农牧地区献血人群布鲁氏菌筛查分析

Screening Analysis of Brucella Spp. in Blood Donators in Farming and Pastoral Areas of Zhangjiakou, the North of China

目的分析疑似布鲁氏菌感染者参与无偿献血给血液安全带来的风险,提高血液安全性。方法对张家口地区农牧县和非涉农牧县区部分参加无偿献血者,采用虎红平板凝集试验进行布鲁氏菌初筛;对初筛阳性样本采用试管凝集试验进行确认,并送至当地传染病医院实验室复查;对1例既往布鲁氏菌病患者参加献血的标本进行PCR确诊试验。根据全部试验数据及跟踪访问记录进行研究分析。结果筛查了农牧地区3134名献血者,并与非农牧县区2667名献血者结果比较,农牧地区初筛阳性率0.35%,确认阳性率0.06%;非农牧县区初筛阳性率0.11%,确认阳性率0.04%。对1名既往布鲁氏菌病患者参加献血的血标本进行PCR-荧光探针检测,确证阳性。跟踪访问布鲁氏菌阳性献血者职业、暴露史、接触史、后续治疗情况等进行感染因素分析。结论张家口地区参加无偿献血者中发现布鲁氏菌感染阳性者,且牧区和非牧区无偿献血者中布鲁氏菌感染者差异无统计学意义(P>0.05),提示布鲁氏菌感染已经不仅限于牧区,该类献血者所捐献血液对于安全输血存在隐患。在布鲁氏菌感染高发流行区无偿献血人群中增加布鲁氏菌初筛及征询具有重要意义。

Objective Conducting a Brucella screening test on some unpaid blood donors in the Zhangjiakou area,statistical analysis of test data,confirmatory testing of suspected cases and follow-up visits,to study the risk of suspected Brucella infected individuals participating in blood donation for blood safety and improve blood safety.Methods For the part of the agricultural and pastoral counties in the Zhangjiakou area and non-agricultural and pastoral areas,the Rose Bengal Plate Test was used for the initial screening of Brucella;The positive screening samples are confirmed by tube agglutination test and sent to the local infectious disease hospital laboratory for review;A PCR confirmation test was performed on a specimen of a patient who had been infected with previous disease.Research and analysis were conduct based on all test data and follow-up visit records.Results The survey screened 3134 blood donors in farming and pastoral areas,and compared with 2667 blood donors in non-agricultural and pastoral areas,the positive screening rate of agricultural and pastoral areas was 0.35%,and the positive rate was 0.06%,the positive screening rate of non-agricultural and pastoral areas was 0.11%,and the positive rate was 0.04%.A PCR-fluorescent probe test was performed on blood samples from a patient with previous disease who participated in blood donation to confirm positive.Infectious factors were analyzed from data including occupational,exposure and contact history and follow-up treatment of Brucella positive blood donors.Conclusion Brucella-positive people were found in unpaid blood donors in Zhangjiakou area,and there was no statistically significant difference in Brucella infection between unpaid blood donors in pastoral and non-pastoral areas.It is suggested that Brucella infection is no longer unique to pastoral areas but gradually invades the lives of urban residents,and the blood donated by those donors has safety risk.It is important to increase the Brucella consultation and preliminary screening test in the unpaid blood donors in the high-risk area of brucellosis.