819份不同痰标本来源分枝杆菌培养结果分析
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摘要
目的分析涂阳培阴及涂阳培养污染的原因分析,为了解决降低涂阳培阴率及涂阳培养污染率提出更合理的操作流程。方法 2013年8月-2014年12月实验室共接收各区实验室耐多药可疑患肺结核涂阳的痰标本和本单位的门诊及住院确诊肺结核病人涂阳的痰标本共819份,进行分离培养。对分离培养阴性及污染结果进行分析。结果 819份痰涂片阳性标本分离培养结果:分离培养阳性709份,占86.57%(709/819);培养阴性77份,占9.47%(77/819);培养污染33份,占4.03%(33/819);总涂阳培阴77份痰标本中:1条-8条23份占29.87%(23/77);1+42份占54.54%(42/77);2+10份占12.98%(10/77);3+1份占1.29%(1/77);4+1份占1.29%(1/77)。结论涂阳培阴标本涂片痰菌量分布在1+>8和条>2+之间,B组比A组患者痰标本出现涂阳培阴率和污染率高,应注意各个步骤操作流程细节。
Objective To analyze the causes of smear-panning and smear-culture pollution, and to propose a more reasonable operation procedure in order to reduce the smear-positive rate and smear-culture pollution rate.Methods From August 2013 to December 2014, the laboratory received a total of 819 specimens from the smear-positive tuberculosis of the multi-drug-susceptible tuberculosis in the laboratory and 819 specimens of the smear-positive smearpositive tuberculosis patients in the unit.The negative culture and contamination results were analyzed. Results A total of 819 smear-positive specimens were isolated and cultured: 709 copies were positive for culture, accounting for 86.57%(709/819); 77 were negative for culture, accounting for 9.47%(77/819); 33 cultures were contaminated, accounting for4.03%(33/819); total of 77 samples of sputum sputum negative: 1-8 articles 23 copies accounted for 29.87%(23/77); 1+42 copies accounted for 54.54%(42/77); 2+10 shares accounted for 12.98%(10/77); 3+1 shares accounted for 1.29%(1/77);4+1 shares accounted for 1.29%(1/77). Conclusion The distribution of sputum in smear of smear-coated smear specimens is between 1+>8 and 2+2+. The sputum specimens of group B have higher smear-positive rate and higher contamination rate than sputum specimens.
Objective To analyze the causes of smear-panning and smear-culture pollution, and to propose a more reasonable operation procedure in order to reduce the smear-positive rate and smear-culture pollution rate.Methods From August 2013 to December 2014, the laboratory received a total of 819 specimens from the smear-positive tuberculosis of the multi-drug-susceptible tuberculosis in the laboratory and 819 specimens of the smear-positive smearpositive tuberculosis patients in the unit.The negative culture and contamination results were analyzed. Results A total of 819 smear-positive specimens were isolated and cultured: 709 copies were positive for culture, accounting for 86.57%(709/819); 77 were negative for culture, accounting for 9.47%(77/819); 33 cultures were contaminated, accounting for4.03%(33/819); total of 77 samples of sputum sputum negative: 1-8 articles 23 copies accounted for 29.87%(23/77); 1+42 copies accounted for 54.54%(42/77); 2+10 shares accounted for 12.98%(10/77); 3+1 shares accounted for 1.29%(1/77);4+1 shares accounted for 1.29%(1/77). Conclusion The distribution of sputum in smear of smear-coated smear specimens is between 1+>8 and 2+2+. The sputum specimens of group B have higher smear-positive rate and higher contamination rate than sputum specimens.
引文
1 中华人民共和国卫生部.全国结核病耐药性基线调查报告(2007-2008年)[M].北京:人民卫生出版社,2010:4-7,228-290.
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3 刘志辉,罗一鲁.结核病实验室诊断现状及展望[J].中国防痨杂志,2003,25(1):38-40.
4 赵雁林.分枝杆菌分离培养标准标准化操作及质量保证手册[M].北京:人民卫生出版社,2013:2.
5 严碧涯,端木宏谨.结核病学[M].北京:北京出版社,2003:14.
6 Jeon K,Koh WJ,Kwon OJ,et al.Recovery rate of NTMfrom AFB smear-positive sputum specimens at a medical centre in South Korea[J].Int J Tuberc Lung Dis,2005,9(9)1046-1051.
7 Chakravorty S,Tyagi JS.Novel multipurpose methodology for detection of mycobacteria in pulmonary and extrapulmonary specimens by smear microscopy,culture and PCR[J].J Clin Microbiol,2005,43(6):2697-2702.
8 全国高等学校医学规划教材(供临床、基础、预防、护理、口腔、药学专业用).医学微生物学[M].北京:高等教育出版社,2004.
9 李国红,苗润青,贾艳辉,等.1,284份痰标本分枝杆菌涂片镜检与培养结果分析[J].中国防痨杂志,2011,33(8):492-495.
2 中国疾病预防控制中心.中国结核病防治规划痰涂片镜检标准化操作及质量保证手册[M].北京:中国协和医科大学出版社2009:1.
3 刘志辉,罗一鲁.结核病实验室诊断现状及展望[J].中国防痨杂志,2003,25(1):38-40.
4 赵雁林.分枝杆菌分离培养标准标准化操作及质量保证手册[M].北京:人民卫生出版社,2013:2.
5 严碧涯,端木宏谨.结核病学[M].北京:北京出版社,2003:14.
6 Jeon K,Koh WJ,Kwon OJ,et al.Recovery rate of NTMfrom AFB smear-positive sputum specimens at a medical centre in South Korea[J].Int J Tuberc Lung Dis,2005,9(9)1046-1051.
7 Chakravorty S,Tyagi JS.Novel multipurpose methodology for detection of mycobacteria in pulmonary and extrapulmonary specimens by smear microscopy,culture and PCR[J].J Clin Microbiol,2005,43(6):2697-2702.
8 全国高等学校医学规划教材(供临床、基础、预防、护理、口腔、药学专业用).医学微生物学[M].北京:高等教育出版社,2004.
9 李国红,苗润青,贾艳辉,等.1,284份痰标本分枝杆菌涂片镜检与培养结果分析[J].中国防痨杂志,2011,33(8):492-495.