基质辅助激光解析电离飞行时间质谱在血流感染快速鉴定中的应用
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摘要
为评价基质辅助激光解析电离飞行时间质谱(MALDI-TOF MS)在血流感染快速鉴定中的应用价值,收集2017年6月—2018年5月咸阳市中心医院血培养阳性菌200例,分离胶促凝管预处理后MALDI-TOF MS直接鉴定,转种后VITEK MS质谱鉴定和传统鉴定仪鉴定。结果显示,200例血培养阳性标本中,革兰阴性杆菌分离率最高,其次是革兰阳性球菌。MALDI-TOF MS鉴定结果与传统的鉴定仪相比较,在种水平上的一致性为93.5%,在属水平上的一致性为96.5%;分离胶促凝法联合MALDI-TOF MS直接鉴定对革兰阴性杆菌的鉴定准确率为95.1%,对革兰阳性球菌的鉴定准确率为83.3%,说明MALDI-TOF MS具有较高的鉴定符合率。联合分离胶促凝管法在血培养的常见病原菌直接鉴定中具有重要意义,可为临床血流感染快速合理选择抗菌药物提供方向和依据。
The application value of matrix-assisted laser desorption lionization time of flight mass spectrometry(MALDI-TOF MS)in rapid identification of blood flow infection is evaluated.200 cases of blood culture positive bacteria in our hospital from June 2017 to May 2018 are collected.They are directly identified by MALDI-TOF MS after pre-treatment in the separation gel coagulation-promoting tube,and then are identified by VITEK MS mass spectrometry and traditional identification instrument after subcultivation.Among the 200 blood culture positive specimens,Gram-negative bacilli have the highest segregation rate,followed by Gram-positive cocci.Compared with the traditional identification instrument,the identification results of MALDI-TOF MS are 93.5%at the species level and 96.5%at the genus level.The accuracy of identification for gram-negative bacilli of the direct identification by combination of separation gel coagulation-promoting method with MALDI-TOF MS is 95.1%,and that for Gram-positive cocci is83.3%.MALDI-TOF MS has a high identification coincidence rate,and is of great significance in the direct identification of common pathogenic bacteria in blood culture in combination with the method of separation gel coagulation-promoting tube,which can provide a direction and basis for rapid and rational selection of antibacterial agents for clinical blood flow infection.
The application value of matrix-assisted laser desorption lionization time of flight mass spectrometry(MALDI-TOF MS)in rapid identification of blood flow infection is evaluated.200 cases of blood culture positive bacteria in our hospital from June 2017 to May 2018 are collected.They are directly identified by MALDI-TOF MS after pre-treatment in the separation gel coagulation-promoting tube,and then are identified by VITEK MS mass spectrometry and traditional identification instrument after subcultivation.Among the 200 blood culture positive specimens,Gram-negative bacilli have the highest segregation rate,followed by Gram-positive cocci.Compared with the traditional identification instrument,the identification results of MALDI-TOF MS are 93.5%at the species level and 96.5%at the genus level.The accuracy of identification for gram-negative bacilli of the direct identification by combination of separation gel coagulation-promoting method with MALDI-TOF MS is 95.1%,and that for Gram-positive cocci is83.3%.MALDI-TOF MS has a high identification coincidence rate,and is of great significance in the direct identification of common pathogenic bacteria in blood culture in combination with the method of separation gel coagulation-promoting tube,which can provide a direction and basis for rapid and rational selection of antibacterial agents for clinical blood flow infection.
引文
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[3]宁长秀,邱锡荣,胡利民,等.3159份血液标本中病原菌的构成和耐药性分析[J].国际检验医学杂志,2017,38(20):2893-2896.
[4]Westh H,Lisby G,Breysse F,et al.Multiplex Real-time PCRand Blood Culture for Identification of Bloodstream Pathogens in Patients with Suspected Sepsis[J].Clinical Microbiol and Infection,2009,15(6):544-551.
[5]Navas M,Pincus D H,Wilkey K,et al.Identification of Aerobic Gram-positive Bacilli by Use of Vitek MS[J].Journal of Clinical Microbiology,2014,52(4):1274-1277.
[6]邱炳峰,张晓飞,顾丹霞,等.VITEK MS基质辅助激光解析电离飞行时间质谱在病原菌鉴定中的应用评价[J].中华医院感染学杂志,2016,26(10):2199-2202.
[7]谢小芳,周惠琴,郑毅,等.基质辅助激光解析电离飞行时间质谱技术直接鉴定血流感染病原菌的效果评价[J].中华临床感染病杂志,2016,9(2):152-155.
[8]尚军,李修远,王丽赟,等.优化差速离心法在血培养报警瓶MALDI-TOF MS细菌鉴定中的应用[J].临床检验杂志,2016,34(12):913-918.
[9]马坚,俞万钧,胡必杰,等.通过基质辅助激光解析电离飞行时间质谱系统直接快速鉴定阳性血培养[J].中华医院感染学杂志,2017,27(12):2676-2679.
[10]Barberino M G,Silva M O,Arraes A C P,et al.Direct Identification from Positive Blood Broth Culture by Matrix-Assisted Laser Desorptionionization Time-of-Flight Mass Spectrometry(MALDI-TOF MS)[J].The Brazilian Journal of Infectious Diseases,2017,21(3):339-342.
[11]周春妹,沈佳瑾,黄声雷,等.评估SDS在MALDI-TOF MS直接鉴定阳性血培养样本中的应用价值[J].检验医学,2018,33(3):228-232.
[12]蒋月婷,黎健成,易建云,等.分离胶辅助VITEK MS质谱仪快速鉴定血培养阳性菌的方法学研究[J].国际检验医学杂志,2016,37(15):2071-2073.
[13]沈林海,韦凌娅,金慧,等.基质辅助激光解析电离飞行时间质谱技术快速鉴定香港海鸥形菌[J].中国卫生检验杂志,2016,26(13):1836-1838.
[14]D Inzeo T,Santangelo R,Fiori B,et al.Catheter-related Bacteremia by Cupriavidus Metallidurans[J].Diagnostic Microbiol&Infectious Disease,2015,81(1):9-12.