淋病奈瑟氏菌培养在诊断女性慢性淋病中的价值

目的:强调淋病奈瑟氏菌(淋球菌)培养在诊断女性慢性淋病中的价值.方法:把曾经用宫颈分泌物涂片革兰氏染色,多形核白细胞外见G-双球菌为依据,诊断为慢性淋病患者的分泌物进行淋球菌的培养鉴定.结果:40例标本中淋球菌检出19株(47.5%),其它奈瑟氏菌检出5株(12.5%),莫拉氏菌属的菌检出9株(22.5%),有7例标本无菌生长.结论:宫颈分泌物涂片革兰氏染色,多形核白细胞外见G-双球菌不能做为诊断女性慢性淋病的依据,应选用国际卫生组织推荐的方法--淋病奈瑟氏菌培养.     

超显检查对细菌性阴道病诊断价值的探讨

目的:比较超高倍显微诊断系统检查(超显检查)阴道加德纳菌(GV)与革兰氏染色法及细菌性阴道病快速检测新方法(BV-blue TM)的差异.方法:对临床诊断疑似细菌性阴道病(BV)的267份阴道分泌物新鲜标本,同时应用超显检查与革兰氏染色法及BV-blue TM法进行检测.结果:超显检查阳性率96.6%,革兰染色法阳性率为92.9%;BV-blue TM方法的阳性率为93.3%.超显检查与革兰氏染色法及BV-blue TM法比较结果差异无显著性(P＞0.05).结论:超显检查、革兰染色法BV-blue TM均可诊断细菌性阴道病,但超显检查更简便、直观、快速.     

女性淋病109例报告

淋病是由一种革兰氏阴性的淋病双球菌(亦叫淋病奈瑟氏菌)引起的,易于侵犯生殖泌尿系统。女性生殖器官淋病是女性性传播疾病中最常见的一种。本组病例初诊多误为是滴虫性阴道炎混合感染,用灭滴灵类药物治疗效果不佳,后进行涂片并用革兰氏染色进行镜检,证实认为是淋病双球菌     

超显检查对细菌性阴道病诊断价值的探讨

目的 :比较超高倍显微诊断系统检查 (超显检查 )阴道加德纳菌 (GV)与革兰氏染色法及细菌性阴道病快速检测新方法 (BV blueTM)的差异。方法 :对临床诊断疑似细菌性阴道病 (BV)的 2 6 7份阴道分泌物新鲜标本 ,同时应用超显检查与革兰氏染色法及BV blueTM法进行检测。结果 :超显检查阳性率 96 .6 % ,革兰染色法阳性率为92 .9% ;BV blueTM方法的阳性率为 93.3%。超显检查与革兰氏染色法及BV blueTM法比较结果差异无显著性(P >0 .0 5 )。结论 :超显检查、革兰染色法BV blueTM均可诊断细菌性阴道病 ,但超显检查更简便、直观、快速。     

唾液酸酶检测对细菌性阴道炎的诊断价值与临床应用

目的评价唾液酸酶检测对细菌性阴道炎(Bacterial Vaginosis,BV)的诊断价值与临床应用,分析BV与其它阴道疾病的关系.方法以酶反应学原理检测阴道分泌物唾液酸酶的活性,同时以革兰氏染色法找线索细胞及白带常规检查作对照.结果在BV诊断中,唾液酸酶法阳性率为29.3%,革兰氏染色法为24.1%,两者之间有显著差异性(p＜0.05).在滴虫性及念珠菌性阴道炎中,唾液酸酶阳性率分别为90.9%和22.2%.结论在BV诊断中,唾液酸酶法阳性率高于传统革兰氏染色法.虽然唾液酸酶法和其它方法一样存在交叉感染滴虫(6.2%)及念珠菌(7.4%)等病原体的问题,但其简便、快捷、可靠、结果易判读、特异性强,可批量操作,不失为一种临床上可行的好方法.     

注意预防儿童淋菌性阴道炎

1 临床资料10例,年龄2～12岁.症状均为外阴痒、痛难忍.检查见外阴部发红或肿胀,有脓性分泌物.诊断:以无菌棉拭插入阴道,取分泌物涂布于载玻片上.自然干燥后立即火焰固定.用革兰氏染色法染色.凡在显微镜下观察到形态典型的革兰氏阴性双球菌,无论存在于多形核白细胞内,还是胞外,均诊断为阳性.结果:10例患儿中,1例胞外阳性,其余9例均为胞内阳性,或胞内、外均为阳性.发病原因:与其密切接触的亲属患淋病者有5     

胃粘膜革兰氏染色和聚合酶链反应检测幽门螺杆菌对比分析

８３例胃粘膜活检标本革兰氏染色和Ｈｐ－ＰＣＲ检测，结果显示革兰氏染色法诊断Ｈｐ感染敏感性８１％，特异性１００％，两种方法检测一致率８７．９％，表明革兰氏染色法是一项快速检测胃粘膜Ｈｐ感染的可靠的细菌学指标。     

淋病性尿道炎208例报告

淋病性尿道炎是由革兰氏阴性淋病双球菌引起的泌尿生殖器粘膜感染性疾病.我院自1988年3月至11月共诊治208例,现报告如下.(一)临床资料1.一般情况:本组208例,男性170例(81%),女性38例(19%);已婚125例,未婚83例;年龄最小3岁,最大56岁,     

阴道分泌物快速革兰氏染色检查的诊断价值

目的评价阴道分泌物快速革兰氏染色检查诊断阴道特异性感染的价值和临床意义.方法 2001年1月至2002年12月91250例门诊病人阴道分泌物,行快速革兰氏染色.按临床基础检验学的诊断标准,观察病原微生物的形态进行诊断.重点对阴道特异性感染,如:滴虫感染、念菌感染、加德纳氏菌感染、淋病奈瑟菌感染进行分析总结.结果滴虫2857例(感染率3.20%),念珠菌感染22759例(感染率24.90%),加德纳菌感染3716例(感染率4%)淋菌感染122例(感染率0.13%).结论阴道分泌物快速革兰氏染色检查为对滴虫、念珠菌及加德纳氏菌感染具有肯定的诊断价值,对淋菌的感染可作快速筛选.     

五种性病监测中临床诊断与实验室诊断的比对

目的:了解性病门诊疑似性病的患者病原体感染情况。方法:选取韶关地区2012年1-9月份临床诊断为五种性病(淋病、梅毒、尖锐湿疣、生殖器疱疹、衣原体)2460例患者进行了实验室诊断的比对。结果:临床诊断2460例患者中,淋病未确认率为8.24%;梅毒未确认率为12.97%;尖锐湿疣未确认率为90.30%;生殖器疱疹未确认率为67.92%;衣原体未确认率为3.47%。结论:五种性病(淋病、梅毒、尖锐湿疣、生殖器疱疹、衣原体)中未确认率从高至低为尖锐湿疣、生殖器疱疹、梅毒、淋病、衣原体。     

Validity and cost-effectiveness of the Gonozyme test in the diagnosis of gonorrhea.

Although bacterial culture is considered to provide the most definitive diagnosis of gonorrhea, it has limitations when specimens must be transported long distances. A study was carried out to evaluate the validity and cost-effectiveness of an alternative method of diagnosing gonorrhea, the Gonozyme test, a commercially available enzyme immunoassay. Urogenital specimens from 100 men and 100 women with symptoms suggestive of or a history of exposure to gonorrhea were tested for the presence of Neisseria gonorrhoeae by means of bacterial culture and for gonococcal antigen with the Gonozyme test. The specimens from the men were also examined by means of microscopy of Gram-stained smears. The sensitivity and specificity of the Gonozyme test with reference to culture results were 95.6% and 97.4% respectively in the men and 84.2% and 98.7% in the women. The predictive value of a positive result was 91.6% in the men and 94.1% in the women, and the predictive value of a negative result 98.6% in the men and 96.3% in the women. The cost-effectiveness of the Gonozyme test was higher than that of bacterial culture in this population, which had a high prevalence rate of gonorrhea (23% in the men and 19% in the women). The Gonozyme test would be an adequate alternative to culture for the diagnosis of gonorrhea and contact tracing in areas far from diagnostic laboratories.     

Accuracy of Gram's stain in identifying pneumococci in sputum.

We prospectively examined the accuracy of Gram-stained sputum for identifying pneumococci in 42 patients with community-acquired pneumonia. We considered the Gram's stain positive if a preponderant flora or more than ten Gram-positive lancet-shaped diplococci were seen per oil immersion (x1,000) field. These criteria were met in 18 (62%) of 29 specimens that actually contained pneumococci as determined by a positive quellung reaction, or culture on plates or in mice. The Gram's stain was negative in 11 of 13 specimens that did not contain pneumococci. Of the 20 specimens yielding positive Gram's stains, 18 contained pneumococci. A positive Gram-stained smear of sputum strongly suggests the presence of pneumococci, but will miss 38% of specimens containing pneumococci. Deviation from these criteria substantially reduces the overall accuracy of the test.     

Microbiological aspects of peritonitis in patients undergoing chronic peritoneal dialysis at the dialysis unit of Sri Jayawardenapura General Hospital.

BACKGROUND: Peritoneal dialysis (PD) is an established form of therapy in the management of end stage renal disease. Peritonitis is the main complication of PD. OBJECTIVES: To study the incidence and microbial aetiology of peritonitis in patients undergoing chronic PD at the dialysis unit of Sri Jayewardenapura General Hospital (SJGH); to assess the diagnostic value of the Gram's stain; and to study the relationship of the total white cell count of effluent to peritonitis. DESIGN: A prospective study over three months. SETTING: Dialysis unit of SJGH. PATIENT POPULATION: The study involved 18 patients undergoing manual intermittent peritoneal dialysis (IPD), 4 patients undergoing chronic ambulatory peritoneal dialysis (CAPD), and 1 patient undergoing nocturnal intermittent peritoneal dialysis (NIPD). MEASUREMENTS: Clinical presentation of patients with peritonitis; total and differential white blood cell counts of effluent samples; Gram stain and culture of the centrifuged deposit to determine microbial aetiology; incidence of peritonitis in different categories of dialysis. RESULTS: 32 samples were examined from patients on IPD, and 17 from patients on CAPD. In IPD most episodes were due to Gram negative organisms whereas in CAPD most episodes were due to Gram positive organisms. Sensitivity of Gram's stain in relation to culture was 32.4%. 98% of effluent samples had white blood cell counts of > 100/ml and none showed neutrophil counts of < 49%. CONCLUSIONS: The incidence of IPD associated peritonitis was 11.1 episodes per patient year, and the incidence of CAPD associated peritonitis was 14 episodes per patient year. Flavobacterium spp. were the predominant organisms in IPD associated peritonitis, whereas CAPD associated peritonitis was commonly caused by coagulase negative staphylococci. Gram's stain was not useful in the initial identification of the causative agent, but the white cell and neutrophil counts were found to be sensitive indicators of peritonitis.     

阴道分泌物中加德那菌检测的价值探讨

目的:了解海口地区细菌性阴道病的发生情况,探讨细菌性阴道病中加德那细菌感染,以及滴虫、霉菌、淋菌感染的分布。方法:对５８３例妇科门诊患者采用阴道涂片超高倍显微诊断系统湿片法和革兰氏染色检测线索细胞,同时观察阴道液的性状,测ｐＨ值及氨试验。结果:单纯霉菌感染８４例,占 １４．４%;滴虫感染４例,占 ０．７%;淋菌感染２例,占０．３%;非淋菌、霉菌、滴虫感染病例中检出线索细胞１０２例,占１７．５%。结论:海口地区细菌性阴道炎大多由加德那细菌感染所致。     

Role of potassium hydroxide mount in rapid diagnosis of fungal corneal ulcers

The aim of the study was to establish the importance of KOH mount in rapid diagnosis of fungal corneal ulcers. Corneal scrapings were collected from 50 patients with corneal ulcers where clinical features suggested fungal aetiology and ulcers showed no signs of healing on initial treatment. Corneal scrapings were subjected to wet mount with 10% KOH, Gram's stain, and culture on SDA media. Wet mount showed fungal elements in 34 cases (68%) and were classified according to morphology. Gram's stain of corneal scrapings did not provide much help. Fungal culture was positive in 9 (26.4%) out of 34 cases. Specific antifungal treatment was instituted in all cases that showed positive wet mount without waiting for culture reports and on follow-up all these 34 patients showed improvement. Thus wet mount with 10% KOH can be relied upon as the singlemost important screening tool for rapid diagnosis of fungal corneal ulcer and treatment should be dispensed on its basis.     

幽门弯曲菌培养特性探讨

本文用多种培养基分别加入血清、脱纤维血、维生素、葡萄糖、活性炭和淀粉分离培养幽门弯曲菌,并与直接镜检、脲酶试验比较。该菌在心脑血琼脂平板上生长良好,在血清琼脂、普通血琼脂、空弯血琼脂上几乎不生长。加入活性炭和淀粉能提高检出率。加入维生素K_1和葡萄糖能显著提高检出率,菌落明显增多,与直接镜检基本一致     

Unrecognized high prevalence of Chlamydia trachomatis cervical infection in an isolated Alaskan Eskimo population

Chlamydia trachomatis genital infections often go unrecognized where specific culture diagnosis is not easily accessible. We studied the prevalence and clinical correlates of C trachomatis in a geographically isolated Alaskan Eskimo population with a high rate of gonorrhea but for whom specific chlamydial diagnosis had never been available. Using a direct immunofluorescent stain of endocervical secretions, we screened 493 women (52% of all women of reproductive age) when they presented to regional health facilities during the year-long study period. Chlamydia trachomatis was identified in 23% (114/493), including 39% (31/80) of teenagers, 30% (34/115) of prenatal patients, 47% (7/15) of pregnant teens, and 40% (8/19) of women with pelvic inflammatory disease. Genital symptoms, clinical signs, and the presence of concomitant gonorrhea were ineffective means of identifying chlamydial infection. This study demonstrates the successful use, and public health importance, of nonculture direct testing to document the unrecognized high prevalence of C trachomatis infection where culture diagnosis is not available.     

聚合酶链反应技术快速诊断淋病

作者采用聚合酶链式反应（ＰＣＲ）诊断女性淋病５０例，并将ＰＣＲ与淋菌分离培养比较，结果５０例宫颈分泌物ＰＣＲ检测获得阳性３５例，其中２０例与常规分离培养法一致，另外１５例ＰＣＲ阳性而分离培养为阴性，此１５例临床诊断为淋病，在检测中未见培养阳性而ＰＣＲ检测阴性者，用ＰＣＲ全部实验过程可在５ｈ内完成，较目前分离培养法鉴定淋球菌在时间上明显缩短，所以作者认为ＰＣＲ检测淋菌优于淋菌分离培养，具有简便快速、     

四腔心切面联合头侧偏斜法诊断胎儿心脏畸形的价值分析

目的：：探讨四腔心切面联合头侧偏斜法诊断胎儿心脏畸形的临床价值。方法：19664例孕妇随机均分为A组和B组,A组孕妇使用四腔心切面联合头侧偏斜法筛查,B组孕妇使用四腔心切面法筛查,并与产后或引产后的检查结果或尸检结果进行对比分析,计算两组胎儿心脏畸形的漏诊率。结果：两组均无误诊情况。A组漏诊11例、漏诊率为10.78%,B组漏诊28例、漏诊率为27.72%,B组的漏诊率明显高于A组（P＜0.05）。结论：四腔心切面联合头侧偏斜法筛查胎儿心脏畸形具有较高的敏感性,且操作简单、无创、费用低,具有较高的临床应用价值。     

应用快速尿素酶试验诊断幽门弯曲菌感染(附151例胃镜分析)

根据幽门弯曲菌(CP)产生尿素酶的原理,对151例胃镜受检者的胃窦部粘膜用快速尿素酶试验(RUT)进行CP 检查,检出率为58.28%,其中十二指肠溃疡的检出率最高,胃癌的检出率最低,并与直接涂片 Gram 染色及改良Giemsa 染色检查做对照,经统计学检验证明 RUT 是一种可靠的检测方法。