BacT/ALERT 3D系统在结核性脑膜炎诊断中的应用

张继萍1，任丽娟2，李永利3，叶迎宾1，黄秀香1，郑立恒4

(1.邯郸市传染病医院肺科，河北邯郸056002；2.邯郸市第一医院呼吸一科，河北邯郸056000；3.曲周县中医院内科，河北邯郸057250；4.河北省胸科医院检验科，河北石家庄050000)

【摘要】目的：评价BacT/ALERT 3D系统在诊断结核性脑膜炎中的应用价值。方法：收集2009年1月～2014年6月间200例结核性脑膜炎患者早期脑脊液标本480份，每份标本分别用离心涂片法、罗氏培养法和BacT/ALERT 3D系统培养法检测，对其结果进行分析，总结3种方法对确诊结核性脑膜炎之间的差异。结果：480份脑脊液标本中，离心涂片法、罗氏培养法、BacT/ALERT 3D系统培养法的结核杆菌阳性检出率分别为3.13%、5.42%、10.63%，BacT/ALERT 3D系统培养法结核杆菌初代分离时间短于罗氏培养法。结论：BacT/ALERT 3D系统有较高的检出率、较快的检出时间，有助于提高结核性脑膜炎的发现率，值得临床推广应用。

【关键词】离心涂片法；罗氏培养法；BacT/ALERT 3D系统

【文献标识码】【中图号】R 529.3A

DOI【】10.3969/j.issn.1002-0217.2015.02.023

Value of BacT/ALERT 3D microbial detection system in rapid diagnosis of tuberculosis meningitisZHANGJiping，RENLijuan，LIYongli，YEYingbin，HUANGXiuxiang，ZHENGLiheng

Department of Pulmonary Diseases，Handan Infectious Disease Hospital,Handan 056002,China

Abstract【】Objective：To evaluate the application value of BacT/ALERT 3D microbial detection system in rapid diagnosis of tuberculosis meningitis.Methods: 480 specimens in cerebrospinsl fluid (CSF) of 200 patients diagnosed with tuberculosis meningitis were collected from January 2009 to June 2014.These specimens were processed for detection of the mycobacterium tuberculosis by centrifugal smear acid-fast stain (Ziehl-Neelsen staining) and Lowenstein-Jensen cultivation,as well as the BacT/ALERT 3D system.The above results were analyzed and compared regarding the positive rates in order to evaluate the value in diagnosing tuberculosis meningitis.Results: The positive rates of the centrifugal smear acid-fast smear,Lowenstein-Jensen cultivation and BacT/ALERT 3D system cultivation were 3.13%,5.42% and 10.63% respectively.Conclusion: BacT/Alert 3D microbial detection system may lead to higher sensitivity and shortened detection time,which is worthy of wider clinical recommendation.

【Key words】 centrifugal smear acid-fast stain;Lowenstein-Jensen cultivation;BacT/ALERT 3D system

结核病是严重危害人类健康的全球性传染性疾病之一，近年来全世界发病率明显上升，结核性脑膜炎(以下简称结脑)是最严重的肺外结核病，病死率30%左右，它是常见的中枢神经系统感染性疾病，由于早期诊断困难，误诊率较高。目前，我国结脑发病率呈上升趋势，快速、准确及阳性率高的的检测方法对于结脑的诊断至关重要[1-2]。结脑的实验室检测方法很多，如何选择一种或几种相对有效的方法对结脑的诊断有着举足轻重的作用。本研究用BacT/ALERT 3D系统培养结脑患者脑脊液标本，并与离心涂片法、罗氏培养法进行比较，以分析BacT/ALERT 3D快速培养系统在结脑诊断中的应用价值，更好地指导临床工作。……