Heineman H S, Radano R R
J Clin Microbiol. 1979 Oct;10(4):567-73. doi: 10.1128/jcm.10.4.567-573.1979.
Our experience in introducing selective sputum microbiology into a clinical laboratory was recorded prospectively and analyzed. Based on low-power microscopy with determination of ratios of polymorphonuclear to squamous cells, 32% of specimens were discarded as unfit for culture. Speedy processing and prompt telephone calls afforded opportunities to replace these with better specimens, but only 29% of rejected specimens were resubmitted. Interpretive readings of smears for microorganisms yielded meaningful yielded meaningful information to clinicians and correctly predicted culture results in 73.8% of acceptable specimens. Technological time was similar to that required to process the same number of specimens in the usual way, but rejection of unsatisfactory specimens led to a 22% saving in supplies. Clinicians readily accepted the new system. Where nurses are responsible for specimen collection, they must be informed of the rationale for selective culture and the unreliability of gross visual inspection in evaluating sputum.
我们前瞻性地记录并分析了将选择性痰微生物学引入临床实验室的经验。基于低倍显微镜检查确定多形核细胞与鳞状细胞的比例，32%的标本因不适合培养而被丢弃。快速处理和及时电话沟通为用更好的标本替换这些标本提供了机会，但只有29%被拒收的标本被重新提交。对涂片进行微生物的解释性读数为临床医生提供了有意义的信息，并在73.8%的可接受标本中正确预测了培养结果。技术操作时间与以常规方式处理相同数量标本所需的时间相似，但拒收不合格标本节省了22%的耗材。临床医生欣然接受了新系统。在护士负责标本采集的地方，必须告知他们选择性培养的基本原理以及肉眼粗略检查评估痰液的不可靠性。
