WS/T 499-2017 (WST499-2017)

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WS/T 499-2017
Performance guideline for bacterial culture of lower respiratory tract infections
ICS 11.020
C 50
People's Republic of China Health Industry Standard
Guidelines for bacterial culture of lower respiratory tract infections
2017-01-15 release
2017-07-01 Implementation
Published by the National Health and Family Planning Commission of the People's Republic of China
1 Scope
This standard specifies guidelines for routine bacterial culture of lower respiratory tract infections.
The wood standard applies to microbiological laboratories in medical institutions.
2 Normative references
The following documents are essential for the application of this document. For dated references, only the dated version applies to this document.
For undated references, the latest version (including all amendments) applies to this document.
WS/T 503 Code of Practice for Blood Culture in Clinical Microbiology Laboratory
3 terms and definitions
Column F terms and definitions apply to this document
3.1
Curschmann's spiral fibers
Kushman spiral fibers are spiral, which are mucus secreted by the small bronchus during chronic inflammation. Due to dyspnea and increased carbon dioxide tension in the lungs
High and condensed, and at the same time rolling and rolling due to intermittent blows of breathing gas. Caterpillars can be seen under the microscope after Gram staining
It is curled, blue-stained on the axis, and the edges are pale red.
3.2
Charcot-Leyden Crystal
Visible in the bronchi, rhombic or needle-like hexagonal colorless transparent crystals, which are sharp at both ends, vary in size, are highly refractive, and are composed of eosinophils.
After cell rupture, eosinophilic particles are fused with each other and can be stained with iodine. Heap of eosinophils can be found in slightly placed sputum. On the smoke
It is common in sputum from asthmatic patients with allergic bacteria or from patients with pulmonary infection with parasites.
3.3
Ciliated columnar epithelium cell
It is mainly distributed on the inner surface of the lower respiratory tract. On the free surface of columnar cells, there are cilia that can swing and are goblet cells that can secrete mucus.
The secreted mucus can stick and remove foreign matter such as dust and bacteria. With the rhythmic swing of the cilia, the mucus containing dust and bacteria can be eliminated.
To the throat.
3.4
Pulmonary macrophages
It is differentiated from monocytes and widely distributed in the interstitial lung. It is more around the tubes below the respiratory bronchioles and in the alveolar septum.
Alveolar giant thallium cells that swim into the alveolar cavity are called alveolar giant thallium cells. Lung macrophages are very active in phagocytosis, immunity and secretion.
Important defense functions. Inhaled dust particles, bacteria and other siblings enter the alveoli and interstitial lungs, and are mostly swallowed and cleared by macrophages, and some are removed from the lungs.
The cavities are coughed out by mucus flow and cilia movement in the respiratory tract.
4 Before analysis
4.1 Specimen collection
4.1.1 Sputum
Suitable for patients with pulmonary infection, especially in intensive care unit (ICU) and hospital-acquired community-acquired pneumonia (CAP), chronic obstructive pulmonary disease
Patients with acute exacerbation of the disease (eight ECOPDs), lung abscess (non-optimal specimens for sputum), patients with pulmonary infection caused by suspected bacterial pathogens (see appendix
A). Before sputum sputum, the patient rinses with sterile saline; instruct the patient to cough up deep sputum, and do not leave saliva and nasopharyngeal secretions.
4.1.2 Tracheal aspirate
Tracheal aspirate specimens can only be collected in patients with tracheal intubation (such as fever or infiltration). Sucking sputum from trachea,
Keep it in a sterile container for inspection.
Note. The trachea colonizes the bacteria 24 hours after intubation. If the tracheal aspirate is not tested when the lung infection is not indicated, the result may not be consistent with the disease.
4.1.3 Blood culture
When a patient with pulmonary infect