痰涂片与痰培养在下呼吸道感染诊断中的对比

Comparison of Sputum Smear and Sputum Culture in the Diagnosis of Lower Respiratory Tract Infection

目的对比分析痰涂片与痰培养在下呼吸道感染诊断中的临床价值。方法选择2021年1—12月在宜兴市中医医院治疗的下呼吸道感染患者594例为研究对象,所有患者均给予痰涂片与痰培养诊断,总结分析痰涂片与痰培养的诊断结果,并统计比较痰涂片与痰培养诊断结果。结果经痰涂片诊断,594例患者中发现致病菌269例,占45.29%,其中革兰阴性杆菌198例,革兰阳性球菌58例,真菌13例。经痰培养诊断,594例患者中发现致病菌274例,占46.13%,其中铜绿假单胞菌47例,肺炎克雷伯菌42例,肺炎链球菌39例,大肠埃希菌34例,鲍曼不动杆菌26例,卡他莫拉菌18例,阴沟肠杆菌17例,金黄色葡萄球菌12例,流感嗜血杆菌11例,白假丝酵母菌9例,嗜麦芽窄食假单胞菌7例,产气肠杆菌6例,粘质沙雷菌4例,产单核细胞李斯特菌2例。痰涂片诊断阳性率为45.29%,痰培养诊断阳性率为46.13%,两种诊断方式比较差异无统计学意义(χ^(2)=0.085,P>0.05)。结论在下呼吸道感染诊断中,痰涂片与痰培养的一致性比较理想,其中痰涂片操作更加简单,可作为初步鉴别病原体的主要方法,为临床诊断与治疗提供参考依据。

Objective To compare and analyze the clinical value of sputum smear and sputum culture in the diagnosis of lower respiratory tract infections.Methods 594 patients with lower respiratory tract infection treated in the Yixing Hospital of Traditional Chinese Medicine from January to December 2021 were selected as the research objects.All patients were diagnosed with sputum smear and sputum culture,and the diagnosis results of sputum smear and sputum culture were summarized and analyzed.And statistically compared the diagnosis results of sputum smear and sputum culture.Results According to the diagnosis of sputum smear,269 pathogenic bacteria were found in 594 patients,accounting for 45.29%,among them,198 were gram-negative bacilli,58 were gram-positive cocci,and 13 were fungi.Diagnosed by sputum culture,274 cases of pathogenic bacteria were found in 594 patients,accounting for46.13%,among them,47 cases were of Pseudomonas aeruginosa,42 cases of Klebsiella pneumoniae,39 cases of Streptococcus pneumoniae,34 cases of Escherichia coli,26 cases of Acinetobacter baumannii,18 cases of Moraxella catarrhalis,17 cases of Enterobacter cloacae,12 cases of Staphylococcus aureus,11 cases of Haemophilus influenzae,9 cases of Candida albicans,7 cases of Stenotrophic Pseudomonas maltophilia,6 cases of Enterobacter aerogenes,4 cases of Serratia marcescens,and 2 cases of Listeria monocytogenes.The positive rate of sputum smear was45.29%,and the positive rate of sputum culture was 46.13%,the difference was not statistically significant between the two diagnoses(χ^(2)=0.085,P>0.05).Conclusion In the diagnosis of lower respiratory tract infection,the consistency of sputum smear and sputum culture is ideal.The operation of sputum smear is simpler.It can be used as the main method for preliminary identification of pathogens and provide reference for clinical diagnosis and treatment.