致病微生物标本培养前涂片革兰染色镜检价值分析
|
摘要
目的如何及时有效的筛除不合格标本,发现标本留取过程中的污染情况十分重要。微生物标本培养前进行革兰染色涂片镜检,具有重要意义。本研究主要探讨致病微生物标本培养前涂片革兰染色镜检的临床价值。方法选取2016-02-01-2018-11-30辽宁健康产业集团本钢总医院送检的微生物标本239例,痰液标本117例,尿液标本87例,其他标本如脓液、胸腔积液、腹水等35例,先进行革兰染色涂片镜检,对理想标本及污染标本进行评定,并鉴定致病微生物培养结果,分析涂片镜检中微生物检出情况,比较涂片镜检与微生物培养结果的相符性。结果本组239例符合涂片镜检与微生物培养要求的标本,其中检出微生物共计87例(36.4%),标本来源为痰液44例(50.6%),尿液18例(20.7%),其他分泌物25例(28.7%),痰液、尿液、其他分泌物涂片镜检与微生物培养结果符合率分别为72.7%、83.3%和56.0%。结论在实施致病微生物培养前进行标本涂片镜检,对于早期排除不合格标本,提高标本采集效率,进而确保检验结果,更好地指导临床治疗有重要意义。
OBJECTIVE How to screen out unqualified specimens in a timely and effective manner,and find that the pollution situation in the specimen collection process are very important.It has a great significance for specimen to be examined by Gram staining with microscope before culture.This study mainly explores the clinical value of smear Gram staining examined with microscopy for specimens before pathogenic microorganisms culture.METHODS A total of 239 microbial specimens were collected from the Japanese hospital from February 1,2016 to November 30,2018.There were 117 sputum specimens,87 urine specimens and 35 other specimens such as pus,pleural effusion and ascites.Gram staining smear examination was carried out to evaluate the ideal specimen and contaminated specimen,and the culture results of pathogenic microorganisms were identified.The results of microbe detection in smear microscopy were analyzed,and the consistency between smear microscopy and microbial culture results was compared.RESULTS A total of 239 specimens in this group met the requirements of smear microscopy and microbial culture.Among them,87 cases(36.4%)were detected.There were 44 cases(50.6%)of sputum,18 cases(20.7%)of urine and 25 cases(28.7%)of other secretions.The coincident rates of sputum,urine and other secretion smears with microbial culture were 72.7%,83.3%and 56.0%,respectively.CONCLUSIONS Microscopic examination of specimens before culturing pathogenic microorganisms is of great significance for early elimination of unqualified specimens,improvement of sample collection efficiency,assurance of test results,and better guidance for clinical treatment.
OBJECTIVE How to screen out unqualified specimens in a timely and effective manner,and find that the pollution situation in the specimen collection process are very important.It has a great significance for specimen to be examined by Gram staining with microscope before culture.This study mainly explores the clinical value of smear Gram staining examined with microscopy for specimens before pathogenic microorganisms culture.METHODS A total of 239 microbial specimens were collected from the Japanese hospital from February 1,2016 to November 30,2018.There were 117 sputum specimens,87 urine specimens and 35 other specimens such as pus,pleural effusion and ascites.Gram staining smear examination was carried out to evaluate the ideal specimen and contaminated specimen,and the culture results of pathogenic microorganisms were identified.The results of microbe detection in smear microscopy were analyzed,and the consistency between smear microscopy and microbial culture results was compared.RESULTS A total of 239 specimens in this group met the requirements of smear microscopy and microbial culture.Among them,87 cases(36.4%)were detected.There were 44 cases(50.6%)of sputum,18 cases(20.7%)of urine and 25 cases(28.7%)of other secretions.The coincident rates of sputum,urine and other secretion smears with microbial culture were 72.7%,83.3%and 56.0%,respectively.CONCLUSIONS Microscopic examination of specimens before culturing pathogenic microorganisms is of great significance for early elimination of unqualified specimens,improvement of sample collection efficiency,assurance of test results,and better guidance for clinical treatment.
引文
[1]牟晓明,宋太吉,周健武,等.颊普雷沃菌和极小陌生菌感染及鉴定[J].中华医院感染学杂志,2018,28(24):3713-3717.
[2]陈军,陈丽峰,饶有益,等.GeneXpert MTB/RIF试验与4种结核分枝杆菌检测方法的比较[J].临床血液学杂志(输血与检验),2018,31(6):956-959.
[3]白永凤,程颖,杨云飞,等.液体分枝杆菌培养管培养和Xpert MTB/RIF对涂阴肺结核诊断价值的评估[J].中国卫生检验杂志,2018,28(22):2709-2711.
[4]李菁原,叶向军,颜艳,等.AIDS患者骨髓涂片检出大量非结核分枝杆菌1例[J].检验医学,2018,33(9):872-874.
[5]秦新峰.痰涂片检查联合结核杆菌培养对肺结核的诊断价值[J].河南医学研究,2018,27(19):3580-3581.
[6]闫高波,栗艳,刘晓蕾,等.不同检验方法对肺结核患者痰中结核分枝杆菌检验价值分析[J].临床军医杂志,2018,46(9):1061-1062.
[7]唐晓燕,何梗秀,黄小梅.279例儿童下呼吸道感染痰涂片与痰菌培养结果的相符率分析[J].抗感染药学,2018,15(6):997-998.
[8]林立,刘彩霞.儿童呼吸道感染微生物检验标本采集转运与检测建议(细菌篇)[J].中国实用儿科杂志,2018,33(9):663-669.
[9]许鑫鑫,闫朋,李寅,等.痰样本性状对抗酸杆菌镜检及液体培养结果的影响[J].中国国境卫生检疫杂志,2018,41(4):247-248.
[10]胡品.浅析微生物标本培养前涂片革兰染色镜检的临床研究意义[J].系统医学,2018,3(15):39-41.
[11]黄艳飞,王丽赟,王玫,等.1 050例鼻窦炎病原菌分析[J].临床检验杂志,2018,36(7):545-548.
[12] Niimi H,Ueno T,Hayashi S,et al.Melting temperature mapping method:A novel method for rapid identification of unknown pathogenic microorganisms within three hours of sample collection[J].Sci Rep,2015,28(5):125-143.
[13] Amarsy-Guerle R,Mougari F,Jacquier H,et al.High medical impact of implementing the new polymeric bead-based BacT/ALERT○R FAPlus and FNPlus blood culture bottles in standard care[J].Eur J Clin Microbiol Infect Dis,2015,34(5):1031-1037.
[14]赵玲.痰标本真菌涂片与培养阳性结构在侵袭性肺部真菌感染中的诊断意义[J].现代医学与健康研究电子杂志,2018,2(9):182.
[15]刘畅,徐英春,宋红梅,等.分枝杆菌实验室诊断方法比较[J].协和医学杂志,2018,9(3):246-250.
[16]张燕.痰涂片革兰染色的临床价值[J].中西医结合心血管病电子杂志,2018,6(4):116-117.
[17]卜静雅,马超超,宁安红,等.阳性血培养涂片结果与培养结果不一致的原因探讨[J].中国微生态学杂志,2017,29(12):1452-1455.
[18]熊章华,陈益国,邹志宁,等.尿培养结合尿沉渣涂片镜检在诊断尿路感染的作用研究[J].实验与检验医学,2017,35(6):865-869,873.
[2]陈军,陈丽峰,饶有益,等.GeneXpert MTB/RIF试验与4种结核分枝杆菌检测方法的比较[J].临床血液学杂志(输血与检验),2018,31(6):956-959.
[3]白永凤,程颖,杨云飞,等.液体分枝杆菌培养管培养和Xpert MTB/RIF对涂阴肺结核诊断价值的评估[J].中国卫生检验杂志,2018,28(22):2709-2711.
[4]李菁原,叶向军,颜艳,等.AIDS患者骨髓涂片检出大量非结核分枝杆菌1例[J].检验医学,2018,33(9):872-874.
[5]秦新峰.痰涂片检查联合结核杆菌培养对肺结核的诊断价值[J].河南医学研究,2018,27(19):3580-3581.
[6]闫高波,栗艳,刘晓蕾,等.不同检验方法对肺结核患者痰中结核分枝杆菌检验价值分析[J].临床军医杂志,2018,46(9):1061-1062.
[7]唐晓燕,何梗秀,黄小梅.279例儿童下呼吸道感染痰涂片与痰菌培养结果的相符率分析[J].抗感染药学,2018,15(6):997-998.
[8]林立,刘彩霞.儿童呼吸道感染微生物检验标本采集转运与检测建议(细菌篇)[J].中国实用儿科杂志,2018,33(9):663-669.
[9]许鑫鑫,闫朋,李寅,等.痰样本性状对抗酸杆菌镜检及液体培养结果的影响[J].中国国境卫生检疫杂志,2018,41(4):247-248.
[10]胡品.浅析微生物标本培养前涂片革兰染色镜检的临床研究意义[J].系统医学,2018,3(15):39-41.
[11]黄艳飞,王丽赟,王玫,等.1 050例鼻窦炎病原菌分析[J].临床检验杂志,2018,36(7):545-548.
[12] Niimi H,Ueno T,Hayashi S,et al.Melting temperature mapping method:A novel method for rapid identification of unknown pathogenic microorganisms within three hours of sample collection[J].Sci Rep,2015,28(5):125-143.
[13] Amarsy-Guerle R,Mougari F,Jacquier H,et al.High medical impact of implementing the new polymeric bead-based BacT/ALERT○R FAPlus and FNPlus blood culture bottles in standard care[J].Eur J Clin Microbiol Infect Dis,2015,34(5):1031-1037.
[14]赵玲.痰标本真菌涂片与培养阳性结构在侵袭性肺部真菌感染中的诊断意义[J].现代医学与健康研究电子杂志,2018,2(9):182.
[15]刘畅,徐英春,宋红梅,等.分枝杆菌实验室诊断方法比较[J].协和医学杂志,2018,9(3):246-250.
[16]张燕.痰涂片革兰染色的临床价值[J].中西医结合心血管病电子杂志,2018,6(4):116-117.
[17]卜静雅,马超超,宁安红,等.阳性血培养涂片结果与培养结果不一致的原因探讨[J].中国微生态学杂志,2017,29(12):1452-1455.
[18]熊章华,陈益国,邹志宁,等.尿培养结合尿沉渣涂片镜检在诊断尿路感染的作用研究[J].实验与检验医学,2017,35(6):865-869,873.