than that of environmental conditional pathogens and common pathogens group, and the difference was statistically significant（P<0.05）. Conclusion By using automatic blood culture system to detect bacteria in apheresis platelets collected in Shanghai from 2017 to 2023, 405 392 cases of detection data were retrospectively analyzed, and relatively reliable and complete data of bacterial screening of apheresis platelets collected in large samples were obtained. Staphylococcus epidermidis, Staphylococcus cephalus and Staphylococcus hominis accounted for a high proportion of positive results. The results showed that there was no statistical difference in bacterial positive detection results of platelet collected by three culture devices, and Bact/Alert 3D and Autobio culture systems were in operation. BACTEC system has advantages in sensitive detection. Relevant units can select relevant equipment according to application scenarios.更多还原