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1、临床常见病原体检测Examinationofclinicalcommonpathogens呼吸内科熊维宁DepartmentofRespiratoryMedicineXiong,Weining1目的Objective确定感染的发生和性质，及早明确诊断；Determinetheoccuringandnatureofinfection,andmakediagnosisearly;尽早选择适当的治疗方案；Selecttheappropriatetreatmentassoonaspossible;采取有效的预防措施，防止感染可能广泛传播所造成的危害。Takeeffectivepreventionmea
2、surestopreventinfectiontocausewidespreaddamage.2基本程序BasicProcedures正确采集和运送标本；Correctcollectionandtransportationofspecimens初步诊断：直接镜检，免疫学和分子生物学检测；Initialdiagnosis:directmicroscopy,immunologyandmolecularbiologyexamination;确定诊断：病原体的分离、鉴定及药敏实验，报告结果；Determineddiagnosis:pathogenisolation,identificationands
3、ensitivitytest,reportingresults;合理用药Appropriatedruguse3第一节SectionOne标本的采集运送、实验室评价和检查方法Transportationandcollectionofspecimen,laboratoryevaluationandexaminationmethods4一、标本采集和运送One.CollectionandtransportationofSpecimen5基本原则Basicprinciples根据病史与临床表现确定标本采集的时间、部位、种类和数量，尽量采集病变明显部位标本；Accordingtohistoryandcl
4、inicalmanifestationstodeterminethecollectiontime,location,typeandquantityofspecimens,collectspecimensatsignificantpartsoflesions;无菌操作，防止污染；Useaseptictechniquetopreventcontamination;采取适宜的方式进行储存，尽快送检；Appropriatewaytostore,assoonaspossibleforexamination;要视所有标本为传染品，高度危险性的标本要有明显标识，急症或危重患者标本要特别注明。Toviewal
5、lthespecimensforinfectious,highriskspecimensshouldbeclearlymarked,acuteorcriticallyillpatientspecimensshouldbespecified.6（一）血液(One)Blood适应症：疑为菌血症、败血症或脓毒血症的病人；Indications:suspectedbacteremia,sepsisorsepsispatients;一般在抗生素使用前，于发热初期或高峰期采血；已用过抗菌药物治疗者，在下次用药前采集；Ingeneral,priortouseofantibiotics,intheearlyo
6、rpeakheat,tocollectblood;ifantibiotictreatmenthasbeenused,collectbloodbeforethenextadministration;以无菌法由肘静脉穿刺，一般成人采血量每次10~20ml，婴儿和儿童1-5ml，在床边接种；Puncturecubitalveinbyasterilemethod,ingeneral,10~20mlbloodpertimeforadult,1-5mlforinfantsandchildren,andinoculateatthebedside;注明抗生素使用情况，选择合适类型的培养瓶；Indicateth
7、euseofantibiotics,selecttheappropriatetypeofcultureflask;24小时内在不同部位采血3次可提高阳性率。Collectingbloodatdifferentparts3timeswithin24hourscanincreasethepositiverate.7血液标本的采集方法Collectionmethodofbloodsamples8（二）尿
