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临床实验室真菌学检查方法的研究——标本预处理与分离

[Study of mycological examination methods in clinical laboratories--specimen pretreatment and isolation].

作者信息

Abe Michiko, Ogawa Zensuke, Tanuma Hiroyuki, Kume Hikaru

机构信息

Dept. of Hygienic Technology, School of Allied Health Sciences, Kitasato University.

出版信息

Nihon Ishinkin Gakkai Zasshi. 2009;50(4):235-42. doi: 10.3314/jjmm.50.235.

Abstract

We performed a comparative study of the effects of centrifugation, large amounts of inoculum and incubation temperature with regard to recovery of Candida albicans, Cryptococcus neoformans and Aspergillus fumigatus from fungal suspensions in order to identify optimal processing methods for mycological examination of clinical specimens. The number of fungal colonies, except for Candida spp., isolated from respiratory specimens, and the duration of incubation needed to isolate pathogenic fungi from clinical specimens were also analyzed retrospectively. There was a difference in the number of recovered colonies, with or without centrifugation, between inoculum sizes of 10 microl and 50 microl, but no differences were observed in the results obtained under two sets of centrifugation conditions: 2,000 x g for 15 minutes and 3,000 x g for 20 minutes. Candida albicans and Aspergillus fumigatus developed more rapidly at 35 degrees C than at 27 degrees C in the first 24 hours of incubation, while Cryptococcus neoformans formed a larger colony at 27 degrees C than at 35 degrees C. One to three colonies of Aspergillus spp. and Cryptococcus spp. were isolated from respiratory specimens in 73% and 50% of cases, respectively. The required incubation period was six days for isolation of 65 Aspergillus spp. strains from respiratory specimens, while 14 days was needed for isolation of 46 dermatophyte strains. Based on these results, we recommend a pretreatment of centrifugation and a large quantity of inoculum for respiratory specimen processing, as well as an incubation period of at least 7 days and 21 days for internal and dermatological specimens, respectively.

摘要

我们进行了一项比较研究,探讨离心、大量接种物和培养温度对从真菌悬液中回收白色念珠菌、新型隐球菌和烟曲霉的影响,以确定临床标本真菌学检查的最佳处理方法。还回顾性分析了从呼吸道标本中分离出的除念珠菌属外的真菌菌落数量,以及从临床标本中分离出致病真菌所需的培养时间。接种量为10微升和50微升时,无论有无离心,回收菌落数量存在差异,但在两组离心条件下(2000×g离心15分钟和3000×g离心20分钟)获得的结果未观察到差异。在培养的前24小时内,白色念珠菌和烟曲霉在35℃比在27℃生长得更快,而新型隐球菌在27℃形成的菌落比在35℃时更大。分别有73%和50%的病例从呼吸道标本中分离出1至3个曲霉菌属和隐球菌属菌落。从呼吸道标本中分离出65株曲霉菌属菌株需要6天的培养时间,而分离出46株皮肤癣菌菌株需要14天。基于这些结果,我们建议对呼吸道标本处理进行离心和大量接种物的预处理,对于内部标本和皮肤病标本,培养时间分别至少为7天和21天。

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