痰菌群定量测定对下呼吸道感染诊断价值研究  

Quantitative Bacteriology Study of Sputum in Patients with Lower Respiratory Tract Infection

作　　者：杨爱[1] 

机构地区：[1]临沂市人民医院临床检验中心,山东临沂276003

出　　处：《中华医院感染学杂志》2009年第11期1335-1338,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨痰菌群定量培养在下呼吸道感染诊断中的应用价值。方法采用Gould提出的痰液细菌定量的简化法,细菌鉴定与药敏采用VITEK32和API系统。结果1534份合格痰标本中分离出1531株细菌和74株真菌,其中病原菌计数>107CFU/ml的1490株细菌和19株假丝酵母菌属;细菌构成比:大肠埃希菌24.3%、肺炎克雷伯菌20.7%、肺炎链球菌20.7%、阴沟肠杆菌10.9%、金黄色葡萄球菌10.4%、流感嗜血菌8.7%、铜绿假单胞菌菌5.9%、黏膜炎莫拉菌4.0%。结论痰涂片和痰培养同时进行,由于口咽部有细菌定植,痰培养的细菌不一定是致病菌,结合临床症状判断是否是致病菌,定量培养能鉴别污染菌和感染菌,一般定量培养细菌数≥107CFU/ml认为是感染菌,如连续>2次分离到同一细菌也认为是感染菌。OBJECTIVE To study the quantitative bacteriology of sputum in patients with lower respiratory tract infection. METHODS A total of 1534 samples were collected from 1351 patients. Bacterial culture, drugs sensitive test and quantitative analysis were carried out. The pathogens were confirmed by VITEK-32 and API system. MIC test was adopted to analyze drug resistance. RESULTS The 1605 strains were isolated of the 1534 samples. The common pathogens were Escherichia coli 24.3%, Klebsiella pneumoniae 20.7%, Streptococcus pneumoniae 20. 7%, Enterobacter cloacae 10.9%, Staphylococcus aureus 10.4%, Haemophilus in fluenzae 8.7%, Pseudomonasaeruginosa 5. 9%, and Moraxella catarrhalis 4. 0%. CONCLUSIONS Sputum cultures usually can not accurately reflect the etiology. Diagnosis of lower respiratory tract infection is based on clinical symptoms. A sputum Gram staining may show many mononuclear or polymorphonuclear cells in viral or bacterial infections, respectively.

关 键 词：痰 细菌定量 下呼吸道感染 

分 类 号：R378[医药卫生—病原生物学]