检验科临床微生物培养质量的相关因素及病原菌的耐药程度研究

Study on the factors related to the quality of clinical microorganism culture quality and the drug resistance degrees of pathogenic bacteria in the laboratory

目的研究检验科临床微生物培养质量的相关因素及病原菌的耐药程度。方法回顾性分析本院2014年1月-2016年1月检验科临床微生物培养的558份样本,从培养的准确性、影响培养质量的相关因素、病原菌分布情况以及病原菌的耐药性几方面进行数据性分析。结果 558份样本中培养结果准确的共458份,准确率为82.08%;其中准确率最高的为痰液样本,其他样本种类间差异均有统计学意义(P<0.05)。患者生理因素、检验人员技术因素、仪器与试剂因素、样本留存时间以及取样方式为微生物培养质量的相关因素(P<0.05)。革兰阴性菌中铜绿假单胞菌占比最高,为15.13%;革兰阳性菌中金黄色葡萄球菌占比最高,为17.02%;真菌中白色假丝酵母菌占比最高,为5.44%。结论对于微生物培养质量可构成影响的因素较多,提高样本的采集、存储规范性,提升培养人员技术水平及规范化操作程序,有利于全面提高检验科培养质量。

Objective To study the related factors of the quality of clinical microorganism culture quality and the drug resistance of pathogenic bacteria. Methods A retrospective analysis was performed on the 558 microorganism cultured samples in the clinical laboratory of our hospital from January 2014 to January 2016,and the culture accuracy,the effects of quality related factors,pathogen distribution and drug resistance of pathogenic bacteria were detected for data analysis. Results 458 samples got correct culture results in all 558 samples and the accuracy was 82. 08%; the highest accuracy rate was with sputum specimens,and the differences among other samples were statistically significant（ P〈0. 05）. Related factors of clinical microorganism cultivation quality were physiological factors of patients,echnical factors of inspectors,instruments and the relevant reagent,sample retention time and sampling time（ P〈0. 05）. Pseudomonas aeruginosa took the highest proportion of gram-negative bacteria,Staphylococcus aureus took the highest proportion of gram-positive bacteria,white candida took the highest proportion of fungus,and the percentages were respectively 15. 13%,17. 02%,5. 44%. Conclusion Many factors affect clinical microorganism cultivation quality,so raising normalization of sample collection and storage,the technical level of the training personnel and normalized operation can improve the inspection quality in clinical laboratories.