肺炎链球菌鉴定方法分析

发布时间：2018-10-16 18:44

【摘要】：目的对从临床标本中分离出的302株成对或短链排列形似肺炎链球菌的革兰阳性球菌进行系统准确鉴定,借此探讨肺炎链球菌鉴定常规方法的不足,提出较为科学的方法。方法自2013年12月-2014年11月两所医院59 607份临床标本中分离出形似肺炎链球菌302株,以形态学、奥普托欣(OP)敏感试验、肺炎链球菌乳胶凝集作为初步鉴定手段,再结合胆汁溶菌等传统生化反应试验,以及Lancefield抗原乳胶试剂凝集试验,对细菌进行系统鉴定。结果 113株细菌被最终鉴定为肺炎链球菌,124株鉴定为C群或F群链球菌,其中87株既与肺炎链球菌乳胶试剂发生非特异性凝集又与Lancefeild C/F乳胶凝集;8株链球菌OP敏感但生化反应和乳胶均不支持;OP耐药乳胶凝集与生化反应支持的有7株,OP敏感生化反应支持但乳胶凝集均阴性的有3株;以生化反应符合加上OP与乳胶凝集中的一种试验符合作为最终鉴定结论,计算出肺炎链球菌乳胶试剂的假阴性为2.6%、假阳性为46.0%。结论鉴定肺炎链球菌,传统生化反应方法不可废弃,综合使用多种手段鉴定细菌可以有效防止鉴定错误。
[Abstract]:Objective to identify 302 strains of gram-positive cocci in pairs or short chain arrangement from clinical specimens, and to explore the deficiency of conventional methods for identification of Streptococcus pneumoniae and to put forward a more scientific method for identification of Streptococcus pneumoniae. Methods from December 2013 to November 2014, 302 strains of Streptococcus pneumoniae were isolated from 59,607 clinical specimens in two hospitals. Morphology, Optoxin (OP) sensitivity test and latex agglutination of Streptococcus pneumoniae were used as the primary means of identification. Combined with the traditional biochemical reaction test such as bile lytic bacteria and agglutination test of Lancefield antigen latex reagent, the bacteria were systematically identified. Results 113 strains of bacteria were identified as Streptococcus pneumoniae and 124 strains as Group C or Group F streptococcus. Among them, 87 strains had both nonspecific agglutination with Streptococcus pneumoniae latex reagent and Lancefeild C / F latex agglutination; 8 strains of Streptococcus pneumoniae OP were sensitive but not supported by biochemical reaction and latex; 7 strains with OP resistant latex agglutination and biochemical reaction supported OP. Three strains were supported by sensitive biochemical reaction but negative in latex agglutination. With biochemical reaction coincidence and a kind of test coincidence between OP and latex agglutination as final identification conclusion, the false negative and false positive of Streptococcus pneumoniae latex reagent were calculated to be 2.6% and 46.0% respectively. Conclusion the identification of Streptococcus pneumoniae can not be abandoned by traditional biochemical reaction methods.
【作者单位】：定西市人民医院检验科;成都市第五人民医院检验科;甘肃省人民医院检验中心;
【基金】：甘肃省科技支撑计划基金资助项目(0708NKCA096)
【分类号】：R446.5

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