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

发布时间：2018-05-19 10:24

本文选题：血培养 + 细菌　；参考：《中华医院感染学杂志》2017年12期

【摘要】：目的基质辅助激光解析电离飞行时间质谱(MALDI-TOF MS)在临床微生物实验室的应用,为阳性血培养中微生物鉴定提供了革命性的新方法,我们报告一种改良的利用MALDI-TOF质谱直接鉴定阳性血培养的方法。方法 2011年10月-2012年10月共收集312瓶阳性培养物,细菌分别属于12个不同属和32个种,MALDI-TOF质谱鉴定的细菌同时进行了常规生化法鉴定,其中不符合的部分通过序列分型明确。结果 200株革兰阳性菌中,161株(80.5%)准确鉴定到属以上水平,121株(60.5%)准确鉴定到种;112株革兰阴性菌中,101株(90.2%)准确鉴定到属以上水平,81株(72.3%)准确鉴定到种水平;MALDI-TOF质谱鉴定革兰阴性菌,在属以上水平和种水平上,准确率均高于革兰阳性菌。结论通过这种方法能在1h内快速、鉴定阳性血培养中的常见细菌,如果将此项技术常规应用于临床,将显著增加菌血症患者在24h内得到最佳抗菌药物治疗的比例。
[Abstract]:Objective the application of matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF) in clinical microbiology laboratory provides a revolutionary method for microbial identification in positive blood culture. We report an improved method for direct identification of positive blood cultures by MALDI-TOF mass spectrometry. Methods 312 positive cultures were collected from October 2011 to October 2012. Bacteria belonging to 12 different genera and 32 species identified by MALDI-TOF mass spectrometry were identified by routine biochemical method. Results among the 200 Gram-positive strains, 161 strains were identified accurately. 121 strains of Gram-negative bacteria were identified. (101 strains of Gram-negative bacteria were identified by MALDI-TOF Mass Spectrometry (MALDI-TOF Mass Spectrometry was used to identify Gram-negative bacteria at the species level).) among 112 strains of Gram-negative bacteria, 101 strains were identified as Gram-negative bacteria, and 81 strains were identified by MALDI-TOF Mass Spectrometry. The accuracy was higher than that of Gram-positive bacteria at the level of genus and species. Conclusion this method can be used to identify the common bacteria in positive blood culture within 1 h. If this technique is used in clinical practice, the proportion of bacteriaemia patients receiving the best antimicrobial treatment in 24 hours will be increased significantly.
【作者单位】：宁波大学附属鄞州医院呼吸科;上海复旦大学附属中山医院感染科;上海复旦大学附属中山医院微生物实验室;
【分类号】：R446.5

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