实验诊断中英文教学课件.ppt

（四）流行环节 1、感染源: 外源或内源性病原体(密度、耐药性） 外源性 生物性感染源：病人和病原携带者（人和动物） 非生物性感染源：医院环境（物品、液体、食物……） 内源性 皮肤、上呼吸道和口咽部、泌尿生殖道、肠道 流行环节 2、感染途径: 交叉感染(外源性) 接触传播： 1）直接：感染源→感染者； 2）间接：感染源→医护人员或设备、物品→感染者 3）飞沫传播：吸入感染 通过消毒隔离可以预防：可预防性感染 自身感染(内源性):正常菌群→ 条件致病 难以预防：不可预防性感染 临床微生物实验室在医院感染控制中的职责 制定标本采集、运送、处理规范 遵循标准化操作程序处理标本，预防实验室感染 监测消毒、灭菌效果，必要时进行环境监测 及时将具有流行病学意义的结果通知相关人员 必要时进行医院感染病原体的流行病学分型 定期报告感染病原菌在不同解剖部位、病房的发 生率及耐药谱 有效的感染控制依赖实验室准确检测病原菌的能力 工作重点 一、手卫生 二、抗菌药物合理应用 三、耐药菌监测和管理 四、重点感染部位的感染控制 无菌操作，减少或缩短侵入性装置 五、消毒灭菌 * 1.Know available diagnostic technologies. 2. Understand specific specimen for specific diagnostic test. 3. Understand procedure for specimen collection. * Check to make sure the sample was taken at the right time, from the right site and delivered to the laboratory in a timely manner.  * 瑞金微生物室目前的检验情况和主要工作 目前日常检测临床标本400份/天, 主要为细菌、真菌、结核菌和支原体分离培养、鉴定和药敏试验，以及院感监测工作。工作金额为70~80万/月，每年递增10% * * * Slide * Some tips Before proceeding to specific specimen requirements in collection, handling and transport, emphasis should be made on the following: Laboratory investigation should start as early as possible Specimens obtained early, preferably prior to antimicrobial treatment likely to yield the infective pathogen Before doing anything, explain the procedure to patient and relatives When collecting the specimen, avoid contamination Take sufficient quantity of material Follow the appropriate precautions for safety * Common contaminants are S. epidermidis, Micrococcus and diphtheroids from skin * * Slide * Serum Once you have collected the venous blood as described before let the blood specimen clot for 30 minutes at ambient temperature, then place in a cool box to retract at 4 to 8°C for a minimum of 1-2 hours, then centrifuge at a speed of 1500 RPM for 5-10 minutes. When serum separation is performed in a field laboratory, proper safety precautions should be taken. If a viral haemorrhagic fever is strongly suspected, samples should only be p