外科感染中的厌氧菌及其快速诊断  

Anaerobic infection and its rapid detection in surgical patients

作　　者：张雅萍[1] 肖光夏[1] 秦孝健[1] 黎鳌[1] 

机构地区：[1]第三军医大学西南医院烧伤研究所,重庆400038

出　　处：《中华外科杂志》1999年第12期765-767,共3页Chinese Journal of Surgery

摘　　要：目的　了解外科感染病原菌 ,并能快速诊断及时指导临床。　方法　对我院 1986～1996年 3 72例外科感染患者的标本进行了细菌学监测 ,采用厌氧菌培养法 (CM) ,探讨间接免疫荧光抗体染色技术 (IFA)和免疫酶标抗体染色技术 (ELA)。　结果　外科厌氧菌感染率高 ,如脓胸为88 9% ,腹腔脓肿为 86 7% ,阑尾炎为 83 9%。鉴定出专性厌氧菌 2 12株 ,无芽胞厌氧菌占绝对优势( 87 8% ) ,其中产黑类杆菌和脆弱类杆菌多见 ,分别为 2 8 8%和 2 5 0 % ;混合感染为 64 0 % ,单纯厌氧菌感染为 10 6%。IFA和ELA厌氧菌检出率明显高于CM法 ,检出率分别为 79 1%、80 9%和 3 7 3 %。产黑类杆菌、脆弱类杆菌、核粒梭形杆菌、产气荚膜杆菌和消化链球菌占检出厌氧菌的 62 1%。结论　IFA和ELA鉴定厌氧菌敏感、特异、简便、快速 ,便于基层单位推广应用。Objective To investigate anaerobic infection and its rapid detection in surgical patients. Methods 372 specimens were collected from surgical patients for anaerobe detection. To find a rapid detectable method,110 specimens were collected for comparative studies by using indirect immunofluorescent antibody technique (IFA),enzyme labeled antibody technique (ELAT) and general cultural method (CM). Results The isolation rate of anaeobes was rather high in pyothorax (88 9%),abdominal abscess (86 7%),appendicitis (83 9%) and cerebral abscess (all five cases were positive). In burn wounds, the rate was about 23 6% especially in deep burn wounds. Among 212 strains detected, the predominant anaerobes were as follows:B. melaninogenicus (28 8%),B. fragilis(25%),F. nucleatum (7 5%),C. perfringens (7 5%), and peptostreptococcus (5 7%); most of them (87 8%) were non sporing anaerobes. Mixed infection with aerobes accounted for 64%. The survey of rapid detection was conducted in B. fragilis, B. melaninogenicus, C. perfringens, F. nucleatum and peptostreptococcus. The detectable rate was higher in IFA (79 1%) and ELAT(80 9%) than in CM (37 3%). Conclusion IFA and ELAT might be rapid, specific, sensitive, and simple for detecting anaerobes.

关 键 词：外科感染 厌氧菌 诊断 

分 类 号：R630.4[医药卫生—外科学]