双甲酸涂靶法对丝状真菌鉴定的临床应用评价  

Evaluation for clinical application of formic acid dimer target-coating method in identification of filamentous fungi

作　　者：袁凯旋[1] 赵越[1] 凌勇[1] 叶龙[1] 胡雪姣 侯铁英[1] YUAN Kaixuan;ZHAO Yue;LING Yong;YE Long;HU Xuejiao;HOU Tieying(Department of Clinical Laboratory,Guangdong Provincial People′s Hospital/Guangdong Academy of Medical Sciences,Guangzhou 510080,Guangdong,China)

机构地区：[1]广东省人民医院/广东省医学科学院检验科,广州510080

出　　处：《临床检验杂志》2020年第8期608-612,共5页Chinese Journal of Clinical Laboratory Science

基　　金：广东省人民医院(广东省医学科学院)“登峰计划”科研专项(DFJH2020019)。

摘　　要：目的探讨双甲酸涂靶法对临床丝状真菌鉴定的应用价值,优化质谱仪对丝状真菌鉴定的前处理流程。方法收集2019年2月至2020年5月广东省人民医院临床分离丝状真菌212株,经形态学初筛并以基因测序为标准,评价双甲酸涂靶法及乙腈-甲酸提取法对菌株鉴定的一致性。结果 212株丝状真菌经基因测序至种、复合群、属的鉴定率分别为84.91%、100%、100%,经双甲酸涂靶法和乙腈-甲酸提取法鉴定至种、复合群、属的鉴定率分别为43.87%、91.04%、91.04%和45.75%、93.40%、93.40%。与测序法比较,双甲酸涂靶法和乙腈-甲酸提取法在种、复合群、属的鉴定Kappa值分别为0.022、0.421、0.421和0.056、0.536、0.536;双甲酸涂靶法与乙腈-甲酸提取法鉴定一致性比较,种、复合群、属水平Kappa值分别为0.880、0.726和0.726。结论双甲酸涂靶法前处理流程在丝状真菌的鉴定能力上与乙腈-甲酸提取法接近,可应用于临床丝状真菌的前处理质谱鉴定。Objective To study the application value of target-coating method with formic acid dimer in the clinical identification of filamentous fungi and optimize the pretreatment process of mass spectrometer for the identification. Methods A total of 212 strains of filamentous fungi were collected from Guangdong People’s Hospital during the period from February 2019 to May 2020. After morphological screening and gene sequencing served as standard,the consistency between formic acid dimer coating method and acetonitrile formic acid extraction in the identification of the fungi strains was evaluated. Results The identification rates of the 212 strains of filamentous fungi by gene sequencing to species,complex groups and genus were 84.91%,100% and 100%,respectively. The identification rates by formic acid dimer target-coating method at the levels of species,complex groups and genus were 43. 87%,91. 04% and91.04%,and those of acetonitrile-formic acid extraction method were 45.75%,93.40% and 93.40%,respectively. Compared with gene sequencing,the Kappa values of identification consistency of the formic acid dimer target-coating method and acetonitrile-formic acid extraction method at species level were 0.022 and 0.056 respectively,showing poor consistency. The Kappa values of identification consistency of the two methods at the complex groups were 0.421 and 0.536 respectively,showing high consistency. Compared with acetonitrile-formic acid extraction method,the Kappa value of formic acid dimer target-coating method at species level was 0. 880,showing good consistency. The Kappa values of the two methods at complex groups and genus levels were both 0.726,showing high consistency.Conclusion The pretreatment process of the formic acid dimer target-coating method for the identification of filamentous fungi should be similar to that of acetonitrile-formic acid extraction method,so it can be considered as a suitable method for mass spectrometry in the clinical identification of filamentous fungi.

关 键 词：质谱仪 双甲酸涂靶法 丝状真菌 鉴定 

分 类 号：R446.5[医药卫生—诊断学]