细菌半定量培养新法(十二级法)研究报告  

A new bacterial semi-quantitative culture method(12 degree classification method)

作　　者：杨肇立[1] 周文[1] 李俊如[1] 李键[1] 杨锦云[1] 任萍[1] 陈旭[1] 黄静[1] 

机构地区：[1]凉山彝族自治州第一人民医院检验科,四川西昌615000

出　　处：《四川医学》2010年第5期561-563,共3页Sichuan Medical Journal

基　　金：四川省卫生厅科研课题(编号:080160)

摘　　要：目的建立开放部位非均质标本细菌半定量培养的新方法 （十二级法）。方法采用＂十二级法＂和传统＂四区划线法＂（即五级法）对＂无呼吸道炎症人群＂咽拭子及临床患者痰液标本进行细菌半定量培养,从重复性、区分细菌相对数量的细致性及临床诊断符合率等方面予以比较。结果重复性：＂十二级法＂和＂四区划线法＂均较差,平均变异系数分别为22.45%和20.38%,但前者受操作等因素影响较小,结果差异多在1-2个档次之内;后者受操作等因素影响明显,同一标本的同种细菌为1＋4＋。区分细菌相对数量的细致性：＂无呼吸道炎症人群＂咽拭子的非厌氧菌半定量培养;若用＂十二级法＂判读,非β-溶血性链球菌、奈瑟菌、凝固酶阴性葡萄球菌、G-杆菌和酵母样真菌的平均携带量分别为0.45、0.35、〈0.1、〈0.1和〈0.1,差别显著;若用＂四区划线法＂判读,以上各菌却有可能差别不大。诊断符合率：对于痰培养的机会致病菌,若与涂片中白细胞区域优势菌对应以＂十二级法＂菌量〉该菌口咽部正常携带量为＂可疑感染菌＂判定标准,阳性率18.92%（521/2754）,与临床确诊加疑诊的符合率〉85%;若以其＂四区划线法＂菌量大于非β-溶血性链球菌菌量为＂可疑感染菌＂判定标准,则阳性率仅5.92%（163/2754）,漏诊较多。二者比较,2χ=213.94,P〈0.001。结论 ＂十二级法＂优于＂四区划线法＂,值得选用。Objective The aim of this study is to establish a new hacterial semi-quantitative culture assay that could be suitable for non-homogeneous specimens.Methods Check the repeatability,meticulous of bacteria opposite quantity distinguished and clinical Applicability against traditional＂four zone streak plate cultivation＂with non-respiratory inflammation throat swab and Sputum specimen of patients.Results Repeatability：C.V of＂12 degree classification method＂and＂four zone streak plate cultivation＂were 22.45% and 20.38%,but the former have been slightly affected by streak plate cultivation operation,the disparity is within 1~2 degree while the latter have heen affected significantly,some zone bacteria colonies semi-quantitative assay rang from 1＋ to 4＋.Meticulous of bacteria opposite quantity distinguished：From grade establishes of method,judged means of bacterial quantity and results of bacterial semi-quant it ative culture all can be seen that the former better than the latter.For bacterial semi-quantitative culture of non-respiratory inflammation throat swab.the average bacterial colonies quantity of ＂12 degree classification method＂ of non-β hemolytic streptococcus,neisseria、staphlococcus、G-bacillus and candida are respectively 0.45、0.35、0.1、0.1 and 0.1,the quantity difference is obvious;If ＂four zone streak plate cultivation＂is adopted,the difference is not very.Coincidence rate of clinical diagnosis：if the standard of judge suspicious infection with the bacterial amount of ＂12 degree classification method＂ is larger than normal carrying of pharynx,the positive rate is 18.92%（521/2754）for opportunist in sputum,,coincidence ratio compared with clinical diagnosis85%;if the standard of judge suspicious infection with the bacterial amount of ＂four zone streak plate cultivation＂is larger tham non-β-hemolytic streptococcus,the positive rate is 5.92%（163/2754）,false negative results of ten occurs.check their χ2=213.94,P0.001.Conclusion ＂12 degree classification

关 键 词：细菌半定量培养 十二级法 四区划线法 

分 类 号：R446.5[医药卫生—诊断学]