血清分离胶促凝管法和HB&L微生物培养体系预处理在MALDI-TOF MS快速鉴定血培养阳性样本病原菌的方法研究  

Comparison of separating gel and HB&L pretreatment methods for rapid identification of the pathogenic bacteria in positive blood culture samples by MALDI-TOF MS

作　　者：丁毅伟 李艳君 钱扬会 韩志海 Ding Yiwei;Li Yanjun;Qian Yanghui;Han Zhihai(Department of Respiratory and Critical Care Medicine,the Sixth Medical Center,Chinese PLA General Hospital,Beijing 100048,China;Clinical Laboratory of the sixth Medical Center,Chinese PLA General Hospital,Beijing 100048,China;Clinical Laboratory of JingDu Children′s Hospital,Beijing 102200,China)

机构地区：[1]解放军总医院第六医学中心呼吸与危重症医学科,北京100048 [2]解放军总医院第六医学中心检验科,北京100048 [3]北京京都儿童医院检验科,北京102200

出　　处：《中华检验医学杂志》2021年第4期341-346,共6页Chinese Journal of Laboratory Medicine

基　　金：解放军总医院第六医学中心创新培育基金(CXPY201915);军队后勤科研面上项目(CLB20J019)。

摘　　要：目的评价血清分离胶促凝管法和HB&L微生物培养体系两种MALDI-TOF-MS预处理方法的鉴定率,为临床快速准确鉴定血流感染病原菌提供新思路。方法收集2020年1—12月北京解放军总医院第六医学中心实验室常规方法鉴定的149份血培养报警后单一细菌感染的阳性样本,分别采用分离胶促凝管法和HB&L微生物培养体系预处理后,并且以传统方法结果为标准,直接MALDI-TOF MS细菌鉴定,比较两种方法的鉴定率。结果在149份血培养阳性样本中,革兰阴性(G^(-))菌占47.0%(70/149)、革兰阳性(G^(+))菌占53.0%(79/149)。对G^(-)菌种水平鉴定率,血清分离胶促凝管法为78.6%(55/70),HB&L微生物培养体系为91.4%(64/70),差异有统计学意义(P=0.033);对G^(+)菌种水平鉴定率,二者分别为73.4%(58/79)和87.3%(69/79),差异有统计学意义(P=0.028)。在3.000~2.300分值段,G^(-)菌鉴定率血清分离胶促凝管法和HB&L微生物培养体系分别为22.9%(16/70)和38.6%(27/70),差异有统计学意义(P=0.044);G^(+)菌鉴定率两种方法分别为19.0%(15/79)和34.2%(27/79),差异有统计学意义(P=0.031)。结论HB&L微生物培养体系种水平鉴定率要高于血清分离胶促凝管法,经过预处理直接MALDI-TOF MS鉴定血培养阳性样本病原菌有一定临床应用价值。Objective To evaluate the identification rate of separating gel or HB&L pretreatment methods of MALDI-TOF-MS,thereby to provide a new idea for the rapid and accurate identification of pathogens of bloodstream infections in daily clinic practice.Methods A total of 149 alarmed positive blood culture samples of single bacterial infection by routine laboratory methods were collected between January to December 2020 from the Sixth Medical Center,Chinese PLA General Hospital.Samples were pretreated with the separation gel accelerating tube method or the HB&L microbial culture system,followed by direct MALDI-TOF MS bacterial identification,the identification rates of the two pretreatment methods were compared and results from the traditional method were used as the standard control.Results Among the 149 positive blood culture samples,47.0%(70/149)were gram-negative(G^(-))bacteria and 53.0%(79/149)were gram-positive(G^(+))bacteria.Identification rate of G^(-)strain level was 78.6%(55/70)by serum separation gel coagulation tube method and 91.4%(64/70)by HB&L microbial culture system,the difference was statistically significant(P=0.033).Identification rate of G^(+)strain levels was 73.4%(58/79)by serum separation gel coagulation tube method and 87.3%(69/79)by HB&L microbial culture system,the difference was statistically significant(P=0.028).For G^(-)bacteria in the range of 3.000-2.300,the identification rate was 22.9%(16/70)by serum separation gel accelerating tube method and 38.6%(27/70)by the HB&L microbial culture system,the difference was statistically significant(P=0.044).For G^(+)bacteria in the range of 3.000-2.300,the identification rate was 19.0%(15/79)by serum separation gel accelerating tube method and 34.2%(27/79)by the HB&L microbial culture system,the difference was statistically significant(P=0.031).Conclusion The identification rate of HB&L microbial culture system is higher than that of serum separation gel coagulation tube method.Direct MALDI-TOF MS identification of pathogenic bacteria in positive bloo

关 键 词：微生物学技术 血培养样本 血清分离胶促凝管法 HB&L微生物培养体系 

分 类 号：R446.5[医药卫生—诊断学]