Interpretation of clinical microbial test report

First of all, accurate identification of pathogens, reporting the results of drug sensitivity tests, to provide scientific reference for clinical selection of drugs, is our microbial laboratory can not shirk the responsibility, but in the selection and practical application of the drug to understand some of the microbial and pharmacological aspects of knowledge, may play a more effective effect on clinical treatmentEspecially in the culture and identification of sputum and pharynx swabs, due to the presence of a variety of conditions pathogenic bacteria, whether to cause infection, whether to need antibacterial treatment, need clinicians after comprehensive analysis of the judgment, the following points are the following clinical work may encounter problems:1, some clinically commonly used drug sensitivity test sourcingsepsis for broad-spectrum antibacterial drugs, mainly used to treat gram-negative bacteria, such as ecoliCLSI stipulates that its determination of Ecoli bacteria at the point of s15 resistance, s21 sensitive, so we add it to the Ecoli bacteria drug sensitivity spectrum, but because cephalosporine / shubatan on staphylococcus bacteria and other Gram-positive bacteria CLSI did not determine the fold, so it can not be determined that it is sensitive to staphylococcus or resistant, nor should we join staphylococcal drug sensitivity test2, some new drugs are not included in the drug allergyfirst, the new drug has not been included in the CLSI monitoring scope, there is no basis to judgeSecondly, all kinds of antibiotics in the drug allergy spectrum have a certain representative, can not be all-encompassing, such as quinolones class second-generation antibacterial drug ciprofloxacin in the drug sensitivity test sensitive, then for the three generations of hyperspectral antibiotics left oxyfluorosacin, spasa star and other clinicians can choose according to the need3, bacteria of natural resistancesome bacteria or species of natural resistance to certain antimicrobial drugs or inherent resistance, the drug resistance is specific(1) Ccoli: Natural resistance to all penicillin and cephalosporinantibiotics except penicillin and ampicillin(2) Malt-obsessed narrow-eating monocytobacteria: natural resistance to amine perina (Tyn), Meroponan(3) Streptococcus pneumoniae: natural resistance to aminoglycoside antibiotics (4) e coli and e coli: natural resistance to cephalosporine (5) grams of jumandobacteria: natural resistance to fluconazole (6) Creebo pneumonia: naturalresistance to ampicillin (7) Copper-green pseudomonas: natural resistance to ampicillin, amoxicillin, amoxicillin/rodacid, compound novnomy, cephalospora 1 generation, cephalospora 2 generation   more special is that copper-green pseudomonas is sensitive to three generations of cephalosporine and cephalosporine, even if the drug sensitivity test is sensitive, in the actual clinical treatment also needs an extra dose to achieve efficacy, but the human body on the super-large dose of three generations of cephalospora does not have a long-term resistance Copper-green pseudomonas has induced resistance to many drugs, may not show in the early stages, once exposed to a certain antibiotic, sleeping genes are activated, drug resistance is shown, this characteristic is particularly evident in beta-lactam antibiotics, may be sensitive in vitro tests, but not effective in the actual treatment, so the treatment of cephalosporine and cephalospora is to risk, this is the first clinical to avoid fully understand the difference between the efficacy of antimicrobial drugs and in vitro drug sensitivity test and the limitations of drug sensitivity test, is intended to find certain causes and regularity, before the use of broad-spectrum antibacterial drugs, should first collect specimens for testing, and then according to the results of drug sensitivity test and clinical efficacy adjustment feeding program, so that clinical application of antimicrobial drugs tend to be reasonable, reduce the blindness and randomness of drug use, improve the success rate of critically ill patients the rational use of antimicrobial drugs need to consider a variety of factors, is not a drug sensitivity test report can be fully summarized, in which the clinical thinking and clinical operation are very complex, in order to make our antibiotic application more scientific, reasonable and effective, which requires the joint efforts of the microbial laboratory and clinical departments, we will continue to learn, update the knowledge of microbial testing, testing and pharmacology, and strive to provide more valuable reference for clinical departments