不同培養基選擇與方法測定血液透析用水總菌落數的比較

Comparisons of Different Media and Operative Methods to Determine Total Number of Colonies of the Dialysate Water

透析用水品質是血液透析安全必要條件，諸多的環節均可造成污染使透析液的細菌含量超標，微生物及其代謝產物更會直接進入人體，造成血液透析相關感染事件的發生，故要定期進行微生物監測，才可避免造成血液透析患者的傷害。本研究調查使用三種6-60CFU/mL標準菌株的模擬污染水樣本，結合傾倒平板法，在三種不同的培養基進行培養，分成25℃及35℃等二組進行培養，紀錄48小時、72小時、7天等時間之生長情況，以確認最佳的培養條件。結果發現生長狀況25℃優於35℃、72小時優於48小時，而7天的孵育並無明顯的增加。因此我們認為血液透析用水需用傾注平板法TGEA培養基，同時進行25℃及35℃孵育至少72小時，始能產生有效的報告確保病人透析安全。

High quality dialysis water is a necessary component for the safety of hemodialysis. Many routes of bacterial contamination can lead to excessive microorganisms in the dialysate. The direct entry of these bacteria and their metabolites through the dialysate can result in hemodialysis-associated infection. Therefore, regular microbiological monitoring is required to avoid infections in patients undergoing hemodialysis. The present study investigated simulated contaminated water samples with 6–60 colony-forming units (CFU)/ml (three standard strains) and using pour plate technique into three different media. Each sample was cultured separately at 25°C and 35°C and 48 h, 72 h, and seven days after culture to confirm the optimal culture conditions. We found that the growth condition at 25°C is better than 35°C; 72 h is better than 48 h, but there was no significant increase after seven days of incubation. Therefore, it was concluded that bacterial culture of dialysis water should be done using the pour plate method in Tryptone Glucose Extract Agar media at an incubation temperature of 25°C and 35°C for at least 72 h to allow optimal growth for effective bacterial status reporting, thereby ensuring the safety of patients undergoing dialysis.