血液透析用液品質之細菌監測

Surveillance of Bacteria Quality of Hemodialysis Fluids

10.6340/KD.2016.28(1).09

蔡佳璋(Chia-Chang Tsai)；王婉菁(Wan-Ching Wang)；陳美伶(Mei-Ling Chen)；黃鳳雄(Fong-Shung Huang)；黃小倩(Hsiau-Chien Hwang)；徐永堂(Yung-Tang Hsu)；黃政文(Jenq-Wen Huang)

塗抹平板法 ； 傾注平板法 ； 濾膜法 ； 細菌培養 ； spread-plate method ； pour-plate method ； membrane filter method ； bacterial culture ； Reasoner's 2A media

腎臟與透析

28卷1期（2016 / 03 / 01）

37 - 42

繁體中文

在本文中將介紹總菌落數檢驗，有三種最常見的培養基及其檢驗方法；其中由於培養基、培養溫度、時間、及檢驗方式不同，得到的總菌落數結果會有所不同，而原始培養的條件若越接近水中相似環境，越能反映透析用水細菌污染之情形。因此，建議應依國內外透析用水檢測指引、使用低營養的培養基如R2A或TGEA，以協助生長緩慢及不完整/受傷的菌體達到最佳生長狀況，且培養在17 ~ 23°C條件下、持續168小時，以利於可能存在透析用液中的細菌形成菌落。

In this article, we will introduce the three most common culture media and culture methods among all methods of measurement of total colony forming units. Due to difference of media, temperatures, durations or culture methods, we will get different counts of total colony forming units. If the initial culture condition is more similar to the condition of water used during hemodialysis, bacterial culture will better reflect the severity of bacterial contamination of water used for hemodialysis. As a result, this article suggests that we should use low nutrient culture media, such as R2A or TGEA, according to Taiwanese/international examination guidelines of water used for hemodialysis. The use of low nutrient culture media will help slow-growing bacteria and injured bacteria to achieve the best growth condition. In the same time, this article also suggests the bacterial culture should be under the temperature of 17 ~ 23°C, and continues for 168 hours, to enhance colony formation for the bacteria that possibly exist in hemodialysis solution.