腿伤克斯特菌致肺部感染1例并对鉴定方法讨论  

One Case Report of Pulmonary Infection Caused by Kerstersia Gyiorum and the Discussion of Identification Methods

作　　者：潘书娟[1] 田恩冰[1] 姚兴伟[1] 靳悦 李伟静 刘杰[1] 何洪 PAN Shujuan;TIAN Enbing;YAO Xingwei;JIN Yue;LI Weijing;LIU Jie;HE Hong(Clinical Laboratory Department of Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院检验科,北京100700

出　　处：《标记免疫分析与临床》2024年第9期1748-1753,共6页Labeled Immunoassays and Clinical Medicine

基　　金：中华中医药学会青年求实项目(编号:2021-QNQS-001)。

摘　　要：目的介绍呼吸道标本中1例少见腿伤克斯特菌的鉴定过程,以及鉴定方法的正确选择,探讨微生物工作对待细菌鉴定合理思维,选择适合的细菌鉴定方法。方法患者痰标本多次规范送检并培养出同一种细菌,通过Vitek2 Compact、MALDI-TOF MS(基质辅助激光解吸电离飞行时间质谱)、16S rRNA、mNGS(宏基因组二代测序)等方法的鉴定。结果该菌在血平皿、麦康凯、巧克力平皿上均生长,扩散型的菌落,表面粗糙,革兰染色阴性小的球杆菌,Vitek2Compact鉴定为木糖氧化无色杆菌,低分辨率,鉴定有误,MALDI-TOF、16S rRNA、mNGS均鉴定为腿伤克斯特菌,并且菌株未检测到毒力因子和耐药基因,为敏感菌株。结论MALDI-TOF、16S rRNA、mNGS对于细菌的鉴定有重要作用,3种方法有各自的特点,MALDI-TOF MS操作简便,成本较低,较适合临床日常工作,16S rRNA适合MALDI-TOF菌株库不包含无法鉴定出的细菌,mNGS成本较高,时间也较长,但鉴定菌株序列信息全面,鉴定较准确。综上所述,细菌鉴定工作,还需结合临床患者病情等众多因素,合理选择适合的方法具有重要意义。Objective To introduce the identification process of a rare bacterium Kerstersia gyiorum in respiratory tract specimens,and the correct selection pipeline of identification methods,and to discuss the rational thinking of the treatment of rare bacteria in microbial research.Methods Sputum samples were appropriately cultured and identified by Vitek2 Compact,MALDI-TOF,16S rDNA and whole genome sequencing.Results The bacterium was able to grow on blood plates,McConkey plates and chocolate plates.It appeared as a diffused colony with a coarse surface and small Gram-negative bacillus.It was identified as Achromobacter xyloxide by Vitek2Compact with low resolution and incorrect identification results.No virulence factor and drug resistance gene were detected in the strain,suggesting that it was a sensitive strain.Conclusion MALDI-TOF,16S rRNA,and mNGS can play an important role in the identification of bacteria.All three methods have their own unique characteristics.MALDI-TOF MS is easy to operate,cost-effective,and more suitable for clinical daily work.16S rRNA is suitable for MALDI-TOF strain libraries,which do not contain bacteria that cannot be identified.mNGS is costly and time-consuming,but the identification of strain sequence information is comprehensive and accurate.In summary,the identification of bacteria requires the careful consideration of various factors such as clinical patient conditions,and the rational selection of suitable methods,which is of great significance.

关 键 词：腿伤克斯特菌 少见菌 鉴定方法 

分 类 号：R378[医药卫生—病原生物学]