MALDI-TOF MS直接检测清洁中段尿液标本中病原菌的价值  

Value of identifying pathogens directly in clean midstream urine samples by MALDI-TOF MS

作　　者：徐令清[1] 张冈毅 钟子莹 温伟洪[1] 汤英贤[1] 钟国权[1] 李介华[1] 刘丽忠 XU Lingqing;ZHANG Gangyi;ZHONG Ziying;WEN Weihong;TANG Yingxian;ZHONG Guoquan;LI Jiehua;LIU Lizhong(Department of Clinical Laboratory,the Sixth Affiliated Hospital of Guangzhou Medical University/Qingyuan People′s Hospital,Qingyuan,Guangdong 511518,China)

机构地区：[1]广州医科大学附属第六医院/清远市人民医院检验科,广东清远511518

出　　处：《国际检验医学杂志》2020年第22期2748-2751,共4页International Journal of Laboratory Medicine

基　　金：广东省中医药局项目(20201407);广东省医学科学技术研究基金项目(A2015226);广东省科技创新战略专项资金项目(DZXQY002);广东省清远市科技计划项目(2019163);广东省清远市人民医院医学科研基金项目(20190209)。

摘　　要：目的探讨基质辅助激光解析电离飞行时间质谱仪(MALDI-TOF MS)对清洁中段尿液标本中细菌的鉴定价值。方法收集300份清洁中段尿液标本,接种于血琼脂平板上,对尿液标本进行离心处理,采用MALDI-TOF MS对离心后的尿沉渣进行鉴定,同时对培养出的单个菌落进行鉴定,并用Vitek 2 Compact及BD phoenixM50全自动微生物分析系统进行鉴定复核。结果300份清洁中段尿液标本中,63份培养鉴定到1种细菌,MALDI-TOF MS的菌株鉴定结果与两种全自动微生物分析系统的细菌鉴定结果的符合率为100.0%;MALDI-TOF MS在以上63份尿沉渣中直接检出25株细菌,检出率为39.7%(25/63);其中大肠埃希菌15株,占60.0%(15/25);肺炎克雷伯菌4株,占16.0%(4/25);粪肠球菌2株,占8.0%(2/25);产气肠杆菌1株,里昂葡萄球菌1株,黏质沙雷菌1株,分别各占4.0%(1/25);20份标本培养出两种细菌,应用MALDI-TOF MS直接在2份尿沉渣中检出2株屎肠球菌,检出率为10.0%(2/20)。结论MALDI-TOF MS鉴定准确率高,可从临床标本直接检测病原菌,节省培养时间,对两种混合菌感染的标本也有一定鉴定能力。Objective To analysis the value of matrix-assisted laser analysis and ionization time-of-flight mass spectrometer(MALDI-TOF MS)for identifying bacteria in clean midstream urine specimens.Methods A total of 300 clean midstream urine specimens were collected and inoculated on blood agar plates,then centrifuged,and the sediments after centrifugation and the cultured singled colony were identified by MALDI-TOF MS,Vitek 2 Compact and BD phoenixM50 automatic bacteria identification instrument were used for identification review.Results Among 300 clean midstream urine specimens,63 samples were cultured with 1 type of bacteria.The coincidence rate of strain identification by MALDI-TOF MS with the two kinds of automatic bacterial identification instrument was 100.0%.MALDI-TOF MS directly detected 25 strains of bacteria among the above 63 urine sediments.The detection rate was 39.7%(25/63).Among them,15 strains of Escherichia coli,accounting for 60.0%(15/25),4 strains of Klebsiella pneumoniae,accounting for 16.0%(4/25),2 strains of Enterococcus faecalis,accounting for 8.0%(2/25),1 strain of Enterobacter aerogenes,1 strain of Staphylococcus leonii,1 strain of Serratia marcescens,each accounting for 4.0%(1/25).Two kinds of bacteria were cultured from 20 specimens,and the dominant bacteria in the 2 specimens were directly detected in the urine sediment by MALDI-TOF MS,and the detection rate was 10.0%(2/20).Conclusion MALDI-TOF MS has a high identification accuracy rate.It could detect pathogenic bacteria directly from clinical specimens,saving culture time,and has a certain ability to identify specimens of two kinds of mixed bacteria.

关 键 词：基质辅助激光解析电离飞行时间质谱 病原菌 中段尿 16sRNA 

分 类 号：R446.12[医药卫生—诊断学]