不同采样方法对透析机与供水回路连接处透析用水微生物监测结果的影响

Effect of different sampling methods on microbial monitoring results of dialysis water at the connection between dialysis machine and water supply circuit

摘要:

目的 研究不同采样方法对透析机与供水回路连接处透析用水微生物监测结果的影响。 方法 采集某院2018年1月—2020年12月54台透析机与供水回路连接处的透析用水, 根据不同采样方法分为3组, 分别为单人采样组(2018年1—12月)、双人采样组(2019年1—12月)、取样阀采样组(2020年1—12月), 监测3组透析用水细菌、内毒素和采样用时情况。 结果 单人采样组、双人采样组、取样阀采样组透析用水内毒素含量分别为(0.24±0.33)、(0.11±0.09)、(0.06±0.03)EU/mL, 细菌培养总数分别为(19.43±23.13)、(9.17±14.73)、(1.26±1.62)CFU/mL, 采样用时分别为(196.50±16.52)、(144.17±11.50)、(55.02±5.87) s, 总体比较差异均具有统计学意义(均P＜0.05)。组间多重比较结果显示, 差异均有统计学意义(均P＜0.05), 取样阀组采样用时最少(55.02 s), 平均内毒素含量最低(0.06 EU/mL), 细菌培养菌落数最低(1.26 CFU/mL)。单人采样组、双人采样组、取样阀采样组3组透析用水内毒素含量合格率分别为66.67%、92.59%、98.15%, 细菌培养合格率分别为77.78%、94.44%、100%, 总体比较差异有统计学意义, 除双人采样组与取样阀采样组比较差异无统计学意义外, 其余各组两两比较差异均有统计学意义(均P＜0.016 7)。 结论 透析机与供水回路连接处的透析用水通过取样阀取样, 能有效保证采样结果的合格率、准确性, 提高采样效率, 保障透析质量和安全, 有效避免科室成本的增加。

Abstract:

Objective To study the effect of different sampling methods on microbial monitoring results of dialysis water at the connection between dialysis machine and water supply circuit. Methods Dialysis water at the connection between 54 dialysis machine and water supply circuit in a hospital from January 2018 to December 2020 was sampled, according to different sampling methods, samples were divided into three groups: single-person sampling group (January-December 2018), double-person sampling group (January-December 2019) and sampling-valve sampling group (January-December 2020). Bacteria, endotoxin and sampling time of dialysis water in three groups were monitored. Results The endotoxin contents of dialysis water in single-person sampling group, double-person sampling group, and sampling-valve sampling group were (0.24±0.33), (0.11±0.09), and (0.06±0.03) EU/mL respectively, the total colony numbers of bacterial culture were (19.43±23.13), (9.17±14.73), and (1.26±1.62) CFU/mL respectively, and the sampling time were (196.50±16.52), (144.17±11.50), and (55.02±5.87) seconds respectively, the overall difference was significant (all P < 0.05). Multiple comparisons among groups showed that differences were all significant (all P < 0.05). In sampling-valve sampling group, sampling time was the shortest (55.02 seconds), average content of endotoxin was the lowest (0.06 EU/mL), and the colony number of bacterial culture was the lowest (1.26 CFU/mL). The qualified rates of endotoxin content in dialysis water of single-person sampling group, double-person sampling group and sampling-valve sampling group were 66.67%, 92.59% and 98.15% respectively, and qualified rates of bacterial culture were 77.78%, 94.44% and 100% respectively, difference of the overall comparison was significant, except that there was no significant diffe-rence between double-person sampling group and sampling-valve sampling group, pairwise comparison of the other groups were all significantly different (all P < 0.016 7). Conclusion Sampling of dialysis water at the connection between dialysis machine and water supply circuit through sampling-valve can effectively ensure qualified rate and accuracy of sampling results, improve sampling efficiency, ensure dialysis quality and safety, and effectively avoid the increase of department cost.