64077例脐带血病原微生物检测结果分析

Analysis of pathogenic microorganisms in 64077 cases of umbilical cord blood

目的了解2012—2021年脐带血、母血病原微生物检测情况,为完善脐带血招募采集,确保脐带血造血干细胞安全提供依据。方法回顾性分析天津市脐带血造血干细胞库2012—2021年共分离64077例脐带血、母血病原微生物检测结果。结果2012—2021年64077例脐带血细菌培养检测结果,总阳性2072例(3.23%);其中需氧菌培养阳性184例(0.29%),厌氧菌培养阳性1504例(2.34%),需、厌氧均阳性384例(0.60%)。2012—2021年脐带血细菌阳性率呈下降趋势,每年阳性率有差异(P<0.05),厌氧菌阳性率高于需氧菌阳性率及需、厌氧双阳性率(P<0.05)。细菌阳性标本经革兰氏染色后,镜检检出率G-杆菌依次高于G+杆菌、G+球菌、G-球菌及其他。2012—2021年64077例脐带血和母血输血传染性病原体检测结果,脐带血检测结果有反应性169例(0.26%),母血检测结果有反应性1231例(1.92%)。脐带血及母血HIV-Ag/Ab检测,初筛有反应性标本经蛋白印迹方法确认后母血不确定1例,其余为阴性。脐带血抗-TP、抗-HCV有反应性率(0.12%、0.11%)高于HBsAg(0.03%)及CMV-IgM(1/64077);不同年份脐带血抗-TP检测有反应性率有差异(P<0.05),HBsAg、抗-HCV、CMV-IgM检测有反应性率无统计学意义(P>0.05)。母血HBsAg有反应性率(1.38%)依次高于CMV-IgM、抗-TP、抗-HCV(0.29%、0.13%、0.12%);不同年份母血HBsAg、抗-HCV、抗-TP检测有反应性率有差异(P<0.05),且母血HBsAg有反应性率呈现下降趋势,CMV-IgM检测有反应性率无统计学意义(P>0.05)。HBsAg、CMV-IgM项目母血有反应性率明显高于脐带血(P<0.05),母血抗-HCV、抗-TP有反应性率与脐带血基本一致(P>0.05)。结论本地区脐带血HIV-Ag/Ab、CMV-IgM及母血HIV-Ag/Ab项目检测有反应性率处于较低水平。脐带血有反应性率较高项目为抗-TP、抗-HCV。母血HBsAg有反应性率是比较高的项目,但呈下降趋势,脐带血HBsAg有反应性率呈低水平,相关母婴阻断措施起到一定作用。

Objective To investigate the detection of pathogenic microorganisms in umbilical cord blood and maternal blood from 2012 to 2021,so as to improve the collection of umbilical cord blood and guarantee the safety of umbilical cord blood hematopoietic stem cells(HSC).Methods Detection results of pathogenic microorganisms of umbilical cord blood and maternal blood among 64077 cases from Tianjin Cord Blood Bank from 2012 to 2021 were retrospectively analyzed.Results A total of,2072 cases(3.23%)were detected positive,a⁃mong which,184 cases(0.29%)were positive for aerobic bacte⁃ria culture,1504 cases(2.34%)were positive for anaerobic bacteria culture,and 384 cases(0.60%)were positive for both aerobic and anaerobic bacteria culture.From 2012 to 2021,the overall positive rate showed a downward trend,with a difference in the positive rate between each year(P<0.05).The positive rate of anaerobic bacteria was higher than that of aerobic bacteria and that of anaerobic and aerobic bacteria(P<0.05).After Gram staining,the microscopic detection rate of bacterial positive samples was highest in G'bacilli,followed by G*bacilli,G*cocci,G'cocci and others.Among the 64077 cases,169 cases(0.26%)showed reactivity in cord blood tests and 1231 cases(1.92%)showed reactivity in maternal blood tests.Umbilical cord blood and maternal blood HIV-Ag/Ab tests showed reactivity after initial screening.After confirmation by Western blotting,there was 1 case of uncertain maternal blood,while the rest were negative.The reactive rates of anti-TP(0.12%)and anti-HCV(0.11%)in umbilical cord blood were higher than those of HBsAg(0.03%)and CMVIgM(1/64077).There was a difference in the reactive rate of anti-TP detection in umbilical cord blood between different years(P<0.05),while there was no statistically significant difference in that of HBsAg,anti-HCV and CMV-IgM(P>0.05).The reactive rate of HBsAg in maternal blood(1.38%)was higher than that of CMV-IgM(0.29%),anti-TP(0.13%)and anti-HCV(O.12%).There were differences in the reactive rates of HBsAg,anti-HCV,and anti-TP in maternal blood among different years(P<0.05),and that of HBsAg showed a decreasing trend,while the reactive rate of CMV-IgM was not statistically significant(P>0.05).The reactive rates of HBsAg and CMV-IgM detected in maternal blood were significantly higher than those in umbilical cord blood(P<0.05).The reactive rates of anti-HCV and anti-TP in maternal blood were consistent with those in umbilical cord blood(P>0.05).Conclusion The reactive rates of anti-HIV and CMV-IgM in cord blood,and that of anti-HIV in maternal blood are low,but those of anti-TP and anti-HCV in cord blood are relatively high.The reactive rate of HBsAg is high in maternal blood,but with a downward trend,but low in umbilical cord blood due to maternal-infantile transmission blocking.The detection of transfusion transmitted pathogens and bacteria plays a critical role on the safety of umbilical cord blood HSCs.Effective detection of transfusion transmitted pathogens and culture of bacteria are the key to ensure the quality of umbilical cord blood,which can improve the safety of umbilical cord blood HSCs transplantation.