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1、2017 年初级检验技师微生物检验讲义第 6 章微生物检验概述|精.|品.|可.|编.|辑.|学.|习.|资.|料.*|*|*|*|欢.|迎.|下.|载.第 1 页，共 18 页|精.|品.|可.|编.|辑.|学.|习.|资.|料.*|*|*|*|欢.|迎.|下.|载.第 1 页，共 18 页第 2 页 共 18 页微生物检验概述临床微生物检验即诊断微生物学，是在医学微生物学的范畴内，侧重研究感染性疾病快速、准确地检出病原体的策略与方法，为临床诊断提供依据，并指导进一步合理用药和防止感染继续扩散的学科。临床细菌实验室的主要工作是从临床标本中分离出病原菌并进行准确鉴定，同时指导临床合理应用药物，
2、为临床诊断、治疗、预后和流行病学调查以及医院内感染的监控提供可靠的依据。一、临床微生物检验的目的和要求（一）临床微生物检验的目的1.为临床感染性疾病的诊断提供病原学依据。2.为临床感染性疾病的治疗提供参考用药的信息。3.为医院感染提供病原微生物及其耐药性动态信息。4.改进或更新临床微生物检验的方法。（二）临床微生物学检验的要求|精.|品.|可.|编.|辑.|学.|习.|资.|料.*|*|*|*|欢.|迎.|下.|载.第 2 页，共 18 页|精.|品.|可.|编.|辑.|学.|习.|资.|料.*|*|*|*|欢.|迎.|下.|载.第 2 页，共 18 页文档编码:CZ4Q10M9W3Y5 HY
3、10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M
4、9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码
5、:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10
6、G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10
7、ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7
8、T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y
9、5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2第 3 页 共
10、18 页1.快速、准确地提出检验报告。2.检验人员必须有较丰富的微生物学基础知识和熟练、正确的操作技能，必须养成有菌观点和无菌操作的习惯。3.临床微生物检验必须进行全面质量控制，并参加和接受质量控制考核。4.重视实验室消毒灭菌工作。（三）诊断试验的选择原则1.选择有鉴定价值的试验要对两种细菌进行鉴定，须选择一项两种菌呈现截然不同结果的试验，即一种菌呈现阳性（阳性反应的菌株阳性率须大于90%），另一种菌为阴性（阴性反应的菌株阳性率应小于10%），这项试验才有鉴定价值。否则，就没有鉴定价值。2.选择简易、快速、方便的试验（1）鉴定一种细菌可能有多种特异的方法，只选择其中一或两种达到目的即可，多选无
11、意义。如金黄色葡萄球菌只选较简单的凝固酶试验就足够了。（2）选择操作简便、快速的方法。（3）选用复合培养基，一次操作可同时看几个生化反应，如克氏双糖铁（KIA），动力靛基质脲酶（MIU）|精.|品.|可.|编.|辑.|学.|习.|资.|料.*|*|*|*|欢.|迎.|下.|载.第 3 页，共 18 页|精.|品.|可.|编.|辑.|学.|习.|资.|料.*|*|*|*|欢.|迎.|下.|载.第 3 页，共 18 页文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编
12、码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F1
13、0G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10
14、 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A
15、7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3
16、Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ
17、4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P
18、2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2第 4 页 共 18 页等。3.综合考虑试验的敏感性和特异性敏感性=所有阳性结果数所有感染病人数，试验敏感性越高，假阴性结果就越少。特异性=阴性结果总数未感染
19、病人数，特异性越高，假阳性结果越少。试验的敏感性和特异性是相互联系的，试验的敏感性增加，会使特异性下降，反之亦然。二、标本的采集和运送对感染性疾病进行病原检查和鉴定，须通过采集患者的标本，经系列实验，才能获得明确的病原学诊断。标本质量直接影响诊断结果，不当的标本可导致假阴性、假阳性结果的出现，因此，在标本采集、送检、保存等各个环节都要规范操作，严格控制，是确保实验结果准确可靠的前提。（一）标本采集的一般原则1.早期采集最好是病程早期、急性期或症状典型时，而且必须在使用抗生素或其他抗菌药物之前采集。2.无菌采集采集的标本应无外源性污染。在采集血液、脑脊液、|精.|品.|可.|编.|辑.|学.|习
20、.|资.|料.*|*|*|*|欢.|迎.|下.|载.第 4 页，共 18 页|精.|品.|可.|编.|辑.|学.|习.|资.|料.*|*|*|*|欢.|迎.|下.|载.第 4 页，共 18 页文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9
21、G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY
22、10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M
23、9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码
24、:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10
25、G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10
26、ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7
27、T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2第 5 页 共 18 页胸腔积液、关节液等无菌标本时，应严格进行无菌操作；对于与外界相通的腔道，如窦道标本应由窦道底部取标本，采集的标本均应盛于无菌容器内。3.根据目的菌的特性厌氧菌、需氧或兼性厌氧菌，以及L 型菌采用的方法不同。4.采集适量标本采集量不应过少，而且要有代表性，同时有些标本还要注意在不同时间采集不同部位标本。5.安全采集采集标本时不仅要防止皮肤和黏膜正常菌群对标本的
28、污染，同时也要注意安全，防止传播和自身感染。（二）标本的处理一些对环境敏感的细菌如脑膜炎奈瑟菌、淋病奈瑟菌和流感嗜血杆菌等应保温并立即送检，而其他所有的标本采集后最好在 2h之内送到实验室。若不能及时送检，标本应置于一定环境中保存。一般情况下，用于细菌培养的标本保存时间不应超过24h。厌氧性标本应放在专门的运送瓶或试管内运送，有时可直接用抽取标本的注射器运送。病人标本中可能含有大量致病菌，不管标本运送距|精.|品.|可.|编.|辑.|学.|习.|资.|料.*|*|*|*|欢.|迎.|下.|载.第 5 页，共 18 页|精.|品.|可.|编.|辑.|学.|习.|资.|料.*|*|*|*|欢.|迎
29、.|下.|载.第 5 页，共 18 页文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5
30、 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q
31、10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文
32、档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9
33、F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G
34、10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY1
35、0A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9
36、W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2第 6 页 共 18 页离远近，都必须注意安全防护。标本切勿污染容器的瓶口和外壁，容器必须包装好，防止送检过程中倒翻或碰破流出。对于烈性传染病标本运送时更要特别严格，必须按规定包装，由专人运送。三、微生物检验临床微生物学实验室接到标本后应立即进行微生物检验。主要包括直接镜检、检测特异性抗原或病原体成分、进行分离培养和鉴定、体外药敏试验等，各种检查方法的比较见表5-9-1。表 5-9-1 微生物检查方法、判断和速度方法鉴定类型速度直接镜检初步诊断510min 免疫荧光（直接法）快速诊断12h 乳胶凝集快速诊断1530min 对流免疫电
37、泳快速诊断2h 气-液相色谱鉴定1.5 2h PCR 快速诊断数小时DNA 探针诊断、鉴定13 天微量鉴定系统鉴定36h 常规法确定诊断数天或以上|精.|品.|可.|编.|辑.|学.|习.|资.|料.*|*|*|*|欢.|迎.|下.|载.第 6 页，共 18 页|精.|品.|可.|编.|辑.|学.|习.|资.|料.*|*|*|*|欢.|迎.|下.|载.第 6 页，共 18 页文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A
38、7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3
39、Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ
40、4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P
41、2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1
42、H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F
43、9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 H
44、Y10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2第 7 页 共 18 页（一）直接镜检标本经涂片、染色、镜检，有些标本如尿液、脑脊液等经过离心浓缩后镜检，其初步结果对疾病诊断有参考价值。直接镜检对于确定进一步检出步骤及鉴定方法也很有帮助。另外，直
45、接镜检还可评价标本是否符合检验要求。（二）快速诊断快速检测病原体成分主要是指特异性抗原和核酸检测。特异性抗原检测包括免疫荧光技术、胶乳凝集试验、酶免疫技术、对流免疫电泳、化学发光测定等。核酸检测包括核酸杂交、PCR 技术。其他快速检测法还有气一液相色谱法、化学发光、生物发光测定法和基因或蛋白芯片技术等。（三）直接药敏试验直接药敏试验即在分离培养病原体的同时，直接将临床标本接种于平板，用抗生素纸片作药物敏感性试验，在 1824h 内可获得结果。但因其在试验时接种量难以标准化，且对混有杂菌和混合感染的标本不易明确其结果，故分离出纯培养物后应再作体外药物敏感试验。|精.|品.|可.|编.|辑.|学.
46、|习.|资.|料.*|*|*|*|欢.|迎.|下.|载.第 7 页，共 18 页|精.|品.|可.|编.|辑.|学.|习.|资.|料.*|*|*|*|欢.|迎.|下.|载.第 7 页，共 18 页文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3
47、F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5
48、HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q1
49、0M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档
50、编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F10G6P2文档编码:CZ4Q10M9W3Y5 HY10A7T3F9G10 ZE1H9F