尿流式细胞术、MALDI-TOF MS及VITEK 2 XL全自动微生物鉴定系统联合试验对尿培养标本的药敏鉴定结果评价  

Evaluation of urine culture specimens identification results by combined method of urine flow cytometry,MALDI-TOF MS and VITEK 2 XL automatic microbial identification system

作　　者：张肖 杨鸿林 蔡辉 沈昊 顾兵 ZHANG Xiao;YANG Honglin;CAI Hui;SHEN Hao;GU Bing(Department of Clinical Laboratory,Ninth Hospital of Suzhou,Suzhou,Jiangsu 215200,China;Department of Clinical Laboratory,Shengze Hospital,Suzhou,Jiangsu 215200,China;Department of Clinical Laboratory,Guangdong Provincial People′s Hospital,Guangzhou,Guangdong 510080,China)

机构地区：[1]苏州市第九医院检验科,江苏苏州215200 [2]江苏盛泽医院检验科,江苏苏州215200 [3]广东省人民医院检验科,广东广州510080

出　　处：《检验医学与临床》2022年第23期3195-3198,共4页Laboratory Medicine and Clinic

摘　　要：目的评价尿流式细胞术、基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)和VITEK 2 XL全自动微生物鉴定系统联合试验对中段尿培养标本直接鉴定结果的可靠性。方法收集2021年1-10月于苏州市第九医院住院的296例泌尿系统感染患者送检的尿培养阳性标本。采用UF-1000i进行尿液标本菌量计数,选择中段尿菌量计数>10^(5)个/毫升的标本,使用MALDI-TOF MS技术进行直接鉴定;再将中段尿菌量计数>10^(5)个/毫升的标本进行稀释,使用VITEK 2 XL全自动微生物鉴定系统进行直接药敏试验,将联合试验结果与常规药敏试验结果进行比较,评价其可靠性。结果MALDI-TOF MS直接法鉴定结果中鉴定到种水平为93.9%,鉴定到属水平为97.6%,MALDI-TOF MS没有提供可靠的鉴定结果占2.3%。次代培养后VITEK 2 XL鉴定结果符合率为100.0%。联合试验鉴定结果与常规药敏试验结果差异无统计学意义(P>0.05)。革兰阴性菌直接药敏最合适的尿液菌量计数在500~1100个/微升。革兰阳性菌直接药敏最合适的尿液菌量计数在500~1500个/微升。结论联合试验进行阳性尿培养标本的直接鉴定与直接药敏试验可快速、准确地得到鉴定及药敏结果。Objective To evaluate the reliability of urine flow cytometry,matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS)and VITEK 2 XL automatic microbial identification system for direct identification of midstream urine culture specimens.Methods From January to October 2021,positive urine culture specimens from 296 patients with urinary tract infection admitted to the Ninth Hospital of Suzhou were collected.UF-1000i was used to count the bacterial count of urine specimens,and specimens with midstream bacterial count>10^(5)/mL were selected for direct identification by MALDI-TOF MS.Then,the specimens with midstream microbiota count>10^(5)/mL were diluted,and the VITEK 2 XL automatic microbial identification system was used for direct drug sensitivity test.The results of the combined test were compared with those of the conventional drug sensitivity test to evaluate the reliability.Results The direct MALDI-TOF MS method identified 93.9%to the species level,97.6%to the genus level,and 2.3%were not identified by MALDI-TOF MS.The coincidence rate of VITEK 2 XL identification after subculture was 100.0%.There was no significant difference between the results of combined test and conventional drug sensitivity test(P>0.05).The most suitable urine bacteria count for direct drug sensitivity of Gram-negative bacteria was 500-1100/μL.The most suitable urine bacteria count for direct drug sensitivity of Gram-positive bacteria was 500-1500/μL.Conclusion The direct identification of positive urine culture specimens and the direct drug sensitivity test could get the identification and drug sensitivity results quickly and accurately.

关 键 词：尿流式细胞术 基质辅助激光解吸电离飞行时间质谱 全自动微生物鉴定系统 尿路感染 药敏试验 病原菌 

分 类 号：R446.11[医药卫生—诊断学]