基质辅助激光解析离子-飞行时间质谱仪在临床分离革兰阴性杆菌鉴定中的应用

摘要

目的 了解基质辅助激光解析离子-飞行时间质谱仪(MALDI-TOF-MS)在临床分离革兰阴性杆菌鉴定中的应用,为临床医师正确诊断提供科学依据.方法 采用 MALDI-TOF-MS技术对1625株临床常见革兰阴性杆菌进行鉴定.VITEK MS鉴定结果与VITEK-2 Compact全自动微生物鉴定系统对比,结果差异的菌株采用16S rDNA测序验证.结果 VITEK MS共鉴定出常见革兰阴性杆菌1625株,肠杆菌科1219株共6种,非发酵菌属406株共4种.VITEK MS系统与VITEK-2 Compact系统鉴定结果比较,120株常见革兰阴性杆菌鉴定符合率为95.83%.5株鉴定结果不符菌株用16S rDNA测序验证,与VITEK-2 Compact 鉴定符合率为2/5(40%),与VITEK MS鉴定符合率为3/5(60%).结论 VITEK MS能快速鉴定出常见革兰阴性杆菌,为临床治疗及鉴别感染病原菌提供了快速的筛选方法.%Objective To investigate the application of matrix - assisted laser desorption/ionozation-time of flight mass spectrometry in rapid identification of gram negative bacilli so as to provide scientific basis for correct clinical diagnosis.Methods A total of 1625 isolates of common Gram-negative bacilli were identified by the MALDI-TOF mass spectrometry. Comparing VITEK MS with VITEK-2 Compact results, the discordant results were validated by 16S rDNA sequencing.Results A total of 1625 strains of Gram-negative bacilli have been identified with the use of MALDI -TOF mass spectrometry, including 6 species of Enterobacteriaceae and 4 species of nonfermentative bacteria. Comparing VITEK MS with VITEK-2 Compact results, the coincidence rate was 95.83% for Gram-negative bacilli. Five strains were validated by 16S rDNA. Comparing with sequencing, the coincidence rate of two methods was 60%(3/5) for VITEK MS and 40%(2/5) for VITEK-2 Compact, respectively.Conclusion The MALDI-TOF mass spectrometry can identify a variety of species of Gram -negative bacilli, and it may facilitate the clinical treatment as the rapid screening of the pathogens causing infections.