MALDI-TOF MS在耐甲氧西林金黄色葡萄球菌快速筛查中的价值  

Application of MALDI-TOF MS in methicillin-resistant Staphylococcus aureus rapid identification

作　　者：郭坤山 王山梅[2] 马冰[2] 许俊红[2] 张江峰[2] 荆楠[2] 闫文娟[2] 马琼 李轶[2] GUO Kunshan;WANG Shanmei;MA Bing;XU Junhong;ZHANG Jiangfeng;JING Nan;YAN Wenjuan;MA Qiong;LI Yi(Xuchang Key Laboratory of Pathogens of Infectious Diseases,Department of Clinical Laboratory,Xuchang Central Hospital,Henan University of Science and Technology,Xuchang 461000,Henan;Department of Clinical Laboratory,Henan People's Hospital,Zhengzhou 450000,Henan,China)

机构地区：[1]许昌市感染性疾病病原体研究重点实验室,河南科技大学附属许昌市中心医院检验科,河南许昌461000 [2]河南省人民医院检验科,河南郑州450000

出　　处：《检验医学》2021年第2期209-212,共4页Laboratory Medicine

基　　金：河南省医学科技攻关计划省部共建项目(SBGJ2018084);安图生物横向课题(1812000211900)。

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)技术在耐甲氧西林金黄色葡萄球菌(MRSA)快速筛查中的价值。方法收集30株MRSA和29株甲氧西林敏感金黄色葡萄球菌(MSSA),采用MALDI-TOF MS技术进行菌种鉴定,比较鉴定结果的准确性;采用MALDI Biotyper软件对细菌的蛋白峰图进行同源性分析,采用ClinProTools 3.0软件对蛋白峰图进行统计分析,选择有统计学差异的蛋白峰建立筛选模型。另收集80株金黄色葡萄球菌临床分离株(40株MRSA、40株MSSA)对所建模型进行验证。结果MALDI-TOF MS对金黄色葡萄球菌的鉴定准确率>99.9%;质荷比为6812、17668、7594和11990 m/z的蛋白峰是区分MRSA和MSSA最主要的特征性峰。受试者工作特征(ROC)曲线结果显示,4个峰对应的曲线下面积(AUC)均为1;凝胶浏览图显示MSSA在4个峰的蛋白强度均高于MRSA;应用4个峰值的组合对80株验证菌株进行筛选,结果显示其敏感性为95.0%、特异性为82.5%、阳性预测值为84.4%、阴性预测值为94.3%。结论MALDI-TOF MS对金黄色葡萄球菌的鉴定具有快速、准确、试剂成本低的特点。同时应用MRSA和MSSA的差异峰可以对两者进行快速鉴别,为临床防治MRSA提供及时、可靠的实验室依据。Objective To discuss the application of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS)in rapid screening of methicillin-resistant Staphylococcus aureus(MRSA).Methods Thirty strains of MRSA and 29 strains of methicillin-sensitive Staphylococcus aureus(MSSA)were collected and identified by MALDI-TOF MS.The accuracy of the results was compared.The protein peaks of the bacteria were homologically analyzed by MALDI Biotyper software.The protein peak maps were analyzed statistically by ClinProTools 3.0 software,and the protein peaks with statistical difference were chosen to establish the screening model.Eighty clinical isolates of Staphylococcus aureus(40 MRSA and 40 MSSA)were selected to validate the model.Results The accuracy rate of MALDI-TOF MS in the identification of Staphylococcus aureus was above 99.9%.The protein peaks with charge-to-charge ratios of 6812,17668,7594,and 11990 m/z were the most important characteristic peaks used to distinguish MRSA from MSSA.The receiver operating characteristic(ROC)curve showed that the area under curve(AUC)of the above four peaks was all 1.Gel scan showed that the protein strength of MSSA group in its four peaks was higher than that of MRSA group.The combination of these four peaks was used to screen 80 tested strains,which showed sensitivity of 95.0%,specificity of 82.5%,positive prediction of 84.4%and negative prediction of 94.3%.Conclusion MALDI-TOF is fast,accurate and low-cost in the identification of Staphylococcus aureus.The differential peaks of MRSA and MSSA can be used to identify the two strains quickly,which provides timely and reliable basis for clinical prevention and treatment of MRSA.

关 键 词：基质辅助激光解吸电离飞行时间质谱 金黄色葡萄球菌 耐甲氧西林金黄色葡萄球菌 甲氧西林敏感金黄色葡萄球菌 筛查 

分 类 号：R446.5[医药卫生—诊断学]