感染创面病原微生物采样方法的临床研究  

Clinical Study on Sampling Methods for Pathogenic Microorganisms in Infected Wounds

作　　者：刘可 张成敏[1] 李志恒[1] 柯为 王丽华[2] LIU Ke;ZHANG Chengmin;LI Zhiheng;KE Wei;Wang Lihua(Emergency Department,Chongqing Medical University The Second Affiliated Hospital,Chongqing 400010;Health Management Center,Chongqing Medical University The Second Affiliated Hospital,Chongqing 400010)

机构地区：[1]重庆医科大学附属第二医院急诊科,重庆400010 [2]重庆医科大学附属第二医院健康管理中心,重庆400010

出　　处：《智慧健康》2023年第17期37-40,53,共5页Smart Healthcare

基　　金：重庆市科卫联合医学科研项目面上项目《感染创面病原微生物采样方法的临床研究》(项目编号:2021MSXM047)。

摘　　要：目的对比棉拭子采样方式与组织采样方式检出感染创面病原微生物的差异。方法回顾性分析重庆医科大学附属第二医院就诊的急慢性创面采样患者共计100例。所有患者均进行了感染创面取样,共计采集标本167对。对患者组织样本结果及棉拭子采样检测出菌种类型进行统计,并对检测效能进行分析。结果棉拭子采样结果为无细菌者(阴性)共计57例次,在活检取样结果阴性共计50例次。在所采集的标本中,培养结果为阳性的标本,均是检测出的单一细菌生长的情况,其中棉拭子结果显示为阳性共计110例次,活检取样中共计117例;在创面检查菌种中,棉拭子阳性检出结果共计103例,其中革兰氏阳性菌38例、革兰氏阴性菌61例、皮肤体表正常菌3例,真菌1例。棉拭子对采样样本检测的敏感度为93.63%,特异度为75.43%,准确度为87.42%。结论当前所应用的棉拭子与深部活检组织取样的细菌检测结果相比较,拥有较好的一致性,应用表浅棉拭子取样,是适合在感染创面病原微生物采样中进行应用的。Objective To analyze detection rate difference of pathogenic microorganisms in infected wounds with cotton swabs and tissue sampling methods.Methods The paper reviewed and analyzed 100 cases acute and chronic wounds sampled from Chongqing Medical University the Second Affiliated Hospital,collected 167 pairs of specimens for infection wound sampling,and carried on statistics on results of patient tissue sampling and types of bacteria detected by cotton swab sampling and analyzed detection efficiency.Results Out of 100 patients in sampling of infected wounds,167 pairs of specimens were collected.57 cases were sterile with cotton swabs(negative)and 50 cases were collected during biopsy sampling.Among collected specimens,specimens with positive culture were all detected as single bacterial growth;cotton swab results of 110 cases showed positive,with 117 cases of biopsy samples.Among bacteria tested on wound surface,103 cases were positive with cotton swabs,including 38 cases of Gram-positive bacteria,61 cases of Gram-negative bacteria,3 cases of skin surface normal bacteria and 1 case of fungus.Sensitivity,specificity and accuracy of sterile cotton swabs for detection was 93.63%,75.43%and 87.42%respectively.Conclusion Comparison showed,bacterial detection results of sterile cotton swab and deep biopsy tissue sampling have good consistency.Superficial sterile cotton swabs for sampling is suitable for application of pathogenic microorganisms in infected wounds.

关 键 词：感染创面 病原微生物 采样 抗生素 定植菌群 

分 类 号：R446.5[医药卫生—诊断学] R632[医药卫生—临床医学]