感染病人细菌L型检测及临床意义

DETERMINATION OF L-FORM BACTERIA IN INFECTIOUS DISEASE AND ITS CLINICAL SIGNIFICANCE

临床上感染病人的细菌培养阳性率较低，为探讨感染漏诊与Ｌ型菌的关系，对疑诊感染的３２１例病人的血液和（或）骨髓、尿液、脓液、胆汁、胸水、腹水、前列腺液、脑脊液及刮宫组织标本在作常规培养的同时加作Ｌ型培养。结果常规培养细菌检出率为１０．９０％（３５／３２１），常规培养阴性标本中Ｌ型菌检出率为２０．５６％（６６ｌ３２１），提示不加作Ｌ型培养，临床感染的漏诊率可达２０．５６％。纯Ｌ型菌感染者，临床症状及辅助检查常不典型，可能是临床感染常见的漏诊及误诊原因。６６例Ｌ型菌药敏治疗，结果治愈４１例，好转１７例。提示临床开展Ｌ型菌培养不仅可提高病原菌的检出率，且对指导治疗防止疾病迁延有重要意义。

The positive rate of the bacterial culture of infectious specimens was usually very low.In order to study the relationship of missed diagnosis of the diseases and L-form bacteria infection,a series of clinical samples from 321 patients were collected,including those of blood and bone marrow,urine,bile,ascites,prostatic fluid,cerebrospinal fluid and endometrium tissue of the uterus.Besides routine bacterial culture,special culture of L-form bacteria was simultaneously performed.The result was that the routine bacterial culture showed a positive rate of l0.90%(35/321).whereas L-form culture gave a rate of 20.56%(66/321).This suggests that missed diagnosis rate was as high as 20.56% if L-form bacterial culture was not performed,Clinical presentations and auxiliary examinations of patients with simple L-form bacterial infection were often not typical and therefore misdiagnosis or missed diagnosis often occurs.