21例CNM脑脊液新生隐球菌的实验检测分析

Laboratory Analysis of Cryptococcus in Cerebrospinal Fluid from 21 Patients with Cryptococcal Meningitis

目的检测新生隐球菌性脑膜炎(CNM)患者脑脊液(CSF)中的新生隐球菌,探讨几个方法的形态特征。方法对21例CNM患者CSF应用细胞计数器直接观察、瑞氏染色、印度墨汁涂片、革兰染色及培养后等实验室方法检测,并比较其阳性率和形态特征。结果隐球菌检测阳性率分别为真菌培养90.5%,印度墨汁染色81.0%,瑞氏染色和细胞学计数各为61.9%,革兰染色42.9%;墨汁涂片检测可显示荚膜和出芽;瑞氏染色可发现其周围毛刺;革兰染色仅现菌体深染。结论在基层医院细胞镜检计数、瑞氏染色、革兰染色及墨汁涂片法与真菌培养的正确、灵活结合可提高CSF中隐球菌的阳性检出率。

Objective To analyze methods of detecting cryptococcus in cerebrospinal fluid from patients with cryptococcal meningitis and to explore morphological character of some methods. Methods Cryptococcus was detected in 21 patients with cryptococcal meningitis using Wright＇s stain, India ink stain, Gram stain, cell counting and fungal culture. Positive rates and morphological character were com- pared between each other. Results In 21 cases, the positive rate of fungal culture, India ink stain, Wright＇s stain, Gram stain and cell counting were 90.5% , 81.0% ,42.9% and 61.9% respectively. Capsules and pullulations could be seen by India ink stain; sentuses a- round its periph could be seen by Wright＇s stain; and hyperchromatic bacteria could be observed by Gram stain. Conclusion In primary hospital, cell counting, Wright＇s stain, India ink stain, Gram stain and fungal culture combined correctly and flexibly can increase the positive ratio for the cryptococcus in CSF.