「別嘌醇」生產溫度不足殺菌 半製成品放置過久 環境助長毛霉菌

「別嘌醇」生產溫度不足殺菌 半製成品放置過久 環境助長毛霉菌
(明報)2010年8月18日 星期三 05:10
【明報專訊】死因庭續審降尿酸藥「別嘌醇」，疑致8名癌病患者感染毛霉菌死亡事件。港大微生物學系系主任袁國勇估計，可能藥丸在生產過程中熱力不足殺菌，且半製成品放置過久，終令藥丸被大量毛霉菌污染。他又形容今次是醫學史上首次有癌症病人爆發腸道毛霉菌感染。

袁國勇於今年3月實地視察歐化藥業廠房，發現生產過程有問題。他指藥丸原材料壓成藥餅後經歷脫水，廠方以攝氏50度烘乾半製成品，繼而在攝氏20度環境下擺放5至14天，他指：「脫水過程太久，藥餅帶3%水分，加上環境溫度，令小芽孢根霉菌（毛霉菌的一種）快速繁殖。」他又指出，瑪麗醫院    病房及藥房的樣本亦超標41倍及31倍。根據在藥廠檢取的藥丸樣本，含菌量超標逾百倍。

倡棄粟粉製藥 升生產溫度滅菌

袁國勇認為藥廠人員並非醫生或微生物學專家，未必注意生產環境問題，認為業界應檢討生產程序，如提升生產溫度至攝氏65度，只需10分鐘便可殺滅霉菌，又建議棄用粟粉製藥以縮短擺放時間，並使用酒精製藥以消毒。

有家屬問及事主死亡與服用帶菌別嘌醇是否有關。袁國勇解釋兩者有直接關係，但不能斷言事主因服食帶菌藥而死，「病人天天服用該藥，藥丸含菌量『千千聲』，機會較大，但非絕對」。

袁國勇：醫學史上首病例

他又形容是次爆發極罕見，「我的論文題目關於骨髓病人感染，未發現類似病例。根據文獻案例亦僅得20個，99%醫生一生都沒遇見；過往有一次爆發案例，患者從舌頭感染，菌來自木製舌壓（即「雪條棍」）。」他又形容今次是醫學史上首次病例，與多個不幸情况一起出現，引致事件。案件今續。

【案件編號：CCDI259-262、283-286/09】

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