溶血离心培养法检测肺结核患者外周血分支杆菌及其L型

目的　建立一种自血液中分离分支杆菌及其L型的新方法。方法　肺结核患者的外周血直接或溶血离心后取沉淀种入 92 3TB和 92 3TBL液体培养基培养 ,培养物用免疫酶染色 (ABC法 )鉴定。结果　 6 5份标本分支杆菌和分支杆菌L型血培养的阳性率、总检出率分别为 15 %、2 6 %、32 % ;溶血离心培养法的阳性率明显高于直接培养法 (P <0 0 5 ) ;相应痰培养中 ,抗酸杆菌和抗酸菌L型的阳性率、总检出率分别为 38%、2 0 %和 5 2 % ,高于肺结核患者外周血培养的阳性率 (P <0 0 5 ) ;但血、痰配对检测总阳性率可达 6 5 %。结论　肺结核患者外周血存在分支杆菌及其L型 ,并以L型为主 ;溶血离心液体培养结合免疫酶染色可常规用于检测血液中分支杆菌及其L型 ;结合痰标本检测 ,可提高肺结核患者细菌学检查的阳性率

Detecting mycobacteria and their L-forms in peripheral blood from pulmonary tuberculosis patients by cultivation with hemolyzed-centrifugated blood in liquid medium

Objective To establish a new method of detecting mycobacteria and their L forms in blood Methods 65 samples of peripheral blood from patients with pulmonary tuberculosis were cultivated directly or cultivated with hemolyzed centrifugated blood sediments in 92 3TB and 92 3TBL liquid medium, and the cultures were staining with immunoenzyme technique (ABC method) Results In 65 specimens,the positive rates of mycobacteria and their L forms were 15%,26% respectively with total isolation rate of 32% In cultivating with hemolyzed centrifugated blood the positive rate was much higher than direct cultural method ( P <0 05) In sputum the positive rates of acid fast bacilli and their L forms were 38% and 20% respectively,with total isolation rate of 52%, higher than that in peripheral blood ( P <0 05), and the total positive rate of combinative detection of blood and sputum salmples was 65% Conclusions Mycobacteria and their L forms exist in peripheral blood of patients with pulmonary tuberculosis ,and mainly in L forms Cultivation with hemolyzed centrifugated blood in liquid medium and staining with immunoenzyme technique are valuable in routine detection of mycobacteria and their L forms in peripheral blood The positive rate of bacterial culture of pulmonary tuberculosis could be increased in combination with sputum mycobacteria and their L forms examination