355例留置导尿管尿培养阳性结果分析  

Analysis of 355 positive urinary culture from patients with Indwelling catheters

作　　者：熊章华[1] 陈益国[1] 陈会[1] 邓林强[1] 余理智[1] 孙敬[1] 

机构地区：[1]江西省人民医院检验科,江西南昌330006

出　　处：《实验与检验医学》2014年第1期21-23,共3页Experimental and Laboratory Medicine

基　　金：江西省自然科学基金(编号20132BAB205049)

摘　　要：目的探讨留置导尿管尿培养阳性结果在尿路感染中的意义。方法回顾性分析我院2012年1月至12月355例留置导尿管住院患者尿培养阳性结果的符合率,以减少此类标本的假阳性率。结果我院留置导尿管尿培养阳性占尿培养阳性结果的47.81%,留置导尿管尿病原菌分布以单一细菌为主,主要为G-杆菌59.15%;其次是肠球菌17.75%;较少的是念珠菌5.35%、葡萄球菌3.10%和其它链球菌占1.13%,混合菌占13.52%。210例中G-杆菌有49例(23.33%)为假阳性;培养出两种细菌(48例)和肠球菌(63例)的假阳性率分别高达56.25%和63.49%;念珠菌(19例)、除金黄色葡萄球菌外的葡萄球菌(11例)及除化脓性链球菌外的其他链球菌(4例)的假阳性率甚至高达70%以上。结论当留置导尿管尿培养实验室检出阳性时,特别是培养生长阳性球菌、念球菌以及多种细菌生长均达到致病菌量生长标准时,应加强临床沟通,结合患者临床症状,判断是否为致病菌。Objective To explore the significance of culture positive results of the indwelling catheter urine in urinary tract infections. Methods A retrospective analysis of coincidence rate of urine culture positive results in 355 cases of hospitalized pa-tients with indwelling catheter in our hospital from January to December in 2012, in order to reduce the false-positive rate of such specimens. Results Among these cultured urinary samples, 210 cases had Gram negative bacteria, 63 cases had enterococcus, the rest cases had mixture of bacteria（48）, Candida（19）, staphylococci（11） and other Streptococcus（4） but pyogenic streptococcus. Fur-ther studies show that 49 cases of 210 （23.33%） patients who have Gram negative bacteria in urinary sample have no urinary tract infection symptoms or no treated when discharged from hospital after recovery, and mix of bacteria, enterococcus and staphy-lococci had false positive proportion of 56.25%, 63.49%and 54.55%, respectively. Furthermore, Candida and other Streptococcus have false positive proportion more than70%, These results above suggested that urinary samples from patients with indwelling catheters are liable to be contaminated by normal flora or microorganisms colonizing in indwelling catheters. Conclusion We should be cautious to deal with urinary samples from patients with indwelling catheters, and it is necessary to communicate with clinician and review Patients＆#39; clinical records.

关 键 词：留置导尿管 尿培养 假阳性率 

分 类 号：R446.5[医药卫生—诊断学] Q939.92[医药卫生—临床医学]