阴道炎感染患者不同方法检测病原体的对比分析

Detection of pathogens causing vaginitis with different methods:a comparative study

目的探讨阴道炎感染患者不同方法检测病原体结果差异性,以期为临床检测方法的选择提供参考依据。方法收集2013年6-12月300例妇科门诊就诊患者送检的阴道分泌物标本,分别采用直接镜检法、Amsel法、培养法、阴道五联检测试剂盒进行检测,并对检测结果进行比较分析。结果培养法显示300例患者送检标本中282例检出病原体,检出阳性率94.00%,主要感染病原体有加德纳菌、滴虫、假丝酵母菌属;细菌性感染检测阳性率镜检法为44.67%、Amsel法为58.67%、五联检测试剂盒为61.33%,调查感染检测阳性率镜检法为33.00%、五联检测试剂盒为42.00%,细菌性感染检测感染阳性率镜检法为14.33%、五联检测试剂盒为18.00%;细菌性感染镜检法检测感染阳性率低于Amsel法、五联检测试剂盒、培养法(P<0.05),滴虫感染镜检法检测感染阳性率低于五联检测试剂盒、培养法(P<0.05),假丝酵母菌属感染镜检法检测阳性率低于培养法(P<0.05)。结论阴道炎感染患者以细菌性感染多见,各种感染病原体检测时显微镜镜检阳性率低,五联检测试剂盒检测阳性率与培养法接近,相对成本较高,临床检测阴道分泌物感染病原微生物时,建议先选择显微镜如无法确定感染病原体或检测结果与临床诊断不符时,可进一步选择五联检测试剂盒检测。

OBJECTIVE To observe the difference in the detection of pathogens causing vaginitis with different methods so as to provide guidance for the clinical detection .METHODS The vaginal secretion specimens were col-lected from 300 patients who were treated in the gynecology outpatient department from Jun 2013 to Dec 2013 , then the collected specimens were detected by respectively using the direct microscopy ,Amsel method ,culture method ,and vaginal immovable detection kits ,and the detection results were comparatively analyzed .RESULTS The culture method showed that the pathogens were detected positive in 282 of 300 patients ,with the positive de-tection rate of 94 .00% ,and the major species of pathogens causing infections included the Gardner f ungus , Trichomonas and Candida sp p . The positive rate of detection of bacterial infections of the microscopy was 44 .67% ,the Amsel method 58 .67% ,the vaginal immovable detection kits 61 .33% .The positive rate of detec-tion of investigated infections cases of the microscopy was 33 .00% ,the vaginal immovable detection kits 42 .00% . The positive rate of detection of bacterial infections of the microscopy was 14 .33% ,the vaginal immovable detec-tion kits 18 .00% .The positive rate of detection of bacterial infections of the microscopy was significanthy lower than that of the culture method ,Amsel method ,or vaginal immovable detection kits （P〈 0 .05） .The positive rate of detection of Trichomonas infection of the microscopy was significanthy lower than that of the vaginal immovable detection kits or the culture method （P〈 0 .05） ;the positive rate of detection of Candida sp p infection of the mi-croscopy was significanthy lower than that of the culture method （P〈 0 .05） .CONCLUSION The bacterial infection is common in the patients with vaginitis ,the positive rate of detection of the various bacterial infections of the mi -croscopy is low ,while the positive rate of detection of vaginal immovable detection kits is similar to that of the cul -ture method ,and the cost is relatively high .It is suggested that the microscopy should be firstly chosen for the de-tection of pathogens in the vaginal secretions and that the vaginal immovable detection kits should be further adopted if the pathogens can not be indentified or the detection results do not conform to the clinical diagnosis .