Clinical study on colony count monitoring and sampling of dialysate in hemodialysis room
血透室透析液菌落数监测采样的临床探讨

摘要

目的 探讨血透室不同透析液采样方法对菌落数监测结果的影响。方法 选取2024年1月至2025年1月份本院血透室采集的透析液样本569份，其中实验组280份采用活塞性采样点采样法，对照组289份采用密封硅胶塞采样点采样法。统一监测培养条件，比较两组样本的菌落数合格率、一次性采样成功率、采样所需时间及操作安全性。结果 两组透析液细菌菌落数合格率比较，实验组为99.64%（279/280），对照组为98.27%（284/289），差异无统计学意义（χ2=0.227，P=0.634）；实验组一次性采样成功率为100.00%（280/280），无重复采样情况，对照组一次性采样成功率为98.61%（285/289），4例需重复采样，两组比较差异无统计学意义（χ2=0.370，P=0.206）；实验组平均采样时间为（5±1.08）s，短于对照组的（7±1.93）s（P=0.06）；操作安全性方面，实验组无针刺伤风险，对照组存在4例潜在针刺伤隐患，且硅胶塞反复穿刺易破损。结论 活塞性采样点与密封硅胶塞采样点的菌落数监测合格率无差异，但活塞性采样法具有操作简便、一次性成功率高、采样时间短、无职业伤害风险等优势，更适合作为血透室透析液菌落数监测的标准化采样方法，可为国家2024—2025年透析液监测工作提供高效、安全的技术支撑。

Abstract

To investigate the impact of different dialysate sampling methods in the hemodialysis room on the monitoring results of colony counts.
Methods 69 dialysate samples collected from the hemodialysis room of our hospital from January 2024 to January 2025 were selected. Among them, 280 samples in the experimental group were sampled using the active sampling point method, and 289 samples in the control group were sampled using the sealed silicone plug sampling point method. The same monitoring and cultivation conditions were applied, and the qualified rate of colony counts, the success rate of one-time sampling, the time required for sampling, and the operational safety of the two groups of samples were compared.
Results There was no significant difference in the qualified rate of bacterial colony count between the two groups: 99.64% (279/280) in the experimental group and 98.27% (284/289) in the control group (χ²=0.227, P=0.634). The one-time sampling success rate in the experimental group was 100.00% (280/280) with no repeated sampling, while that in the control group was 98.61% (285/289) with 4 cases requiring repeated sampling, and the difference between the two groups was not statistically significant (χ²=0.370, P=0.206). The average sampling time in the experimental group was (5±1.08) s, which was significantly shorter than (7±1.93) s in the control group (P=0.06). In terms of operational safety, there was no risk of needlestick injury in the experimental group, while there were 4 potential needlestick injury hazards in the control group, and the silicone plug was easy to be damaged after repeated puncture.
Conclusion   There is no significant difference in the qualified rate of bacterial colony count monitoring between piston sampling points and sealed silicone plug sampling points, but the piston sampling method has the advantages of simple operation, high one-time success rate, short sampling time and no risk of occupational injury. It is more suitable as a standardized sampling method for dialysate bacterial colony count monitoring in hemodialysis rooms, and can provide efficient and safe technical support for the national dialysate monitoring work from 2024 to 2025, which is worthy of clinical promotion and application.