25 KB99 KB22 KB192920262002Šorli, JurijTomič, Viktorijaštevilka:2letnik:71str. 83-86ISSN:1318-0347COBISSID:14507225URN:URN:NBN:SI:doc-P50QLEUVslSlovensko zdravniško društvoZdravniški vestnikAspiracijaAspirationbacteriabakterijeDiagnosisdiagnostikadihalaDihala, infekcijeGram pozitivne bakterijeGram-positive bacteriainfekcijeIsolation and purificationMicrobiologymikrobiologijaRespiratory tract infectionsSapnikSputumTracheaDiagnostična vrednost razmaza sputuma in endotrahealnega aspirata, obarvanega po Gramu| Diagnostic value of sputum and endotracheal aspirate Gram stain|Background. For decades the microscopic examination of sample Gram stain has been one of the basic diagnostic procedures in the microbiology laboratory. Still opinions about usefulness of sputum and endotracheal aspirate Gram stains in initial management of patients with lower respiratory tract infections differ. We were interested in the value of sputum and endotracheal aspirate Gram stain in a nonselected group of patients. Material and methods. During 7 months period we examined 1739 sputum samples and 88 endotracheal aspirates. The samples were evaluated for quality by determining the amount ofsquamous cells and leukocytes. We compared the Gram stain examination to culture results. Results. Due to poor quality we rejected 48% of sputum samples. The sensitivity of Gram stain for Streptococcus pneumoniae, Haemophilus sp. and Moraxella catarrhalis was 61%, 74% and 73% respectively. Predominance of one typical bacterial morphotype (eg. Gram positive lancet-shaped diplococci) correlated perfectly with culture. Conclusions. Examination of sputum and endotracheal aspirate Gram stain is useful procedurein patient management and in bacteriological culture evaluationIzhodišča. Čeprav je mikroskopski pregled obarvanih razmazov kužnin v mikrobioloških laboratorijih že desetletja eden osnovnih diagnostičnih testov,so mnenja o uporabnosti razmaza respiratornih kužnin pri začetni obravnavi bolnikov z okužbami spodnjih dihal še vedno deljena. Zanimala nas jepovednost mikroskopskega pregleda sputuma in endotrahealnega aspirata pri neselekcionirani skupini bolnikov. Material in metode. V sedemmesečnem obdobjusmo pregledali 1739 sputumov in 88 aspiratov traheje. Vsem kužninam smodoločili ustreznost za nadaljno kultivacijo glede na vsebnost celic ploščatega epitela in polimorfonuklearnih levkocitov. Izvide mikroskopskega pregleda razmazov, obarvanih po Gramu, smo primerjali s kulturo kučnin. Rezultati. Zaradi neustreznosti smo zavrnili 48% sputumov. Ugotovili smo, da je občutljivost razmaza za Streptococcus pneumoniae 61%, za Haemophilus sp. 74% in za Moraxello catarrhalis 73%. Kadar so v razmazu prevladovale tipične oblike bakterij (npr. po Gramu pozitivni lancetni diplokoki), sta se kultura in izvid razmaza vedno ujemala. Zaključki. Mikroskopski pregled razmaza sputuma in endotrahealnega aspirata, obarvanih po Gramu, je uporabna in potrebna preiskavaTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo