质谱快速鉴定血培养阳性标本的方法研究  

Establishment of a method of rapid identification of positive blood culture samples by MALDI-TOF MS

作　　者：宋启飞 刘敏雪 李梦娇[1] 刘雅[1] 邓劲[1] 谢轶[1] Qi-fei Song;Min-xue Liu;Meng-jiao Li;Ya Liu;Jin Deng;Yi Xie(West China Hospital of Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西医院,四川成都610041

出　　处：《中国现代医学杂志》2018年第35期23-26,共4页China Journal of Modern Medicine

摘　　要：目的建立快速、精准的细菌质谱鉴定方法,以缩短血培养阳性的实验周转时间。方法共收集血培养阳性瓶91个(活性炭吸附瓶),采集培养液分别转种肉汤和血平板增菌培养4 h后,用基质辅助激光解吸/电离飞行时间质谱(MALDI-TOF MS)进行菌种鉴定。以血平板培养24 h的质谱鉴定结果为对照,比较2种方法细菌质谱鉴定符合率。结果 91株细菌包括51株革兰阴性菌和40株革兰阳性菌。4 h肉汤增菌法和4 h血平板培养法鉴定到种的符合率分别为46.15%和89.01%,无鉴定结果率分别为47.25%和3.30%,错误鉴定率分别为3.30%和4.40%。2种方法鉴定到种的符合率比较,差异有统计学意义(P <0.05),4 h血平板培养法鉴定到种的符合率高于4 h肉汤增菌法。2种方法对革兰阴性菌鉴定到种的符合率分别为58.82%和94.12%,差异有统计学意义(P <0.05),4 h血平板培养法高于4 h肉汤增菌法。2种方法对革兰阳性菌鉴定到种的符合率分别为30.00%和82.50%,差异有统计学意义(P <0.05),4 h血平板培养法高于4 h肉汤增菌法。结论 4 h血平板培养质谱鉴定法可快速鉴定血培养阳性标本中的病原菌。Objective To establish a rapid and accurate method of bacterial identification in order to shorten turnaround time of positive blood cultures.Methods A total of 91 bacteria were collected from positive blood cultures,incubated in nutrient broth and blood agar plate respectively for 4 h and then identified by matrix-assisted laserdesorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS).Taking the results of MALDI-TOF MS of 24-h blood plate culture as the standard,the coincidence rates of the two incubation methods for identification of bacteria by mass spectrometry were compared.Results Among the 91 bacteria there were 51 strains of Gramnegative bacteria and 40 strains of Gram-positive bacteria.In all,46.15%and 89.01%of the isolates were accurately identified after 4-h incubation in nutrient broth and blood plate respectively,while there were 47.25%and 3.30%strains with no results,and the error identification rates were 3.30%and 4.40%,respectively.The agreement rates of the two methods had significant difference(P<0.05).The coincidence rates of 4-h incubation in nutrient broth and blood plate were 58.82%and 94.12%respectively for Gram-negative bacteria at species level(P<0.05),the latter was significantly higher than the former.The coincidence rates of 4-h incubation in nutrient broth and blood plate were 30.00%and 82.50%for Gram-positive bacteria(P<0.05),the accuracy of blood agar plate inoculation was better than that of nutrient broth culture.Conclusions Using technology of MALDI-TOF MS,rapid bacteria identification of positive blood culture samples can be achieved after 4-h incubation in blood agar plate.

关 键 词：培养 MALDI-TOFMS/质谱法 生物学鉴定法 符合率 

分 类 号：R446.5[医药卫生—诊断学]