不同临床标本微生物检验的阳性率分析及其临床价值探讨

Positive rate and clinical value of microbiological test of different clinical specimens

目的探讨不同临床标本微生物检验的阳性率分析及其临床价值。方法选取2015年1月至2018年12月本院微生物检验科收集的样本共40 960份,依据不同收集年份分为:2015年1月至2015年12月,9 461份;2016年1月至2016年12月,9 462份;2017年1月至2017年12月,10 668份;2018年1月至2018年12月,11 269份。将所有收集的样本均在本院实验室进行微生物检验。观察比较所有不同年份临床标本的微生物检验阳性比率。结果在2015年度:血液标本数为2 561份,阳性率为8.0%(204份);尿液标本数为1 984份,阳性率为16.0%(317份);呼吸道标本数为2 353份,阳性率为28.0%(658份);粪便标本数为1 741份,阳性率为12.0%(209份);穿刺液标本数为822份,阳性率为18.9%(155份)。在2016年度:血液标本数为2 602份,阳性率为14.0%(364份);尿液标本数为2 011份,阳性率为19.1%(385份);呼吸道标本数为2 401份,阳性率为33.1%(795份);粪便标本数为1 633份,阳性率为15.1%(247份);穿刺液标本数为815份,阳性率为21.0%(171份)。在2017年度:血液标本数为2 919份,阳性率为17.1%(498份);尿液标本数为2 392份,阳性率为21.1%(505份);呼吸道标本数为2 770份,阳性率为38.1%(1056份);粪便标本数为1 845份,阳性率为16.9%(311份);穿刺液标本数为742份,阳性率为23.5%(174份)。在2018年度:血液标本数为2 996份,阳性率为19.1%(571份);尿液标本数为2 461份,阳性率为24.1%(593份);呼吸道标本数为2985份,阳性率为45.9%(1371份);粪便标本数为1909份,阳性率为17.8%(340份);穿刺液标本数为918份,阳性率为24.3%(223份)。分析结果可知,在2015年度至2018年度,医院血液标本、尿液标本、呼吸道标本及粪便标本数量均逐年持续增加,不同年度间的差异显著,差异均有统计学意义(均P<0.05);在2015年度至2018年度,医院血液标本、尿液标本、呼吸道标本、粪便标本及穿刺液标本阳性比率呈逐年持续增加趋势,不同年度间的不同临床标本阳性比率比较,差异有统计学意义(P<0.05)。结论通过对医院不同时期及临床标本的微生物检验结果进行分析,能够对医院的病原菌流行情况进行充分的了解,为临床诊疗提供更为丰富的参考依据;但是在对临床标本进行微生物检验的过程中一定要确保检验质量,确保检验的准确率,以为临床诊疗提供更为准确的参考资料。

Objective To explore the positive rate and clinical value of different clinical specimens.Methods a total of 40 960 samples were selected from the microbial inspection department of our hospital from January,2015 to December,2018,which were divided into 9461 samples from January to December,2015,9462 samples from January to December,2016,10668 samples from January to December 2017,and 11269 samples from January to December,2018 according to different collection years.All the collected samples were tested in the laboratory of our hospital.The positive ratios of microbiological test in all the clinical specimens of different years were observed and compared.Results In 2015,there were 2 561 blood samples,with a positive rate of 8.0%(204 samples);1984 urine samples,with a positive rate of 16.0%(317 samples);2353 samples from respiratory tract,with a positive rate of 28.0%(658 samples);1 741 feces samples,with a positive rate of 12.0%(209 samples);and 822 punctured fluid samples,with a positive rate of 18.9%(155 samples).In 2016,there were 2602 blood samples,with a positive rate of 14.0%(364 samples);2011 urine samples,with a positive rate of 19.1%(385 samples);2401 samples from respiratory tract,with a positive rate of 33.1%(795 samples);1633 feces samples,with a positive rate of 15.1%(247 samples);and 815 punctured fluid samples,with a positive rate of 21.0%(171 samples).In 2017,there were 2 919 blood samples,with a positive rate of 17.1%(498 samples);2392 urine samples,with a positive rate of 21.1%(505 samples);2 770 samples from respiratory tract,with a positive rate of 38.1%(1056 samples);1 845 feces samples,with a positive rate of 16.9%(311 samples);and 742 punctured fluid samples,with a positive rate of 23.5%(174 samples).In 2018,there were 2 996 blood samples,with a positive rate of 19.1%(571 samples);2461 urine samples,with a positive rate of 24.1%(593 samples);2985 samples from respiratory tract,with a positive rate of 45.9%(1371 samples);1 909 feces samples,with a positive rate of 17.8%(340 samples);and 918 punctured fluid samples,with a positive rate of 24.3%(223 samples).According to the analysis results,from 2015 to 2018,the numbers of blood,urine,respiratory,and fecal samples in the hospital increased year by year,with statistical differences between different years(P<0.05).From 2015 to 2018,the positive rates of blood,urine,respiratory,fecal,and puncture fluid samples in the hospital increased year by year,and the positive rates of different clinical samples were significantly different from year to year(P<0.05).Conclusion By analyzing the microbial test results of different periods and clinical specimens in the hospital,we can fully understand the prevalence of pathogenic bacteria in the hospital,and provide more references for clinical diagnosis and treatment.However,in the process of microbial examination of clinical specimens,the quality and accuracy of the examination must be ensured,so as to provide more accurate reference materials for clinical diagnosis and treatment.