CAJ | 학술논문

目的以16S rRNA基因测序鉴定结果为金标准,研究比较两种基质辅助激光解析电离飞行时间质谱鉴定系统(MALDI Biotyper和VITEK MS)在临床分离链球菌鉴定中的表现.方法 2014年4至6月收集浙江大学医学院附属第二医院临床分离的链球菌162株,经16S rRNA基因测序确认菌种,分别使用MALDI Biotyper和VITEK MS质谱鉴定系统进行鉴定,并评价其鉴定能力.结果 MALDI Biotyper鉴定系统将155株(155/162,95.68％)链球菌准确鉴定到种,将3株缓症链球菌群鉴定为肺炎链球菌,1株副血液链球菌鉴定为澳大利亚链球菌,另有3株肺炎链球菌不能准确鉴定(分值＜1.7);VITEK MS鉴定系统将156株(156/162,96.30％)链球菌准确鉴定至种(包括亚种),其将2株肺炎链球菌鉴定为缓症链球菌/口腔链球菌,1株马肠链球菌鉴定为婴儿链球菌婴儿亚种.两系统对化脓性链球菌和无乳链球菌的鉴定准确率均为100％ (51/51),对肺炎链球菌的准确率均＞85％.结论两系统对临床分离的链球菌均有较强的鉴定能力,VITEK MS系统对某些亚种的准确鉴定更有临床意义.质谱可作为临床链球菌快速鉴定的手段.
목적 이16S rRNA기인측서감정결과위금표준,연구비교량충기질보조격광해석전리비행시간질보감정계통(MALDI Biotyper화VITEK MS)재림상분리련구균감정중적표현.방법 2014년4지6월수집절강대학의학원부속제이의원림상분리적련구균162주,경16S rRNA기인측서학인균충,분별사용MALDI Biotyper화VITEK MS질보감정계통진행감정,병평개기감정능력.결과 MALDI Biotyper감정계통장155주(155/162,95.68％)련구균준학감정도충,장3주완증련구균군감정위폐염련구균,1주부혈액련구균감정위오대리아련구균,령유3주폐염련구균불능준학감정(분치＜1.7);VITEK MS감정계통장156주(156/162,96.30％)련구균준학감정지충(포괄아충),기장2주폐염련구균감정위완증련구균/구강련구균,1주마장련구균감정위영인련구균영인아충.량계통대화농성련구균화무유련구균적감정준학솔균위100％ (51/51),대폐염련구균적준학솔균＞85％.결론 량계통대림상분리적련구균균유교강적감정능력,VITEK MS계통대모사아충적준학감정경유림상의의.질보가작위림상련구균쾌속감정적수단.
Objective Using 16S rRNA gene sequencing as the gold standard method,to compare the performance of two matrix-assisted laser desorption ionization time of flight mass spectrometry system (MALDI Biotyper and VITEK MS) for identifying clinical isolates of Streptococcus spp.Methods One hundred and sixty two clinical Streptococcus isolates were collected at the Second Affiliated Hospital of Zhejiang University,from April to June,2014,and confirmed by 16S rRNA gene sequencing analysis.MALDI Biotyper and VITEK MS mass spectrometry system were used for identification and further evaluated by performance respectively.Results Of all the isolates tested,155 (155/162,95.68％) Streptococcus isolates were accurately identified to species level by MALDI Biotyper.Besides,MALDI Biotyper identified three Streptococcus mitis group as S.pneumoniae and one S.parasanguinis as S.australis.Another three S.pneumonia isolates were not identified accurately (values ＜ 1.7).Although 156 (156/162,96.30％) isolates were accurately identified to species level (including subspecies) by VITEK MS system,two S.pneumoniae as S.mitis/S.oralis and one S.euinus as S.infantarius ssp.infantarius were misidentified.The two systems showed a 100％ (51/51) accuracy in identifying all S.pyogenes and S.agalactiae isolates,and an accuracy higher than 85％ for S.pneumoniae.Conclusions Both systems showed potent identification ability for Streptococcus spp.,VITEK MS system showed more clinical significance in accurately identifying some subspecies.Mass spectrometry system can be used as a rapid identification method for Streptococcs spp.in clinical practice.