检验医学
檢驗醫學
검험의학
LABORATORY MEDICINE
2015年
2期
108-112
,共5页
王琳%李佳萍%陈功祥%张嵘
王琳%李佳萍%陳功祥%張嶸
왕림%리가평%진공상%장영
基质辅助激光解析电离飞行时间质谱%中段尿%细菌直接检测
基質輔助激光解析電離飛行時間質譜%中段尿%細菌直接檢測
기질보조격광해석전리비행시간질보%중단뇨%세균직접검측
Matrix-assisted laser desorption/ionization-time of flight mass spectrometry%Midstream urine%Bacterial direct identification
目的：运用基质辅助激光解析电离飞行时间质谱（MALDI-TOF MS ）鉴定系统对中段尿样本中的细菌进行直接快速检测，以建立快速的细菌检测方法便于临床应用。方法692例中段尿样本接种于固体培养基上，利用 MALDI-TOF MS 和 Vitek 2 Compact 全自动微生物分析系统（简称 Vitek 2 Compact）对单个菌落进行鉴定；同时对尿液样本进行前处理后直接进行质谱分析。结果692例中段尿样本中，98例单一菌感染且细菌数＞104 CFU ／mL 的样本应用 MALDI-TOF MS 直接检测出74株菌，检出率达75．5％，其中大肠埃希菌39株，检出率达79．6％；粪肠球菌23株，检出率为100．0％；摩根摩根菌5株，检出率为100．0％。64例样本为2种菌混合感染，采用 MALDI-TOF MS 直接检测出44例样本中的1种优势细菌。质谱直接检测尿液的鉴定结果与单菌落质谱鉴定结果及 Vitek 2 Compact 鉴定结果完全一致，符合率为100．0％。结论MALDI-TOF MS 可用于直接检测尿液样本中的细菌，检出率高，结果可靠；MALDI-TOF MS 对混合菌感染的样本有一定鉴定能力；该方法可比常规尿培养鉴定方法提早42 h 报告鉴定结果，是对临床尿液样本细菌鉴定的一大革命性进步。
目的：運用基質輔助激光解析電離飛行時間質譜（MALDI-TOF MS ）鑒定繫統對中段尿樣本中的細菌進行直接快速檢測，以建立快速的細菌檢測方法便于臨床應用。方法692例中段尿樣本接種于固體培養基上，利用 MALDI-TOF MS 和 Vitek 2 Compact 全自動微生物分析繫統（簡稱 Vitek 2 Compact）對單箇菌落進行鑒定；同時對尿液樣本進行前處理後直接進行質譜分析。結果692例中段尿樣本中，98例單一菌感染且細菌數＞104 CFU ／mL 的樣本應用 MALDI-TOF MS 直接檢測齣74株菌，檢齣率達75．5％，其中大腸埃希菌39株，檢齣率達79．6％；糞腸毬菌23株，檢齣率為100．0％；摩根摩根菌5株，檢齣率為100．0％。64例樣本為2種菌混閤感染，採用 MALDI-TOF MS 直接檢測齣44例樣本中的1種優勢細菌。質譜直接檢測尿液的鑒定結果與單菌落質譜鑒定結果及 Vitek 2 Compact 鑒定結果完全一緻，符閤率為100．0％。結論MALDI-TOF MS 可用于直接檢測尿液樣本中的細菌，檢齣率高，結果可靠；MALDI-TOF MS 對混閤菌感染的樣本有一定鑒定能力；該方法可比常規尿培養鑒定方法提早42 h 報告鑒定結果，是對臨床尿液樣本細菌鑒定的一大革命性進步。
목적：운용기질보조격광해석전리비행시간질보（MALDI-TOF MS ）감정계통대중단뇨양본중적세균진행직접쾌속검측，이건립쾌속적세균검측방법편우림상응용。방법692례중단뇨양본접충우고체배양기상，이용 MALDI-TOF MS 화 Vitek 2 Compact 전자동미생물분석계통（간칭 Vitek 2 Compact）대단개균락진행감정；동시대뇨액양본진행전처리후직접진행질보분석。결과692례중단뇨양본중，98례단일균감염차세균수＞104 CFU ／mL 적양본응용 MALDI-TOF MS 직접검측출74주균，검출솔체75．5％，기중대장애희균39주，검출솔체79．6％；분장구균23주，검출솔위100．0％；마근마근균5주，검출솔위100．0％。64례양본위2충균혼합감염，채용 MALDI-TOF MS 직접검측출44례양본중적1충우세세균。질보직접검측뇨액적감정결과여단균락질보감정결과급 Vitek 2 Compact 감정결과완전일치，부합솔위100．0％。결론MALDI-TOF MS 가용우직접검측뇨액양본중적세균，검출솔고，결과가고；MALDI-TOF MS 대혼합균감염적양본유일정감정능력；해방법가비상규뇨배양감정방법제조42 h 보고감정결과，시대림상뇨액양본세균감정적일대혁명성진보。
Objective To construct rapid identification method for clinical laboratory with the use of matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS)for the direct identification of bacteria in midstream urine samples.Methods A total of 692 midstream urine samples were cultivated on agar,and were identified by MALDI-TOF MS and Vitek 2 Compact automated microbial amalyslis system (Vitek 2 Compact ). Direct identification of midstream urine samples were also conducted by MALDI-TOF MS after preparation.Results Of the 692 midstream urine samples,98 samples were positive for one kind of bacteria (>1 04 CFU /mL).The overall detection rate of direct identification by MALDI-TOF MS was 75.5%,and 74 isolates were identified,among which 39 isolates were Escherichia coli with the detection rate of 79.6%,23 isolates were Enterococcus faecalis with the detection rate of 1 00.0%,and 5 isolates were Morganella morganii with the detection rate of 1 00.0%.Among the 64 midstream urine samples with multiple microorganisms,44 samples were detected with a dominant bacteria by direct identification. The consistency rate was 1 00.0% among the results by direct identification,the identification of colony by MALDI-TOF MS and Vitek 2 Compact.Conclusions MALDI-TOF MS could be applied to identify directly bacteria in midstream urine samples with high detection rate and accuracy,and MALDI-TOF MS also shows certain performance in identifying samples containing multiple bacteria.The identification results could be 42 h earlier available than regular methods.It is a revolutionary improvement for the clinical identification of bacteria in urine samples.
