【正文】 ? 病原體抗體檢測(cè)。 ? Antibody detection of pathogens ? 難培養(yǎng)或培養(yǎng)要求高的細(xì)菌：綜合運(yùn)用免疫學(xué)或分子生物學(xué)檢測(cè)，如結(jié)核分枝桿菌感染以及幽門螺桿菌感染等。 ? Difficult for high culture or bacterial culture: the integrated use of immunology or molecular biology, such as Mycobacterium tuberculosis and Helicobacter pylori infection. ? 細(xì)菌培養(yǎng)是最重要的確診方法。 ? Bacterial culture is the most important diagnostic method. 64 （二）實(shí)驗(yàn)結(jié)果分析和臨床應(yīng)用Analysis and clinical application of experimental results ? 顯微鏡檢查或分離培養(yǎng)的陰性結(jié)果不能完全排除感染； ? Microscopy or isolation and culture of negative results can not be pletely ruled out infection ? 共同抗原引起的交叉反應(yīng)； ? Antigenic crossreactivity caused by the mon ? 核酸檢測(cè)的假陽性； ? Falsepositive nucleic acid detection ? 血清學(xué)的動(dòng)態(tài)檢測(cè)。 ? Dynamic detection of serological 65 第六節(jié) 醫(yī)院感染常見病原體檢測(cè)Detection of mon pathogens of nosoial infection 66 ? 醫(yī)院感染（ nosoial infection）：又稱醫(yī)院獲得性感染（ hospital acquired infection），指患者在入院時(shí)不存在，也不處于潛伏期，而在醫(yī)院內(nèi)發(fā)生的感染，包括醫(yī)院內(nèi)獲得的而在出院后發(fā)病的感染。廣義的醫(yī)院感染對(duì)象不僅指住院患者，還包括門診病人、醫(yī)院職工、探視人員與陪護(hù)人員等。 ? Nosoial infection (nosoial infection): also known as hospitalacquired infection (hospital acquired infection), that does not exist on admission of patients, nor in the incubation period, while in the hospital infections occurred, including the hospital after discharge from hospital acquired disease in Infection. Generalized infection, not only by means of hospital inpatients, including outpatient, hospital staff, visiting officers and escort personnel. 67 一、流行病學(xué)和臨床類型Epidemiology and clinical types 68 （一）流行病學(xué)Epidemiology 69 1. 病原學(xué) Pathogen ? 細(xì)菌是最常見的病原體。 ? Bacterial is the most mon pathogens. ? 變化趨勢(shì)：革蘭氏陰性桿菌比例在增加，革蘭氏陽性球菌比例在減少。 ? Trend: increasing the proportion of Gramnegative bacteria, Grampositive cocci ratio decreased. ? 罕見細(xì)菌變成流行株：陰溝腸桿菌、洋蔥假單孢菌，軍團(tuán)菌等 ? Strains of bacteria bee rare: Enterobacter cloacae, Pseudomonas onion, Army monocytogenes ? 其它：病毒、真菌等 ? Other: viruses, fungi, etc 70 2. 感染源 Source of infection ? 住院病人、醫(yī)院職工、探視人員、陪伴人員； ? Patients, hospital staff, visiting staff, his panion。 ? 醫(yī)院環(huán)境、未徹底消毒的醫(yī)療器械、血液制品等。 ? Hospital environment, without thorough disinfection of medical devices, blood products, etc. 71 高危人群 Highrisk groups ? 慢性疾病患者，如腫瘤、糖尿病以及肝硬化患者等 ? Patients with chronic diseases such as cancer, diabetes and liver cirrhosis, etc. ? 免疫抑制劑及激素的使用者 ? Immunosuppressive drugs and hormone users ? 化療及放療患者 ? Chemotherapy and radiotherapy in patients ? 手術(shù)及麻醉患者 ? Surgery and anesthesia in patients ? 使用介入性診斷與治療的患者 ? Use of interventional diagnosis and treatment of patients ? 廣譜抗生素使用者 ? Broadspectrum antibiotic users 72 （二）常見臨床類型 Common clinical types ? 1 下呼吸道感染：最常見 ? Lower respiratory tract infection: the most mon ? 2 尿路感染 ? Urinary Tract Infection ? 3 手術(shù)切口感染：外源性和內(nèi)源性 ? Surgical wound infection: exogenous and endogenous ? 4 胃腸道感染 ? Gastrointestinal infections ? 5 血液感染 ? Blood infection ? 6 皮膚和軟組織感染 ? Skin and soft tissue infections 73 二、檢查項(xiàng)目和臨床應(yīng)用inspection items and clinical applications 74 （一）醫(yī)院感染病原體檢查項(xiàng)目和臨床應(yīng)用 inspection items and clinical applications for Hospital Infection 75 ? 基本原則與病原體感染類似，但更應(yīng)注意正常菌群的污染以及條件致病菌在醫(yī)院感染中的地位。 Similar to the basic principles and pathogen infection, but more should pay attention to the pollution of the normal flora and opportunistic pathogens in the hospital infection status. 76 1. 標(biāo)本采集和送檢基本原則 The basic principles of specimen collection and submission ? 及時(shí)采集標(biāo)本 ? Collect specimens in a timely manner ? 嚴(yán)格無菌操作 ? Strict aseptic ? 立即送出 ? Immediately sent ? 在抗菌藥物使用前 ? Before the use of antibiotics ? 合適的容器 ? Appropriate container ? 注明來源和目的 ? Indicate the source and destination ? 定量或半定量培養(yǎng) ? Quantitative or semiquantitative culture ? 分級(jí)報(bào)告和限時(shí)報(bào)告 ? Reports and limit grading report 77 2. 涂片鏡檢 Smear microscopy ? 痰標(biāo)本 ? Sputum 78 3. 分離培養(yǎng)鑒定法 Isolation and culture identification method ? 尿路感染 ? Urinary Tract Infection ? 手術(shù)切口感染 ? Surgical wound infection ? 大便培養(yǎng) ? Stool culture ? 血培養(yǎng) ? Blood culture 79 （二）醫(yī)院環(huán)境中細(xì)菌污染的監(jiān)測(cè)和消毒滅菌效果的監(jiān)測(cè) Bacterial contamination in the hospital environment monitoring and the monitoring of sterilization results 80 ? 定期對(duì)醫(yī)院環(huán)境進(jìn)行病原體監(jiān)測(cè)：空氣、物體表面、醫(yī)務(wù)人員手部； ? Regular monitoring of pathogens in hospital environment: air, surface, the medical staff of hand。 ? 定期對(duì)醫(yī)療器械的消毒效果進(jìn)行監(jiān)測(cè)：高壓蒸氣、紫外線、化學(xué)消毒劑。 ? Regular disinfection of medical devices to monitor: highpressure steam, UV light, chemical disinfectants. 81 Thanks！