下呼吸道肺炎克雷伯菌感染诊断与痰液半定量培养细菌数量的相关研究  

Investigation of the correlation of diagnosis of klebsiella pneumoniae infection in lower respiratory tract and the bacteria quantity confirmed by semi-quantitative culture of sputum

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

机构地区：[1]四川省凉山州第一人民医院检验科,615000

出　　处：《国际检验医学杂志》2011年第10期1033-1034,共2页International Journal of Laboratory Medicine

基　　金：四川省卫生厅科研课题项目(080160)

摘　　要：目的探讨自然咳出痰标本半定量培养12级法筛检肺炎克雷伯菌的指标。方法每份痰标本均同时涂片和接种。涂片观察标本质量,以白细胞吞噬菌或白细胞浓集区域优势菌为拟分离菌;培养采用半定量12级法。查阅2005年6月1日至2010年5月31日住院患者痰内筛检出肺炎克雷伯菌者病历,统计分析首次培养的细菌数量、标本质量与出院诊断的关系。结果白细胞吞噬菌的确存在,但阳性率不高;肺炎克雷伯菌131株,其首次培养的相对数量为0.1、≥0.2的阳性率分别为52.78%、66.31%;两者确诊率比较,χ2=5.24,0.05<P<0.1。首次培养的标本质量为A/B级、C级的阳性率分别为64.77%、58.14%;两者确诊率比较,χ2=0.54,P>0.25。结论按规定要求采集自然咳出痰标本,若其半定量12级法培养出涂片拟分离菌对应性肺炎克雷伯菌的相对数量大于该菌口咽部平均携带数量时,应作药敏实验并报告医师。Objective To explore the indexes of naturally expectorated sputum cultured by the ＂semi-quantitative 12 order method＂ to screening the infection of klebsiella pneumoniae（Kp）. Methods Smear and inoculation test were performed for each sputum sample at the same time. The quality of samples were confirmed by smear test, and the bacteria phagocytized by white blood cells or the dominant bacteria in the white blood cells centralized region were isolated. The inoculated sputum samples were cultured by ＂semi quantitative 12 order method＂. The case history of patients, sputum samples of whom were detected with Kp from June 1, 2005 to May 31,2010. Then the relationship of the bacteria quantity in the sputum samples at the first time of culture,the quality of samples and the diagnosis of patients. Results The bacteria phagocytized by white blood cells were detected,but the positive rate was not high. There were total 131 strains of Kp. The positive rate of relative number of 0. 1 and ≥ 0. 2 were 52. 78% and 66.31 %, at the first time of culture and there was no significant difference between them（χ2 = 5.24,0.05 （P〈0.1）. The positive rate of samples at grade A/B and C were 64.77%and 58.14% respectively,and there was no significant difference between them （χ2 = 0.54, P）0.25）. Conclusion In the qualified naturally expectorated sputum samples,if Kp, which cultured by ＂semi-quantita tive 12 order method＂,is according to the smear,and its quantilty is more than the average carrying quantity in pars oralis pharyngis, susceptibility test should be performed.

关 键 词：克雷伯菌 肺炎 呼吸道感染 痰半定量培养 细菌数量 

分 类 号：R446.5[医药卫生—诊断学]