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分枝杆菌分离培养、药敏试验 及菌种鉴定方法标准化 PowerPoint PPT Presentation


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分枝杆菌分离培养、药敏试验 及菌种鉴定方法标准化. 河南 CDC 结核病预防控制所 赵玉玲 2006年4月. 耐药菌株尤其是耐多药菌株的不断扩散,正日益成为我国结核病控制的一大难题,若耐药结核菌的播散和流行得不到有效遏止,将会出现较多慢性传染源,从而导致结核病治疗、管理的难度进一步加大,对国家结核病防治规划的有效实施将构成威胁。因此,监测结核病耐药性情况可以为制定、评价和完善国家结核病防治规划( NTP) 提供参考依据。. 我国2000年全国流调结核菌耐药状况. 初始耐药:18.6%

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分枝杆菌分离培养、药敏试验 及菌种鉴定方法标准化

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CDC

20064


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NTP


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2000

  • 18.6%

  • 46.5%

  • 27.8%


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2000

  • 7.6%

  • 17.1%

  • 10.7%


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6

  • 17.6%

  • 17.3%

  • 16.6%

  • 2.8%

  • 1.5%

  • 1.3%)


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8


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8


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8


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  • (Mycobaterium)1007(M.tuberculosis).7


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  • Nontuberculosis Mycobacteria,NTM


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Rubyun

-


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  • 37


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  • 37PH6.8~7.2

  • 10~1810~30


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  • (1)


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  • (2)

  • (3).


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()

  • 1~24%NaOH)1min15~20min


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()

  • 0.5~1ml3000r/min30min[2~42%NaOH)15min]

  • 4~5h,10ml,3000r/min30 min,[4%H2SO4,15min].


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()

  • 4%H2SO41325min)0.1mlL-J225min

  • , .


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()

  • ,24h,L-J; 3000r/min30 min,L-J.,[4%NaOH),10~15min]L-J


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  • ,;,3000r/min10 min;[2~44%H2SO4],15~20 min)L-J.

  • ,, 4%NaOH),15 min.


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0.1ml

2

1~2

4%NaOH

1~2min

15min

,

8

3,7

,

37


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  • 1.37118


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  • 2.2%~5%


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  • (1):,,.

  • (2)1/4

  • (3)21/2

  • (4)33/4

  • (5)4

  • (6):1/4


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  • 20.


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  • 10~100/


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  • 2~8

  • 7~8


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  • ,


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  • Bectec -TB64014C14CCO2CO24~25


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  • Bectec-tb9607H9O7~42

  • 60


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  • Bect/alert 3DCO2 CO2 CO2

  • 10


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  • 3~6


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  • G. Meissner () 1964,30

  • G. Canetti J.Grossete1963 ,WHO .

  • D.A.Mitchison,,.


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  • ,(WHO) ,30 ,WHO ,


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  • 2,4 96 %,,HSR E


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  • ,: (1) 10-3mg,,,,2 10-4mg10-6mg,,


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  • (2) 1 %,20 ,1 %

    ,2 ,,

    3


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  • (KH2PO4)


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  • 1.

  • 2.(INH)(RFP)(TB1)(TH1321)(SC).SM-SO4)EMB-Cl)(KM-SO4)(CPM-SO4)(VM-SO4)(PAS-Na)


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  • 3.

    =/1000

    mg %

    g/ml %

    ml


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  • 4

  • 5.5~10ml,-20 3

    RFPTB1TH1321


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  • 100ml1ml7ml85 50min.

  • 3724h4 1


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1

12

20.Tween-80MacFaarland No.1mg/ml


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  • 2.

  • 122mg/ml0.01 mg/ml0.1 mg/ml

  • (a):22100222mg/ml2 ml0.01 mg/ml10010-4 mg/ml220.7mm,3mm0.01ml


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  • 2.

    (b)100.5ml1mg/ml4.50.1mg/ml.1010-2 mg/ml10-4 mg/ml


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  • 3.:221(0.01ml) 10-2 mg/ml10-4 mg/ml10-4 mg 10-6 mg

  • 4.:37 4


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  • 1..

    (1)50:

    (2)50~100: 1+

    (3)100~200: 2+

    (4)(200~500): 3+

    (5)(500): 4+


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  • 2.:

    =/*100%

    1%


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  • 1.(10-4 mg/ml)20

    2.(H37RV)10-3 mg

    10.1ml 1%(BaCl2)9.9 ml 1%(H2SO4)


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2~3

mg/ml

37 4


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  • 1

    2

    3

    4H37RV


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1

2

3

4

5


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  • 4


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  • 198012%89.6%8.0%

  • 4.3%


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  • 28 28 TNM


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  • PNB-2-TCH


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  • 3~4


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  • 7H9


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L-JL-J


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-45


Gen probe

Gen Probe

  • GEN-PROBE HPARNADNARNADNAGEN-PROBE LEADER


Gen probe1

Gen Probe

  • Gen Probe

  • Gen ProbeMTDrRNA


Gen probe2

Gen Probe

  • 18MTD2.53.5rRNAMTD


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