感染性眼病的病原微生物实验室诊断专家共识  

Expert consensus on laboratory diagnosis of pathogenic microorganisms in ocular infectious diseases

作　　者：北京医学会检验分会 鲁辛辛[2] 梁庆丰 王智群 Laboratory Branch of Beijing Medical Association;Lu Xinxin;Liang Qingfeng

机构地区：[1]不详 [2]首都医科大学附属北京同仁医院检验科 [3]首都医科大学附属北京同仁医院北京市眼科研究所

出　　处：《中华检验医学杂志》2022年第1期14-23,共10页Chinese Journal of Laboratory Medicine

基　　金：国家重点研发计划(2019YFC1200702,2021YFC2301000);国家自然科学基金(81470607,82171017)。

摘　　要：感染性眼病是发展中国家重要致盲原因之一,病原微生物检查是感染性眼病诊断的金标准。由于眼部组织取材困难、标本量少,实验室诊断阳性率偏低,严重影响疾病的诊断和预后。我国大多数医疗机构感染性眼病实验室诊断能力不足,缺乏眼部微生物检测的标准化方法。为此,北京医学会检验分会组织专家和相关课题组通过讨论和临床验证,总结出适合我国眼科临床实践的病原学诊断路径,形成感染性眼病实验室诊断专家共识。该共识从常见感染性眼病临床表现和送检指征入手,规范眼部标本采集、转运、质量评估的方法和流程;强调眼科医师应与微生物检验人员充分配合,正确选择适宜的微生物检测方法,提倡床旁接种,同时针对刮片细胞学检查、传统微生物培养、棘阿米巴培养以及核酸检测、宏基因组测序等技术提出建议。Ocular infectious disease is one of the most important causes of blindness in developing countries.Pathogenic microorganism examination is the gold standard for the diagnosis of ocular infectious disease.The prognosis of ocular infectious disease is seriously affected by the difficulty to take samples from ocular tissues,a limited specimen for examination,and the low positive rate of laboratory diagnosis.In China,ability to make a suitable laboratory diagnosis of ocular infectious disease is low in most of the medical institutions,and consensus on standardized methods to detect pathogenic microorganisms is also absent.Therefore,the Laboratory Branch of Beijing Medical Association organized experts and relevant research groups to establish the etiological diagnosis algorism suitable for ophthalmic clinical practice and formed this expert consensus on the laboratory diagnosis of pathogenic microorganisms of ocular infectious disease.The consensus starts with the clinical manifestations and the indications of laboratory examination,provides the standard protocol for the processes of ocular specimen collection,transportation and quality evaluation.It is emphasized that ophthalmologists should fully cooperate with microbiological testing personnel to collect specimens correctly and select appropriate microbiological testing methods.Bedside inoculation of the specimen is advocated,some suggestions are given for smear cytology,traditional microbial culture,Acanthamoeba culture,nucleic acid detection and metagenome sequencing,etc.The consensus can play a guiding role in the laboratory diagnosis of ocular infectious disease,and effectively improve the level of diagnosis and treatment of ocular infectious disease in China.

关 键 词：感染性眼病 病原微生物 实验室诊断 共识 

分 类 号：R771[医药卫生—眼科]