MALDI-TOF-MS技术快速鉴定丝状真菌的临床评价  

Clinical evaluation of MALDI-TOF-MS in identification of filamentous fungi

作　　者：吴友伟[1,2] 石红 刘万静[1] 答嵘 

机构地区：[1]西安交通大学第一附属医院检验科,西安710061 [2]西安交通大学第三附属医院消化内二科,西安710068

出　　处：《检验医学与临床》2017年第21期3155-3156,3159,共3页Laboratory Medicine and Clinic

基　　金：西安交通大学第一附属医院基金资助项目(2014YK30)

摘　　要：目的探讨基质辅助激光解吸电离飞行时间质谱(MALDI-TOF-MS)技术在丝状真菌快速鉴定中的临床应用价值。方法对西安交通大学第一附属医院2015年3月至2017年1月分离自临床的丝状真菌进行聚合酶链式反应(PCR)测序鉴定与MALDI-TOF-MS鉴定,同时回顾形态学方法鉴定结果,对丝状真菌菌种分布、标本来源进行分析,采用Kappa值一致性评价方法对质谱鉴定与形态学方法鉴定结果进行统计分析。结果本研究共包含分离自临床的丝状真菌102株,非重复分离株83株。烟曲霉50株(60.24%),黄曲霉26株(31.33%)。标本来源主要为呼吸道标本,其中痰液68株(81.93%),支气管灌洗液11株(13.25%)。MALDI-TOF-MS技术与形态学方法鉴定结果比对,Kappa值为0.141 0。结论 MALDI-TOF-MS技术在丝状真菌鉴定正确性与时效性优于形态学方法。Objective By comparing the identification results of clinical strains of filamentous fungi using MALDI-TOF-MS and morphological identification,explore the clinical application value of MALDI-TOF-MS in the rapid identification of filamentous fungi.Methods The study was conducted in the First Affiliated Hospital of Xi＇an Jiaotong University between March 2015 and January 2017.Eighty-three clinical strains of filamentous fungi were identified using PCR and sequencing as well as the MALDI-TOFMS.Morphological identification results was reviewed in LIS;species distribution and specimen source of filamentous fungi were analyzed.The consistent of mass spectrometry and morphological identification were appraised with Kappavalue consistent evaluation method.Results This study enrolled 102 strains of filamentous fungi,including 83 non-repeated strains.Aspergillus fumigates was the most common strains,including 50 strains（60.24%）,followed by Aspergillus flavus of 26 strains（31.33%）.Specimen source were mainly respiratory specimens,including sputum of 68 strains（81.93%）and bronchial lavage of 11 strains（13.25%）.The results of MALDI-TOF-MS and morphology method were appraised and the Kappavalue was 0.141.Conclusion MALDI-TOF-MS was a rapid detection method and was better in accuracy of identification of filamentous fungi than morphological method.

关 键 词：基质辅助激光解吸电离飞行时间质谱 丝状真菌 形态学方法 评价 

分 类 号：R734.2[医药卫生—肿瘤]