摘要
【目的】探讨基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)技术对医院不动杆菌和鲍曼不动杆菌的鉴定准确性及临床意义。【方法】分析并比较经一代测序技术鉴定为医院不动杆菌感染的18例患者和鲍曼不动杆菌感染的115例患者的MALDI-TOF MS结果,分析其临床特征和药敏数据。【结果】MALDI-TOF MS对鲍曼不动杆菌的鉴定准确率最高为100.0%,对医院不动杆菌的鉴定准确率最高为66.67%,总体鉴定准确率为93.98%。医院不动杆菌感染患者的平均住院时间显著长于鲍曼不动杆菌患者(P<0.05),鲍曼不动杆菌对大多数抗菌药物的耐药率高于医院不动杆菌(P<0.05)。【结论】MALDI-TOF MS对鲍曼不动杆菌的鉴定准确性较高,但对医院不动杆菌存在较高的误判率,易被误鉴为鲍曼不动杆菌。尽管两者的临床感染特征相似,但医院不动杆菌感染患者住院时间更长,且耐药率显著低于鲍曼不动杆菌。临床在无法准确鉴定两种细菌时,应尽可能进行药敏试验,根据其结果选用抗生素治疗。
【Objective】To investigate the accuracy of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS)in identifying Acinetobacter hospitalis(A.hospitalis)and Acinetobacter baumannii(A.baumannii),and to analyze the clinical features and antibiotic resistance differences between the two species in order to evaluate the impact of misidentification on clinical diagnosis and treatment.【Methods】MALDI-TOF MS results were compared with those of first-generation sequencing in 18 patients infected with A.hospitalis and 115 patients infected with A.baumannii.Their clinical characteristics and antimicrobial susceptibility data were analyzed.【Results】MALDI-TOF MS achieved an identification accuracy of 100.0%for A.baumannii,but only 66.67%for A.hospitalis,with an overall accuracy rate of 93.98%.Patients with A.hospitalis infection had significantly longer hospital stays than those with A.baumannii infection(P<0.05).Resistance rates to most antibiotics were higher in A.baumannii than in A.hospitalis(P<0.05).【Conclusion】MALDI-TOF MS demonstrates high accuracy in identifying A.baumannii but a relatively high misidentification rate for A.hospitalis,which is often incorrectly identified as A.baumannii.Although the clinical infection characteristics of the two species are similar,A.hospitalis infections are associated with longer hospitalization and significantly lower antibiotic resistance compared to A.baumannii.Therefore,when the two cannot be reliably distinguished in clinical practice,antimicrobial susceptibility testing should be performed whenever possible to guide antibiotic therapy.
作者
陈艳
韩清珍
张婷
CHEN Yan;HAN Qingzhen;ZHANG Ting(Clinical Testing Center and Innovation&Transformation Platform,the Fourth Affiliated Hospital of Soochow University,Suzhou Jiangsu 215123)
出处
《医学临床研究》
2025年第10期1781-1784,共4页
Journal of Clinical Research
关键词
光谱法
质量
基质辅助激光解吸电离
鲍氏不动杆菌
不动杆菌属
诊断
鉴别
Spectrometry,Mass,Matrix-Assisted Laser Desorption-Ionization
Acinetobacter Baumannii
Acinetobacter
Diagnosis,Differential
