皂素处理联合MALDI-TOFMS直接鉴定血培养阳性病原菌  

Direct identification of microorganisms from positive blood cultures by MALDI-TOF MS using a saponin method

作　　者：张蓓 赵丽娜[1] 韩清珍[1] 毛菊珍[1] 张有涛[1] 张险峰[1] 何军[1] 徐杰[1] 史进方[1] ZHANG Bei,ZHAO Lina,HAN Qingzhen,MAO Juzhen,ZHANG Youtao,ZHANG Xianfeng,HE Jun,XU Jie △,SHI Jinfang ▲(Center for Clinical Laboratory,the First Affiliated Hospital of SuzhouUniversity,Suzhou,Jiangsu 215006,China)

机构地区：[1]苏州大学附属第一医院临床检测中心,江苏苏州215006

出　　处：《检验医学与临床》2018年第17期2525-2528,共4页Laboratory Medicine and Clinic

基　　金：国家自然科学基金青年项目(81501425);江苏省卫生和计划生育委员会医学科研项目(Q201401);江苏省青年医学人才项目(QNRC2016726)

摘　　要：目的评估皂素处理联合基质辅助激光解析电离飞行时间(MALDI-TOF MS)直接鉴定血培养阳性病原菌的可行性,以及比较与传统血培养联合MALDI-TOF MS法鉴定结果的符合率。方法共收集阳性血培养标本240例,使用皂素处理方法裂解血细胞富集和纯化待测菌,采用MALDI-TOF MS对待测标本进行菌种鉴定,同时阳性血培养瓶也转移接种至血平板进行培养,纯菌落同样用MALDI-TOF MS鉴定菌种。结果 240例阳性血培养瓶有197例真阳性瓶和43例假阳性瓶。在193例单菌株感染血培养瓶中,菌株的鉴定符合率为69.9%。其中75例革兰阴性杆菌的鉴定率为84.0%;65例葡萄球菌属的鉴定率分别为78.5%;10例肠球菌属的鉴定率为80.0%。43例假阳性报警血培养瓶的鉴定符合率为86.0%。结论皂素提取联合MALDI-TOF MS可作为一种快速鉴定血流感染常见菌的有效方法,有较高的鉴定符合率,且成本低廉,可为临床快速、合理选用抗菌药物提供依据。Objective To evaluate the feasibility of the direct identification of microorganisms from positive blood cultures by MALDI-TOF MS using a saponin method.Methods A total of 240 cases with positive blood cultures were included in this study.The microorganisms were enriched and purified from positive blood cultures by the saponin-based extraction method,and then the microorganisms were identified by MALDI-TOF MS system.At the same time,the mcrioorganisms were transferred and cultured in blood agar plate,and the pure colony was also identified by MALDI-TOF MS system.Results The composition of 240 positive blood culture bottles were 197 true positive and 43 false positive blood culture bottles.For 193 monomicrobial blood cultures,the identification rate by MALDI-TOF MS using a saponin method was 69.9%.For 75 cases of gramnegative bacillus among them,the identification rate were 84.0%,and for 65 cases of Staphylococcus,the identification rate were 78.5%;and the rate of Enterococcus was 80.0%（8/10）.The coincidence rate was 86.0% to 43 cases positive alarm of Biphase Blood Culture.Conclusion The method by MALDI-TOF MS using a saponin method is effective in rapidly identifying common bloodstream infection microorganisms with a higher identification rate.Furthemore,it is less expensvie and provides evidences for quick and rational use of antibiotics.

关 键 词：皂素 基质辅助激光解析电离飞行时间质谱 血培养 直接鉴定 

分 类 号：R446[医药卫生—诊断学]