检验医学 ›› 2015, Vol. 30 ›› Issue (12): 1214-1218.DOI: 10.3969/j.issn.1673-8640.2015.12.012

• 临床应用研究·论著 • 上一篇    下一篇

泌尿生殖道支原体感染的优化检测方案研究

吴磊1, 周运恒2, 陈向明3, 王国江3, 刘瑛4, 陈峰4, 冯景5, 唐群力5, 汪瑞忠6, 房华6, 赵虎7, 方毅7, 周春妹8, 黄声雷8, 唐振华9, 陆庭嫣9, 汤瑾10, 王坚镪10, 韩立中11, 肖淑珍11, 胡伟忠1, 杨阳1, 顾伟鸣1   

  1. 1.海市皮肤病医院检验科,上海 200443
    2.武警上海市总队医院检验科,上海 201103
    3.上海市嘉定区南翔医院性病科,上海 201802
    4.上海交通大学医学院附属新华医院检验科,上海 200092
    5.上海市奉贤区中心医院检验科,上海 201499
    6.浦东新区人民医院检验科,上海 201299
    7.复旦大学附属华东医院检验科,上海 200040
    8.复旦大学附属中山医院检验科,上海 200032
    9.上海交通大学医学院附属中国福利会国际和平妇幼保健院检验科,上海 200030
    10.上海交通大学附属第六人民医院检验科,上海 200233
    11.上海交通大学医学院附属瑞金医院临床微生物科,上海 200025
  • 收稿日期:2015-08-25 出版日期:2015-12-20 发布日期:2016-01-04
  • 作者简介:null

    作者简介:吴 磊,男,1978年生,硕士,主管技师,主要从事性病检测方法学研究。

    通讯作者:顾伟鸣,联系电话:021-61833177。

  • 基金资助:
    上海市自然科学基金资助项目(06ZR14074);吴阶平医学基金会资助项目(320.6750.13233)

Research on the modification detection scheme for mycoplasma infection of genitourinary tract

WU Lei1, ZHOU Yunheng2, CHEN Xiangming3, WANG Guojiang3, LIU Ying4, CHEN Feng4, FENG Jing5, TANG Qunli5, WANG Ruizhong6, FANG Hua6, ZHAO Hu7, FANG Yi7, ZHOU Chunmei8, HUANG Shenglei8, TANG Zhenhua9, LU Tingyan9, TANG Jin10, WANG Jianqiang10, HAN Lizhong11, XIAO Shuzhen11, HU Weizhong1, YANG Yang1, GU Weiming1   

  1. 1. Department of Clinical Laboratory, Shanghai Dermatology Hospital, Shanghai 200443, China
    2. Department of Clinical Laboratory, Shanghai Crops Hospital of Chinese People's Armed Police, Shanghai 201103, China
    3. Department of Venereology, Shanghai Jading Nanxiang Hospital, Shanghai 201802, China
    4. Department of Clinical Laboratory, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
    5. Department of Clinical Laboratory, Shanghai Fengxian District Central Hospital, Shanghai 201499, China
    6. Department of Clinical Laboratory, Shanghai Pudong New Area People's Hospital, Shanghai 201299, China
    7. Department of Clinical Laboratory, Huadong Hospital, Fudan University, Shanghai 200040, China
    8. Department of Clinical Laboratory, Zhongshan Hospital, Fudan University, Shanghai 200032, China
    9. Department of Clinical Laboratory, the International Peace Maternity and Child Health Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China
    10. Department of Clinical Laboratory, the Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China
    11. Department of Organism, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Received:2015-08-25 Online:2015-12-20 Published:2016-01-04

摘要:

目的 通过优化支原体培养的方法和流程建立新的检查方案,提高检测解脲脲原体(Uu)和人型支原体(Mh)感染的准确性。方法 优化支原体固体和液体组合培养的检测模式,制定了一套可操作性的标准化实验方案,遴选11家二级以上医疗机构,对随机入选病例的泌尿生殖道分泌物样本开展联合研究。相关的实验数据进行统计分析,评价临床应用前景。结果 747例样本总体阳性率45.1%(337/747),其中Uu阳性率41.1%(307/747),Mh阳性率13.9%(104/747)。Uu和Mh原始样本接种的阳性符合率分别为92.6%和94.0%(P均<0.01)。Uu和Mh转种后的阳性符合率分别为97.5%和96.1%(P均>0.05)。液体培养变色后转种提高了固体培养的敏感性。有17例液体培养阳性的样本经过原代和转种2次固体培养,均没有观察到菌落。固体培养降低了液体培养的假阳性。固体培养与液体培养同时接种样本,明显缩短了固体培养的检测周期。超过85%的支原体在24 h以内观察到菌落,而48 h以内固体培养与液体培养的阳性率几乎没有差别。结论 以固体和液体组合培养的检测模式,尽管增加了检验成本,但对泌尿生殖道支原体感染的检测具有更高的敏感性和特异性,新检测方案可以在临床推广应用。

关键词: 支原体, 解脲脲原体, 人型支原体, 培养, 检测方法, 标准化

Abstract:

Objective To optimize culture methods and processes for mycoplasma and to establish a new scheme to improve the detection accuracy of ureaplasma urealyticum (Uu) and mycoplasma hominis (Mh) infections.Methods A practical standard laboratory procedure was established, and the models of mycoplasma culture in solid and liquid cultures were optimized. A total of 11 hospitals above Grade 2 in Shanghai participated in the study. Study cases were randomly selected, and genitourinary samples were determined. Statistical analysis was performed, and the clinical application of the procedure was evaluated. Results A total of 747 samples were collected. The overall positive rate was 45.1% (337/747), for Uu 41.1% (307/747) and for Mh 13.9% (104/747). The positive coincidence percentages of original sample inoculation were 92.6% and 94.0% (P<0.01), respectively. The positive coincidence percentages after transmission inoculation were 97.5% and 96.1% (P>0.05). The sensitivity of solid culture was improved when culture was transferred from liquid culture with color changes. A total of 17 liquid culture samples did not produce any colonies on the solid culture, and even the solid culture was passed twice. This indicated that solid culture decreased the false positivity in liquid culture. The determination time reduced significantly when solid and liquid cultures were performed simultaneously. Over 85% mycoplasma samples had colony formation within 24 h, and in 48 h liquid culture and solid culture had same positive percentage. Conclusions The combination of liquid culture and solid culture of mycoplasma produces high sensitivity and specificity, although the costs of the testing increase. This combination determination procedure should be recommended in the laboratory diagnosis of mycoplasma infections.

Key words: Mycoplasma, Ureaplasma urealyticum, Mycoplasma hominis, Culture, Determination method, Standardization

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