摘要
目的 评价基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)直接检测阳性血培养瓶中肠杆菌目细菌碳青霉烯酶活性的可行性。方法 收集2012年1月至2018年12月分离自温州市中医院各临床科室的46株肠杆菌目细菌和3株质控菌分别模拟血培养检测,用MALDI-TOF MS直接对阳性血培养液做细菌鉴定及亚胺培南水解试验,从而判断碳青霉烯酶的活性。另收集临床26例阳性血培养标本对该方法进行验证。结果 25株产碳青霉烯酶肠杆菌目细菌(CPE)显示300 m/z和489 m/z处的质谱峰均消失,21株非产碳青霉烯酶肠杆菌目细菌(NCPE)的两处质谱峰依然存在。质谱检测46株细菌的碳青霉烯酶结果对比基因表型高度一致(Kappa=1),对血培养液直接鉴定的细菌种水平鉴定率为96.0%。26例临床血培养样本方法验证结果显示,9例耐碳青霉烯酶类肠杆菌目细菌和17例碳青霉烯类药物敏感菌株均被正确识别,灵敏度、特异度均为1.00。结论 MALDITOF MS碳青霉烯酶测定法是一种直接从血液培养瓶中检测碳青霉烯酶活性的可行、快速的方法,有助于临床更快地调整经验性抗菌药物治疗和实施感染控制措施。
Objective To evaluate the feasibility of using matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS) to detect carbapenemase activity of Enterobacteriaceae in positive blood cultures.Methods A total of 46 strains of Enterobacteriaceae and 3 strains of quality control bacteria isolated from clinical departments of Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medicine University, from January 2012 to December 2018 were collected. Bacteria identification and imipenem hydrolysis tests were performed by MALDI-TOF MS to determine the activity of carbapenase. In addition, 26 clinical positive blood culture samples were collected to verify this method. Results The mass spectrum peaks at 300 m/z and 489 m/z were not present in 25 strains of carbapenemase-producing Enterobacteriaceae(CPE), while still existed in 21 strains of non-carbapenemase-producing Enterobacteriaceae(NCPE). The carbapenemase results of 46 strains of Enterobacteriaceae detected by mass spectrometry were highly consistent with gene phenotype(Kappa=1),and the identification rate of bacterial species directly identified in blood cultures medium was 96.0%. The results of validation test of 26 clinical blood culture samples showed that 9 strains of carbapenemase-resistant Enterobacteriaceae and 17 carbapenemase-sensitive strains were correctly identified with both specificity and sensitivity of 1.00. Conclusion MALDI-TOF MS is a feasible and rapid test to identify carbapenemase activity directly from blood culture samples. It may contribute to clinical readjustment of empirical antimicrobial therapy for prompt infection control.
作者
梁世周
许建平
蔡文品
孔万仲
奚经巧
金晓立
曾云祥
LIANG Shizhou;XU Jianping;CAI Wenpin;KONG Wanzhong;XI Jingqiao;JIN Xiaoli;ZENG Yunxiang(Department of Clinical Laboratory,Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medicine University,Wenzhou 325000,China;不详)
出处
《浙江医学》
CAS
2022年第16期1731-1735,1763,共6页
Zhejiang Medical Journal
基金
温州市基础性医疗卫生科技项目(Y20210744)。
关键词
产碳青霉烯酶肠杆菌目细菌
基质辅助激光解吸电离飞行时间质谱
血培养
亚胺培南
Carbapenemase-producing Enterobacteriaceae
Matrix-assisted laser desorption ionization time-offlight mass spectrometry
Blood culture
Imipenem
