本文關鍵詞： 血流感染 血培養(yǎng)陽性標本處理流程 基質輔助激光解析電離飛行時間質譜 直接藥敏試驗　出處：《上海交通大學學報(醫(yī)學版)》2017年07期 　論文類型：期刊論文

【摘要】：目的·以分離膠促凝管聯(lián)合Microflex?基質輔助激光解析電離飛行時間質譜直接檢測血培養(yǎng)陽性標本中細菌,并依據質譜鑒定結果進行直接藥敏試驗,對傳統(tǒng)血培養(yǎng)陽性標本處理流程再造進行初步探索。方法·收集2015年9月1日至2016年8月31日上海交通大學醫(yī)學院附屬新華醫(yī)院臨床微生物實驗室血培養(yǎng)報陽單菌株感染標本449份,按照新的血培養(yǎng)陽性標本處理流程進行操作。改造后的新處理流程主要包括:涂片染色鏡檢、分離膠/質譜直接鑒定、菌膜/質譜鑒定、純菌落/質譜鑒定、直接藥敏試驗和常規(guī)藥敏試驗等。依據鏡檢、鑒定與藥敏試驗結果依次發(fā)出:Ⅰ級直接鏡檢報告、陽性血培養(yǎng)Ⅱ級(直接鑒定/菌膜鑒定或直接藥敏)報告和Ⅲ級最終報告。結果·改造后的新處理流程在工作當日10:00、17:00和次日10:00可分別獲得82.2%、95.8%和100%陽性血標本中細菌"種"水平鑒定結果并報告至臨床;對于經初步評估有臨床意義的病原菌在血培養(yǎng)陽性報警次日就能發(fā)出初步藥敏結果報告,且與常規(guī)藥敏結果有較高的符合率。結論·與傳統(tǒng)處理流程相比,改造后的處理流程使得血培養(yǎng)瓶陽性報警至發(fā)送初步鑒定和藥敏結果所需時間縮短1~2 d,為臨床醫(yī)師提供快速準確的血流感染病原學診斷依據,對提高臨床血流感染的早期診斷和治療能力具有重要意義。
[Abstract]:Objective: to combine microflexx? Matrix assisted laser desorption ionization time of flight mass spectrometry was used to detect bacteria in blood culture positive samples, and direct drug sensitivity test was carried out based on the results of mass spectrometry. Methods: from September 1st 2015 to August 31st 2016, the clinical microbiology laboratory of Xinhua Hospital of Shanghai Jiaotong University was collected. 449 strains were infected, According to the new blood culture positive sample processing procedure, the modified new treatment procedure mainly includes: smear staining microscopy, isolation / mass spectrometry direct identification, bacteria membrane / mass spectrometry identification, pure colony / mass spectrometry identification, the new treatment process mainly include: smear staining microscopy, isolation / mass spectrometry identification, bacterial membrane / mass spectrometry identification, pure colony / mass spectrometry identification, Direct drug sensitivity test and routine drug sensitivity test, etc. According to the results of microscopic examination, the results of identification and drug sensitivity test were issued successively: grade I direct microscopic examination report, The positive blood culture grade 鈪，

本文編號：1536922