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題名 | 2018年宜蘭縣丙型干擾素釋放試驗血液樣本異常調查報告=Investigation of Abnormal Operation of Specimen for Interferon-Gamma Release Assay, Ilan County, 2018 |
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作者 | 謝鶯玉; 林秋華; 劉明經; 魏欣怡; 姜淑莉; 董曉萍; 顏哲傑; | 書刊名 | 疫情報導 |
卷期 | 36:4 2020.02.25[民109.02.25] |
頁次 | 頁52-57 |
分類號 | 412.43 |
關鍵詞 | 潛伏性結核菌感染; 丙型干擾素釋放試驗; 凝血; Latent tuberculosis infection; Interferon-gamma release assay; Clot; |
語文 | 中文(Chinese) |
中文摘要 | 2018年7至8月間,宜蘭縣進行潛伏結核菌感染檢查時,送驗四起事件之檢體經合約實驗室判定凝血而要求重新採檢,為釐清原因而啟動本次調查。本調查藉由某長照機構進行重新採檢時,完整檢視採檢送驗過程,顯示採血管儲存環境與採檢後混合方式尚有改善空間,採檢管培養後仍有紫管出現明顯凝塊。然而,所有檢體均無出現不確定之檢驗結果。本次調查推測,實驗室判定之凝血,可能易受受測者血液或疾病狀態、檢體靜置時間等因素影響而造成血球凝聚,使判讀出現干擾。因此,凝血判定時機宜於採血進行時或於採檢完成後,由採檢者加強檢視採血管凝血狀態,實驗室應於檢測後出現不確定結果時,再對公衛端提出重新採檢建議,可避免第一線公衛人員不必要之壓力與工作負荷。 |
英文摘要 | From July to August, 2018, four events of latent tuberculosis infection tests using Interferon-gamma release assay in Ilan county were rejected and were requested for re-sampling by the laboratory because of specimen clot. To figure out the cause of clotting, we investigated the procedures of sampling and transferring of specimen by checklist. The results showed that the storage environment of tubes and tube-shaking method were improper and needed to be modified. After culturing, some of the purple tubes showed obviously clumping. However, there were no indeterminate results in all specimens, which suggested that the clot read by the laboratory staff might be interfered by the diseases of the patients and the storage time of the specimens. Therefore, the time to check clot of specimens should be done while sampling by the medical technicians. Laboratory staff should suggest re-sampling only when the results show indeterminate outcomes, which could avoid unnecessary stress and workloads on public health officials. |
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