检验科微生物检验质量的影响因素与病原菌耐药性研究  

Study on the Influencing Factors of Microbiological Quality and the Drug Resistance of Pathogenic Bacteria in Clinical Laboratory

作　　者：钟平[1] 

机构地区：[1]汉川市人民医院检验科,湖北汉川431600

出　　处：《中国卫生标准管理》2017年第10期116-118,共3页China Health Standard Management

摘　　要：目的分析检验科微生物检验质量的影响因素,观察病原菌耐药性。方法回顾性分析检验科2015年1月—2017年1月给予微生物检验的206例患者的检测报告,观察微生物检验结果及病原菌耐药性检测结果。结果 206例检测报告中,结果准确168例,准确率81.6%;结果出现误差38例,误差发生率19.4%。经分析,38例出现误差的检测报告中,因人员因素导致12例,占31.6%;因标本因素导致15例,占39.5%;因操作规范因素导致7例,占18.4%;因其他因素导致4例,占10.5%。206例送检标本中,共培养出272株病原菌,其中,革兰阴性菌140株,占51.5%;革兰阳性菌108株,占39.7%;真菌24株,占8.8%。大肠埃希菌耐药率占据前三位的抗菌药物分别为头孢噻肟(56.7%)、阿莫西林(53.5%)、头孢噻吩(53.3%);金黄色葡萄球菌耐药率占据前3位的抗菌药物分别为青霉素(97.5%)、红霉素(82.5%)、左氧氟沙星(80.0%)。结论检验科微生物检验质量主要受到人员因素、标本因素的影响,应针对性的制定干预措施,减少误差事件的发生;临床治疗感染性疾病患者时,耐药性实验结果可为抗菌药物的选择提供依据。Objective To analyze the influence factors of microorganism inspection quality, observe the pathogen resistance. Methods A retrospective analysis of clinical laboratory from January 2015 to January 2017 for microbial testing, test report of 206 cases were observed microbiol test results and pathogen resistance test results. Results Of 206 cases, 168 cases were accurate, the accuracy rate was 81.6%. There were 38 errors, and the error rate was 19.4%. After analysis, 38 cases of errors appeared in the test report, 12 cases were due to human factors, accounting for 31.6%. There were 15 cases due to specimen factors, accounting for 39.5%. Because of operating norms, 7 cases, accounting for 18.4~,4; 4 cases were caused by other factors, accounting for 10.5%. 272 pathogenic bacteria were cultured in 206 samples. Among them, there were 140 gram negative bacteria, accounting for 51.5%; Gram positive bacteria 108, accounting for 39.7%; 24 fungi, accounting for 8.8%. The three antibiotic resistance rates of Escherichia coli were cefotaxime （56.7%）, amoxicillin （53.5%） and cefoxitin （53.3%）; The resistance rates of Staphylococcus aureus in the top 3 were penicillin （97.5%）, erythromycin （82.5%） and levofloxaein （80,0%）. Conclusion The microorganism inspection quality is mainly influenced by personnel factors, specimens, should be targeted to develop interventions to reduce error events; Clinical treatment of patients with infectious diseases, drug resistance experiment results can provide the basis for the selection of antimicrobial agents.

关 键 词：检验科 微生物检验 影响因素 病原菌 耐药性 

分 类 号：R445.5[医药卫生—影像医学与核医学]