TSLM-GP-B01 1 痰液檢體培養作業指引 - …

1 TSLM-GP-B01 (1) Taiwan Society of Laboratory Medicine 2015 7 1 TSLM-GP-B01 (1) 22061 239 6 TEL : 886-2-896785031 FAX : 886-2-89670031 E-mail : Copyright Taiwan Society of Laboratory Medicine. All Right Reserved. TSLM-GP-B01 (1) 1 5 acute bronchitis community acquired pneumonia hospital acquired pneumonia

2 1. 2. 3. standard precaution low-power field, LPF 100 pure growth of a primary pathogen TSLM-GP-B01 (1) 2 5 4.

3 2 2-8 C 24 2 Streptococcus pneumonia, Haemophilus influenzae 48 standard precaution purulent blood-tinged gram-negative pleomorphic coccobacilli 1982 Wong

4 Neutropenia immunocompromised Bartlett 1974 mucus ( ) 1 Neutrophils LPF Grade < 10 0 10-25 +1 > 25 +2 Mucus +1 Epithelial cells LPF 10-25 -1 > 25 -2 TSLM-GP-B01 (1) 3 5 Murray Washington 1975 Epithelial cells LPF Neutrophils LPF Group 1 > 25 < 10 Group 2 > 25 10-25 Group 3 > 25 > 25 Group 4 10-25 > 25 Group 5 < 10 > 25 Group 4 5 5% sheep blood agar, MacConkey agar EMB , Chocolate agar, 35-37 C 24 48 Legionella spp.

5 Bordetella pertussis few 1+ >10 colonies <5 moderate 2+ >5 colonies <5 heavy 3+ 4+ 1 2 PMN 3 pure growth of a primary pathogen PMN ( ) viridans group streptococci, commensal Neisseria spp., diphtheroids, CoNS, Rothia, group F streptococci, anaerobes, Haemophilus spp. ( not H. influenzae), entercocci, Candida spp., Eikenella, Actinobacillus, Capnocytophaga, and Moxaxella.

6 ( ) 1. Streptococcus pyogenes 2. Brucella spp. 3. Francisella tularensis 4. Yersinia pestis 5. Bacillus anthracis TSLM-GP-B01 (1) 4 5 6. Rhodococcus equi 7. Streptomyces 8. Nocardia 9. Cryptococcus neoformans 10. non saprophytic molds ( ) 1. Streptococcus pneumoniae 2. Staphylococcus aureus 3. Moraxella catarrhalis 4. Haemophilas influenzae 5. Neisseria meningitides 6.

7 Group B, C, and G streptococci 7. Pasteurella spp. 8. One or two types Enterobacteriaceae 9. Bordetella bronchiseptica 10. Stenotrophomonas maltophilia 11. Acinetobacter 12. Pseudomonas aeruginosa 13. Burkholderia cepacia 14. Other aerobic gram-negative bacilli 15. Urea (+) Corynebacterium ( ) 1. 2. 1-9/LPF 25/LPF PMN comment A. Normal mix flora B.

8 Mixed flora saliva contamination specimen TSLM-GP-B01 (1) 5 5 6. Gram Stain. In: Isenberg , ed. Clinical Microbiology Procedures Handbook. 3rd ed. Washington, DC: ASM Press; 2010 Lower Respiratory Tract Cultures. In: Isenberg , ed. Clinical Microbiology Procedures Handbook. 3rd ed. Washington, DC: ASM Press; 2010 Sharp SE, et al. 2004. Cumitech 7B, Lower Respiratory Tract Infections.

9 Coordinating ed., S. E. Sharp. ASM Press, Washington.