目的: 评估 “临床少见菌报告解释”制度的实施对医疗实践的影响,以及微生物实验室与临床沟通的效果。方法: 对2015年2月至2016年11月,新华医院临床微生物实验室发送的所有“临床少见菌报告解释”进行汇总,收集患者临床信息及临床医师对于报告解释的反馈情况等,采用SPSS 19.0软件对数据进行分析。结果: 2015年2月至2016年11月新华医院临床微生物实验室共向24个临床科室发出75份“临床少见菌报告解释”,涉及45种少见菌,其中93.3%（42/45）病原微生物的抗菌药物敏感性试验目前在上海地区尚无法常规开展。实验室从接收标本到出具“临床少见菌报告解释”的平均时间为（3.5±1.5） d。临床医师接收到报告解释后采取相应措施的比例为56.0%（42/75）,且2016年该比例（62.7%,37/59）较2015年（31.3%,5/16）明显增高,差异有统计学意义（P=0.024）。75例分离到少见菌的患者中有59例临床诊断为感染,其中按照报告解释建议的抗菌药物进行治疗的患者35例,其抗感染治疗有效率（33/35）较未按建议进行治疗者（12/24）更高,差异有统计学意义（P<0.01）。结论: “临床少见菌报告解释”在医疗实践中起到了积极的作用,且临床医师对该报告解释的接受度正逐渐增高。

Objective: To evaluate the impact of implementation of "report and interpretation of rare pathogenic microorganism isolated" on clinical practice and communication between microbiology laboratory and clinicians. Methods: From Feb 2015, the microbiology laboratory of our hospital added a "report and interpretation of rare pathogenic microorganism isolated" form for the identification report when rare microorganism was isolated from clinical samples,which was considered to be of potential clinical significance. All the "report and interpretation of rare pathogenic microorganism isolated" issued during Feb 2015 to Nov 2016 were analyzed and the information of clinical data of patients and clinician's feedback were collected. SPSS Statistics 19.0 software was used to analyze the data. Results: From Feb 2015 to Nov 2016, 75 "report and interpretation of rare pathogenic microorganism isolated" were sent to 24 clinical departments, which involved 45 kinds of rare microorganism. Susceptibility test could not be performed routinely in Shanghai area on 93.3%(42/45) of the rare pathogens isolated. The average time from sample reception to delivery of the "report and interpretation of rare pathogenic microorganism isolated" was (3.5±1.5) days. After receiving the" report and interpretation of rare pathogenic microorganism isolated", 56.0%(42/75) of clinicians took related actions, with a higher ratio in 2016(62.7%, 37/59) than that in 2015(31.3%, 5/16) (P=0.024). Fifty-nine out of 75 patients from whom rare pathogen was isolated were clinically diagnosed as infectious disease.Patients who accepted therapy according to the recommendation offered with "report and interpretation of rare pathogenic microorganism isolated" had a higher successful rate than those who didn't(P<0.01). Conclusions: The "report and Interpretation of rare pathogenic microorganism isolated" has a positive role in clinical practice, and the clinician's acceptance for the "report and interpretation of rare pathogenic microorganism isolated" is increasing gradually.