Microbial contamination of harvested bone marrow and peripheral blood.
Microbial contamination of harvested bone marrow and peripheral blood.
复制标题
收获的骨髓和外周血的微生物污染。
DOI：
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发表时间：
1995
影响因子：
4.8
通讯作者：
A. Stewart
中科院分区：
文献类型：
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作者：
H. Prince;S. Page;A. Keating;R. Saragosa;N. Vuković;Kevin Imrie;M. Crump;A. Stewart
自体骨髓和外周血祖细胞微生物污染的发生率和临床后果没有很好的文献记载。因此，我们回顾性分析了采集的骨髓和/或外周血中细菌或真菌污染的经验。1987年1月至1994年1月底，共收获器官499例，移植301例。在三个处理阶段共获得3910份标本进行微生物污染评估：(1)收获后立即在手术室（1662袋），培养阳性为2.1%;(2)冷冻保存后处理（1039袋），培养阳性为1.1%;(3)解冻回输时（1209袋），培养阳性为2.2%。外周血祖细胞产物未见培养阳性标本。从骨髓中获得的85个培养阳性标本中绝大多数是皮肤菌群（89%），所有阳性收获标本中35%在处理和冷冻后仍呈阳性。至少36%的培养阳性标本被认为是由于血液培养瓶的外源性污染而产生的。9例（0.2%）标本中存在潜在致病性肠道微生物，其中4例发生了这些微生物的输注。另外7名患者接受了皮肤微生物阳性的骨髓培养。在输注任何受污染的产品后没有发现不良的临床后遗症。然而，临床决策仍然受到培养结果的影响，多阶段微生物培养在骨髓受者的管理中仍然具有价值。
The incidence and clinical consequences of microbiological contamination of autologous bone marrow and peripheral blood progenitor cells are not well documented. We therefore retrospectively analysed our experience with bacterial or fungal contamination of harvested bone marrow and/or peripheral blood. From January 1987 to the end of January 1994, 499 patients were harvested or which 301 were transplanted. A total of 3910 specimens obtained during three stages in the processing were assessed for microbial contamination: (1) in the operating room immediately after harvesting (1662 bags) with 2.1% culture positivity, (2) after processing for cryopreservation (1039 bags) with a further 1.1% cultures positive, and (3) after thawing at the time of reinfusion (1209 bags) of which 2.2% were culture positive. There were no culture positive specimens obtained from any peripheral blood progenitor cell products. The vast majority of the 85 culture positive specimens obtained from marrow were skin flora (89%) and 35% of all positive harvest specimens remained positive following processing and freezing. At least 36% of culture positive specimens were thought to have arisen as a result of exogenous contamination of blood culture bottles. Potentially pathogenic enteric organisms were present in nine (0.2%) specimens and infusion of these organisms occurred in four cases. A further seven patients were reinfused with marrow culture positive for skin organisms. No adverse clinical sequelae were noted following infusion of any contaminated products. However, clinical decision making continues to be influenced by culture results and multistage microbial culture continues to be of value in the management of our marrow recipients.