肺炎链球菌鉴定方法分析  

Identification of Streptococcus pneumoniae

作　　者：惠燕霞 卢先雷[2] 马启明 杨永清[3] 魏莲花[3] 

机构地区：[1]定西市人民医院检验科,甘肃定西743000 [2]成都市第五人民医院检验科,四川成都611130 [3]甘肃省人民医院检验中心,甘肃兰州730000

出　　处：《中华医院感染学杂志》2016年第2期283-285,共3页Chinese Journal of Nosocomiology

基　　金：甘肃省科技支撑计划基金资助项目(0708NKCA096)

摘　　要：目的对从临床标本中分离出的302株成对或短链排列形似肺炎链球菌的革兰阳性球菌进行系统准确鉴定,借此探讨肺炎链球菌鉴定常规方法的不足,提出较为科学的方法。方法自2013年12月-2014年11月两所医院59 607份临床标本中分离出形似肺炎链球菌302株,以形态学、奥普托欣(OP)敏感试验、肺炎链球菌乳胶凝集作为初步鉴定手段,再结合胆汁溶菌等传统生化反应试验,以及Lancefield抗原乳胶试剂凝集试验,对细菌进行系统鉴定。结果 113株细菌被最终鉴定为肺炎链球菌,124株鉴定为C群或F群链球菌,其中87株既与肺炎链球菌乳胶试剂发生非特异性凝集又与Lancefeild C/F乳胶凝集;8株链球菌OP敏感但生化反应和乳胶均不支持;OP耐药乳胶凝集与生化反应支持的有7株,OP敏感生化反应支持但乳胶凝集均阴性的有3株;以生化反应符合加上OP与乳胶凝集中的一种试验符合作为最终鉴定结论,计算出肺炎链球菌乳胶试剂的假阴性为2.6%、假阳性为46.0%。结论鉴定肺炎链球菌,传统生化反应方法不可废弃,综合使用多种手段鉴定细菌可以有效防止鉴定错误。OBJECTIVE To systematically and accurately identify 302 strains of gram-positive bacteria isolated from various clinical specimens that are arranged in pairs or short chains and similar to Streptococcus pneumoniae and explore the deficiencies of the conventional identification method so as to raise a scientific method.METHODS A total of 302 strains of bacteria that were similar to the S.pneumoniae were isolated from 59 607 clinical specimens that were obtained from two hospitals from Dec 2013 to Nov 2014.The morphology,Optochin（OP）susceptibility test,and Streptococcus pneumoniae latex agglutination test were carried out for the preliminary identification,and the systematic identification of the strains was performed in combination with the traditional biochemical reaction test such as bile solubility test and Lancefield antigen latex reagent agglutination test.RESULTS Totally 113 strains of bacteria were finally identified as the S.pneumoniae,124 strains identified as group C or F Streptococcus;87strains reacted with Streptococcus pneumoniae latex reagent for the non-specificity agglutination and then for Lancefeild C/F latex agglutination.Totally 8strains of Streptococcus were sensitive to the OP test but were not supported to the biochemical reactions or latex.There were 7strains that were supported to OP resistance latex agglutination and biochemical reaction and 3strains that were supported to the OP susceptibility biochemical reaction but were negative for the latex agglutination test.The final identification conclusion was drawn based on the accordance with the biochemical reaction plus OP test or latex agglutination test;the false negative of the S.pneumoniaelatex reagent was 2.6%,the false positive 46.0%.CONCLUSION The traditional biochemical reaction method can not be abandoned for the identification of the S.pneumoniae.It is an effective way to comprehensively use multiple identification methods so as to raise the accuracy of the identification.

关 键 词：肺炎链球菌 奥普托欣 生化反应 凝集试验 

分 类 号：R378.14[医药卫生—病原生物学]