临床分离多重耐药鲍曼不动杆菌在呼吸道感染诊断中的价值

Clinical Value of Clinical Isolation of Multidrug-Resistant Acinetobacter Bauman in the Diagnosis of Respiratory Tract Infection

探讨临床分离多重耐药鲍曼不动杆菌(MR-AB)在呼吸道感染(RTI)诊断中的价值。回顾性选取2014年12月至2017年12月该院收治的RTI患儿186例,均给予痰标本直接涂片(DSSS)、细菌定量培养(BQC),药敏试验确认为MR-AB感染,并依据综合分析原则分为感染组(n=102例)和定植组(n=84例),分析DSSS、BQC对MR-AB所致RTI的诊断价值。在诊断MR-AB所致RTI的敏感度、特异度、准确度、约登指数方面,DSSS诊断分别为80. 39%,78. 57%,79. 57%,0. 501,BQC诊断分别为75. 49%,71. 43%,73. 66%,0. 412,二者联合诊断分别为88. 23%,83. 33%,86. 02%,0. 764,二者联合明显高于二者单独,差异有统计学意义(P <0. 05),DSSS高于BQC,但差异无统计学意义(P> 0. 05)。DSSS、BQC对MR-AB所致RTI具有良好的诊断价值,二者联合具有更佳的诊断价值,其可作为可靠的实验室诊断方法,值得临床进一步推广。

To discuss the clinical value of clinical isolation of multidrug-resistant( MR-AB) Acinetobacter Bauman in the diagnosis of respiratory tract infection( RTI),retrospective study of 186 children with RTI in author’s hospital from December 2014 to December 2017 was reviewed. Direct smear( DSSS) and bacterial quantitative culture( BQC) were given to all sputum specimens. The drug sensitivity test was confirmed as MR-AB infection. And according to the principle of comprehensive analysis,they were divided into infection group( n = 102 case) and colonization group( n = 84);the value of DSSS and BQC in the diagnosis of RTI caused by MR-AB were analyzed. In the diagnosis of MR-AB induced RTI sensitivity,specificity,accuracy,and yueden index,the DSSS diagnosis were 80. 39%,78. 57%,79. 57%,0. 501;the BQC diagnosis was 75. 49%,71. 43%,73. 66%,0. 412;the combined diagnosis of two were 88. 23%,83. 33%,86. 02%,0. 764,the combination of the two was significantly higher than that of the two,the difference was statistically significant( P < 0. 05). DSSS was higher than BQC,but the difference was not statistically significant( P > 0. 05). DSSS,BQC have good diagnostic value for RTI caused by MR-AB. The combination of the two has a better diagnostic value. It can be used as a reliable laboratory diagnostic method and it’s worth for further clinical promotion.