汚染された冷凍保存タンクからのB型肝炎の感染
R S Tedder1, M A Zuckerman, A H Goldstone
1Division of Virology, University College London Medical School, UK.
Lancet (London, England)
|July 15, 1995
まとめ
凍結保存タンクの漏れにより,細胞毒性治療を受けている6人の患者がB型肝炎ウイルス (HBV) を感染させた. これは,血液に感染するウイルスの拡散を防ぐために,ドナーのスクリーニングと安全な冷凍保存容器の密封の必要性を強調しています.
科学分野:
- ウイルス学 ウイルス学 ウイルス学
- 血液学 ヘマトロジ
- 移植医学 移植医学について
背景:
- 細胞毒性治療を受けている複数の輸血を受けた患者は,感染症に脆弱です.
- 骨髄や幹細胞などの生物学的物質の冷凍保存は,将来の移植の可能性のために一般的です.
- B型肝炎ウイルス (HBV) は,血液に感染する重要な病原体です.
研究 の 目的:
- 6人の患者の急性B型肝炎ウイルス (HBV) 感染の原因を調査する.
- 凍結保存された組織を含む臨床環境でHBVの伝播経路を特定する.
- 組織冷凍保存とドナースクリーニングにおける安全対策の重要性を強調する.
主な方法:
- 25ヶ月の期間における患者記録と臨床結果の遡及的分析.
- 凍結保存タンクの液体窒素にヒトDNA,B型肝炎表面抗原 (HBsAg),HBVDNAを検出する.
- 患者と冷凍保存タンクからのHBVDNAの配列分析により,関連性を確認する.
主要な成果:
- 複数の輸血を受けた6人の患者は,冷凍保存された骨髄または幹細胞を受けた後,下痢性急性HBV感染を発症しました.
- 同様のHBVDNA配列は,冷凍保存タンクの液体窒素と感染した患者のうち4人の体内で見つかりました.
- 証拠によると,最初の感染した患者の冷凍保存袋からの漏れがタンクを汚染し,HBVを感染させた.
結論:
- 凍結保存袋の漏れは,HBVの広範囲にわたる汚染と伝染につながる可能性があります.
- 血液に感染するウイルスに対する組織ドナーの厳格なスクリーニングは不可欠です.
- 主要な冷凍保存容器は,患者の安全を確保するために,冷凍剤との物質交換を防ぐように設計されなければならない.
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