本文關(guān)鍵詞： 血流感染 血培養(yǎng)陽(yáng)性標(biāo)本處理流程 基質(zhì)輔助激光解析電離飛行時(shí)間質(zhì)譜 直接藥敏試驗(yàn)　出處：《上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)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(zhì)輔助激光解析電離飛行時(shí)間質(zhì)譜直接檢測(cè)血培養(yǎng)陽(yáng)性標(biāo)本中細(xì)菌,并依據(jù)質(zhì)譜鑒定結(jié)果進(jìn)行直接藥敏試驗(yàn),對(duì)傳統(tǒng)血培養(yǎng)陽(yáng)性標(biāo)本處理流程再造進(jìn)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(xué)醫(yī)學(xué)院附屬新華醫(yī)院臨床微生物實(shí)驗(yàn)室血培養(yǎng)報(bào)陽(yáng)單菌株感染標(biāo)本449份,按照新的血培養(yǎng)陽(yáng)性標(biāo)本處理流程進(jìn)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(zhì)譜直接鑒定、菌膜/質(zhì)譜鑒定、純菌落/質(zhì)譜鑒定、直接藥敏試驗(yàn)和常規(guī)藥敏試驗(yàn)等。依據(jù)鏡檢、鑒定與藥敏試驗(yàn)結(jié)果依次發(fā)出:Ⅰ級(jí)直接鏡檢報(bào)告、陽(yáng)性血培養(yǎng)Ⅱ級(jí)(直接鑒定/菌膜鑒定或直接藥敏)報(bào)告和Ⅲ級(jí)最終報(bào)告。結(jié)果·改造后的新處理流程在工作當(dāng)日10:00、17:00和次日10:00可分別獲得82.2%、95.8%和100%陽(yáng)性血標(biāo)本中細(xì)菌"種"水平鑒定結(jié)果并報(bào)告至臨床;對(duì)于經(jīng)初步評(píng)估有臨床意義的病原菌在血培養(yǎng)陽(yáng)性報(bào)警次日就能發(fā)出初步藥敏結(jié)果報(bào)告,且與常規(guī)藥敏結(jié)果有較高的符合率。結(jié)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(yáng)性報(bào)警至發(fā)送初步鑒定和藥敏結(jié)果所需時(shí)間縮短1~2 d,為臨床醫(yī)師提供快速準(zhǔn)確的血流感染病原學(xué)診斷依據(jù),對(duì)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(hào)：1536922