血标本中伤寒、副伤寒沙门氏菌培养结果与临床诊断相符度分析

陈蔚冰 王立芸

摘 要：目的 讨论本院血培养分离出伤寒、副伤寒沙门氏菌阳性结果和临床诊断相符度。方法 采用Bact/ALERT 3D全自动血培养仪及其配套的血培养瓶，对临床血标本进行培养，将伤寒、副伤寒沙门氏菌阳性结果及临床诊断进行分析。结果 在血培养标本中共检出伤寒、副伤寒沙门氏菌110例，其中入院疑似诊断沙门氏菌感染72例，其他38例发热腹泻等原因待查病例为均为沙门氏菌阳性。结论 目前伤寒、副伤寒沙门氏菌检验仍以血培养为主，与临床诊断相符度高，其他临床表现不典型病例也检出沙门氏菌，应加强致病菌血培养及其对抗生素的耐药性监测，提高传染病防控意识。

关键词：血培养；伤寒；副伤寒沙门氏菌；临床诊断相符度

中图分类号：R446.5 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.09.051

文章编号：1006-1959（2018）09-0157-02

Abstract：Objective To discuss the positive results of typhoid and paratyphoid Salmonella isolated from blood culture in our hospital and the clinical diagnostic consistency.Methods Bact/ALERT 3D automatic blood culture instrument and its supporting blood culture flask were used to culture clinical blood samples.The positive results of typhoid and paratyphoid Salmonella were analyzed.Results A total of 110 cases of typhoid and paratyphoid Salmonella fever were detected in blood culture specimens.Among them，72 cases were suspected to have been diagnosed with Salmonella infection in hospitals，and the other 38 cases with fever diarrhea were positive for Salmonella.Conclusion The test of typhoid and paratyphoid Salmonella bacteria is still based on blood culture，which is consistent with the clinical diagnosis.Other clinical manifestations of Salmonella are also detected.The blood culture of pathogenic bacteria and the monitoring of antibiotic resistance should be strengthened and the awareness of prevention and control of infectious diseases should be improved.

Key words：Blood culture；Typhoid；Salmonella paratyphoid；Clinical diagnosis consistency

伤寒（typhoid）是由肠沙门菌肠亚种伤寒血清型引起的肠道传染病。副伤寒（paratyphoid）是由肠沙门菌肠亚种副伤寒甲或乙或丙血清型引起的一种和伤寒相似的疾病。伤寒、副伤寒是《中华人民共和国传染病防治法》规定的乙类传染病，在我国发病率高，传染性强，病程长，并发症多，是我国面临的一个严重的公共卫生问题[1]。目前伤寒、副伤寒的检验仍以传统的培养法为主，其确诊必须以实验室细菌分离培养和鉴定的结果为准。由于伤寒、副伤寒的流行株变异和抗生素滥用等因素，医疗单位所担负的临床诊断病例数难以真实反映伤寒、副伤寒的疾病，而世界上对伤寒、副伤寒的诊断、报告尚无统一的标准[2]，报告病例多凭临床表现诊断。……