不同分娩方式采集的脐带血污染菌群分析

Contamination bacteria in cord blood among pregnant women with different delivery modes

目的对不同分娩方式采集的脐带血污染的细菌谱及污染菌的来源进行分析,为提高脐带血采集质量提供数据参考。方法收集2012年8月至2014年7月上海市脐带血造血干细胞库保存的脐带血11 435例,分离出细菌511株,对511株细菌进行鉴定并分析其可能的来源。结果在不同分娩方式采集的脐带血中,顺产和剖腹产的单纯厌氧菌污染率分别为65.2%(274例)和64.9%(48例),需氧菌污染率分别为34.8%(146例)和35.1%(26例);使用产钳分娩采集的脐带血厌氧菌和需氧菌的污染率分别为56.3%(9例)和43.8%(7例)。脐带血污染的厌氧菌主要为拟杆菌属和真杆菌属细菌,占厌氧菌总数的69.3%;需氧菌污染主要是肠杆菌科和葡萄球菌属细菌,占74.3%。结论不同分娩方式采集的脐带血被污染最多的菌株是厌氧菌,但污染率没有明显差异。污染脐带血的大部分厌氧菌(以拟杆菌属和真杆菌属细菌为主)和需氧菌(以肠杆菌科和葡萄球菌属细菌为主)是产妇生殖道的定植菌,是脐带血被污染的主要来源,在采集脐带血的过程中严格执行无菌操作将会提高脐带血的质量。

Objective To analyze contamination bacterium spectra in cord blood among pregnant women withdifferent delivery modes and the sources of contamination when collecting,in order to improve the collection qualityfor cord blood. Methods A total of 11 435 specimens of cord blood from Shanghai Cord Blood Bank were collectedfrom August 2012 to July 2014. A total of 511 isolates and their sources were identified. Results The contaminationrates of anaerobic bacteria by spontaneous deliver and cesarean were 65.2%(274 cases) and 64.9%(48 cases),and their contamination rates of aerobic bacteria were 34.8%(146 cases) and 35.1%(26 cases). The contaminationrates of anaerobic bacteria by forceps delivery were 56.3%(9 cases) and 43.8%(7 cases). The main anaerobicbacteria were Bacteroides and Eubacterium,accounting for 69.3%. The main aerobic bacteria were Enterobacteriumand Staphylococcus,accounting for 74.3%. Conclusions Anaerobic bacteria are main contamination bacteria incord blood,and its contamination rate has no difference by different delivery modes. Colonization bacteria fromgenital tract are anaerobic bacteria(Bacteroides and Eubacterium) and aerobic bacteria(Enterobacterium andStaphylococcus),which are the main contamination sources for cord blood. It should strengthen aseptic processingwhen collecting cord blood in order to improve its quality.