Middlebrook7H11斜面培养基分枝杆菌培养效果评价

doi:10.3969/j.issn.1673-8640.2021.05.013

摘要/Abstract

摘要：

目的评价Middlebrook7H11斜面培养基用于临床样本分枝杆菌培养的效果。方法收集上海市公共卫生临床中心住院和门诊患者各类临床样本599例,分别采用Middlebrook7H11斜面培养基和罗氏培养基培养分枝杆菌,比较2种培养基培养阳性率、报阳时间和污染率差异。结果 599例样本中,Middlebrook7H11斜面培养基培养阳性率为12.9%（77例）,罗氏培养基培养阳性率为12.4%（74例）,两者联合培养阳性率为15.0%（90例）。Middlebrook7H11斜面培养基培养阳性率稍高于罗氏培养基,但差异无统计学意义（χ²=0.07,P>0.05）;罗氏培养基污染率高于Middlebrook7H11斜面培养基（χ²=4.67,P<0.05）;Middlebrook7H11斜面培养基报阳时间比罗氏培养基短1周,阳性早出现1周的例数多于罗氏培养基（χ²=11.62,P<0.01）。结论 Middlebrook7H11斜面培养基用于分枝杆菌培养优于罗氏培养基,两者联合培养可提高阳性率。

关键词: 分枝杆菌, Middlebrook7H11斜面培养基, 罗氏培养基

Abstract:

Objective To evaluate Middlebrook7H11 slant medium for culturing Mycobacterium from clinical specimens. Methods Totally,599 clinical specimens of inpatients and outpatients in Shanghai Public Health Clinical Center were cultured by Middlebrook7H11 slant medium and Löwenstein-Jensen medium. The positive rates,positive occurrence times and contamination rates of the 2 media were compared. Results Of the 599 clinical specimens,77（12.9%） cases were positive for Middlebrook7H11 slant medium,and 74（12.4%） cases were positive for Löwenstein-Jensen medium. The combined positive rate was 15.0%（90 cases）. There was no statistical significance in the positive rates between Middlebrook7H11 slant medium and Löwenstein-Jensen medium（χ²=0.07,P>0.05）. The contamination rate of Löwenstein-Jensen medium was higher than that of Middlebrook7H11 slant medium（χ²≤4.67,P<0.05）. The positive occurrence time of Middlebrook7H11 slant medium was 1 week shorter than that of Löwenstein-Jensen medium,and the number of positive clinical specimens appeared earlier than that of Löwenstein-Jensen medium（χ²≤11.62,P<0.01）. Conclusions Middlebrook7H11 slant medium is superior to Löwenstein-Jensen medium in Mycobacteriumculturing. The combined determination of the 2 media can improve the positive rate.

Key words: Mycobacterium, Middlebrook7H11 slant medium, Löwenstein-Jensen medium

中图分类号:

R521

钱雪琴, 卢洪洲. Middlebrook7H11斜面培养基分枝杆菌培养效果评价[J]. 检验医学, 2021, 36(5): 519-523.

QIAN Xueqin, LU Hongzhou. Evaluation of Middlebrook7H11 slant medium for culturing Mycobacterium from clinical specimens[J]. Laboratory Medicine, 2021, 36(5): 519-523.

图/表 5

参考文献 10

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培养基	阳性率/%	阳性出现时间/d					平均报阳时间/d	相同样本阳性早出现1周例数/例
培养基	阳性率/%	中位时间		最短时间		最长时间	平均报阳时间/d	相同样本阳性早出现1周例数/例
Middlebrook7H11斜面培养基	12.9	28		11		56	31	13
罗氏培养基	12.4	30		12		56	31	1
培养基	2周有菌落内生长		30 d内有菌落生长			42 d内有菌落生长		相同样本菌落多例数/例	污染率/%
培养基	例数/例	百分比/%	例数/例		百分比/%	例数/例	百分比/%	相同样本菌落多例数/例	污染率/%
Middlebrook7H11斜面培养基	4	5.2	41		53.2	60	77.9	35	5.3
罗氏培养基	3	4.1	38		51.4	60	81.1	26	8.5

培养基	阳性率/%	阳性出现时间/d					平均报阳时间/d	相同样本阳性早出现1周例数/例
培养基	阳性率/%	中位时间		最短时间		最长时间	平均报阳时间/d	相同样本阳性早出现1周例数/例
Middlebrook7H11斜面培养基	12.9	28		11		56	31	13
罗氏培养基	12.4	30		12		56	31	1
培养基	2周有菌落内生长		30 d内有菌落生长			42 d内有菌落生长		相同样本菌落多例数/例	污染率/%
培养基	例数/例	百分比/%	例数/例		百分比/%	例数/例	百分比/%	相同样本菌落多例数/例	污染率/%
Middlebrook7H11斜面培养基	4	5.2	41		53.2	60	77.9	35	5.3
罗氏培养基	3	4.1	38		51.4	60	81.1	26	8.5

样本类型	样本数/例	Middlebrook7H11斜面培养基		罗氏培养基		联合培养
样本类型	样本数/例	阳性例数/例	阳性率/%	阳性例数/例	阳性率/%	阳性例数/例	阳性率/%
灌洗液	22	7	31.8	6	27.3	7	31.8
穿刺液	37	10	27.0	8	21.6	11	29.7
引流物	5	1	20.0	1	20	1	20.0
脓性分泌物	18	2	11.1	3	16.7	3	16.7
支气管刷取物	19	2	10.5	3	15.8	3	15.8
胃液	27	2	7.4	2	7.4	4	14.8
痰液	374	47	12.6	45	12.0	55	14.7
胸腔、腹腔积液	21	3	14.3	3	14.3	3	14.3
尿液	29	3	10.3	3	10.3	3	10.3
脑脊液	22	0	0	0	0	0	0
骨髓	2	0	0	0	0	0	0
肺组织	2	0	0	0	0	0	0
粪便	21	0	0	0	0	0	0
合计	599	77	12.9	74	12.4	90.0	15.0

样本类型	样本数/例	Middlebrook7H11斜面培养基		罗氏培养基		联合培养
样本类型	样本数/例	阳性例数/例	阳性率/%	阳性例数/例	阳性率/%	阳性例数/例	阳性率/%
灌洗液	22	7	31.8	6	27.3	7	31.8
穿刺液	37	10	27.0	8	21.6	11	29.7
引流物	5	1	20.0	1	20	1	20.0
脓性分泌物	18	2	11.1	3	16.7	3	16.7
支气管刷取物	19	2	10.5	3	15.8	3	15.8
胃液	27	2	7.4	2	7.4	4	14.8
痰液	374	47	12.6	45	12.0	55	14.7
胸腔、腹腔积液	21	3	14.3	3	14.3	3	14.3
尿液	29	3	10.3	3	10.3	3	10.3
脑脊液	22	0	0	0	0	0	0
骨髓	2	0	0	0	0	0	0
肺组织	2	0	0	0	0	0	0
粪便	21	0	0	0	0	0	0
合计	599	77	12.9	74	12.4	90.0	15.0

罗氏培养基	Middlebrook7H11斜面培养基
罗氏培养基	阳性	阴性	合计
阳性	37	8	45
阴性	10	319	329
合计	47	327	374