摘要
目的:比较各等级痰涂片标本中的培养阳性率,各等级痰涂片标本中患者炎症指标与培养阳性率之间的符合程度,探讨涂片和炎症指标在痰培养检验中的应用价值。方法:回顾性选取2021年10月-2023年11月送检培养标本276例,根据革兰染色镜检结果将痰涂片分为ABCDE五大类,对培养结果进行细菌鉴定及药敏,同时记录患者白细胞计数(WBC)、中性粒细胞计数(NE)、降钙素原(PCT)及C-反应蛋白(CRP)水平,比较五组痰涂片培养阳性率及炎症指标增高患者中的细菌检出率。结果:276份痰标本,涂片合格标本91例,合格痰标本阳性检出率57.1%(52/91),不合格标本185例,不合格痰标本阳性检出率16.8%(31/185)。A组标本54份,痰培养阳性率57.4%;B组标本37份,痰培养阳性率56.7%;C组标本50份,痰培养阳性率24.0%;D组标本65份,痰培养阳性率27.7%;E组标本70份,痰培养阳性率1.4%;炎症指标增高患者中痰培养阳性率,其中A组40人,疾培养阳性率67.5%;B组24人,痰培养阳性率66.7%;C组31人,痰培养阳性率25.8%;D组34人,痰培养阳性率26.5%;E组44人,痰培养阳性率2.3%。结论:合格痰涂片不管是培养阳性率还是与患者炎症指标的符合程度都显著高于不合格痰涂片,提高痰培养分析前质量控制是重点,涂片结合患者PCT、CRP、WBC、NE水平及时判断细菌感染或定植,有助于指导临床早期抗生素的合理使用,更好发挥痰培养在呼吸道细菌感染诊断中的作用。
l Objective:To compare the culture positivity rate in each grade of sputum smear specimen,the degree of conformity between the patient's inflammatory index and the culture positivity rate in each grade of sputum smear specimen,and to explore the value of smear and inflammatory index in sputum culture testing.Methods:276 sputum culture specimens were retrospectively selected from October 2021 to November 2023.The sputum smears were classified into five categories of ABCDE according to the results of Gram staining microscopy.Positive specimen were analysed for bacterial identification and drug sensitivity test.Patients'white blood cell counts(WBC),neutrophil counts(NE),procalcitonins(PCT),and C-reactive protein(CRP)levels were recorded at the same time.The sputum smear culture positivity rate and bacterial detection rates among patients with increased inflammatory indexes were compared among the five groups.Results:Among 276 sputum specimens,91 sputum smears were qualified,with a positive rate of 57.1%(52/91).The positive detection rate of185 unqualified sputum specimens were was 16.8%(31/185).54 specimens from group A showed a positive sputum culture rate of 57.4%.37 specimens from group B showed a positive sputum culture rate of 56.7%.50 specimens from group C showed a positive sputum culture rate of 24.0%.65 specimens from group D showed a positive sputum culture rate of 27.7%.70 specimens from group E showed a positive sputum culture rate of 1.4%;Sputum culture positivity among patients with increased inflammatory indexes:40 patients in group A,sputum culture positivity 67.5%;24 patients in group B,sputum culture positivity 66.7%;31 patients in group C,sputum culture positivity 25.8%;34 patients in group D,sputum culture positivity 26.5%;And 44 patients in group E,sputum culture positivity 2.3%.Conclusion:Qualified sputum smears are significantly higher than unqualified sputum smears both in terms of culture positivity rate and degree of conformity with patients'inflammation indexes.Improving the quality control of sputum culture before analysis is the key point,and the smears combined with the patients'PCT,CRP,WBC,and NE levels to timely determine bacterial infections or fixation,which can help to guide the rational use of antibiotics in the early stage,and to better play the role of sputum culture in the diagnosis of respiratory bacterial infections.
作者
马自蓉
李红梅
张少川
MA Zi-rong;LI Hong-mei;ZHANG Shao-chuan(Department of Medical Laboratory,Yunnan Mental Hospital and Mental Health Center of Kunming Medical University,Yunnan Kunming650224)
出处
《医学检验与临床》
2025年第1期44-48,共5页
Medical Laboratory Science and Clinics
关键词
痰培养
涂片镜检
炎症指标
质量控制
Sputum culture
Smear microscopy,Inflammatory indexes
Quality control
