摘要
目的:建立基于基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)平台的耐碳青霉烯类肠杆菌(CRE)耐药快速检测方法,为提高临床诊断效果提供依据。方法:收集2023年10月至2024年9月上海健康医学院附属嘉定区中心医院临床检验分离得到的120株疑似CRE菌株,最终完成44株的实验检测。44株疑似CRE科细菌菌株均来自住院患者。建立和完善基于MALDI-TOF MS平台的快速检测方案,采用全自动快速微生物质谱检测系统(VITEK MS)进行实验检测,以VITEK-2 Compact仪器进行菌种鉴定及药敏试验(AST)复核结果作为参考标准,对比VITEK-2 Compac和VITEK MS两种检测方法的筛查结果及检测效能。结果:44株疑似CRE菌株经MALDI-TOF MS检测筛出31株CRE,VITEK-2 Compact复核检测亦筛出31株CRE。其中,1株阴沟肠杆菌MALDI-TOF MS检测为阴性,VITEK-2 Compact检测为CRE;1株肺炎克雷伯菌MALDI-TOF MS检测为阳性,VITEK-2 Compact检测为对碳青霉烯类药物中介。以VITEK-2 Compact检测结果为标准,通过四格表(2×2列联表)统计法得知MALDI-TOF MS灵敏度为96.7%,特异度为92.3%,准确率为100%,约登指数(R)为89.1%。结论:基于MALDI-TOF MS平台的CRE耐药快速检测方法,操作流程简单,准确率高,能够为早期靶向抗菌药物应用提供依据。
Objective:To establish a rapid detection method based on matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS)for drug resistance of Carbapenem-resistant Enterobacteriaceae(CRE),so as to provide basis for enhancing clinically diagnostic effect.Methods:A total of 120 suspected CRE strains that were isolated from the clinical laboratory of Jiading District Central Hospital Affiliated to Shanghai University of Medicine&Health Sciences during October 2023 and September 2024 were collected,and the experimental detection of 44 strains was finally completed.The 44 suspected CRE bacterial strains were all from hospitalized patients.A rapid detection protocol based on the MALDI-TOF MS platform was initially established and improved,and experimental detection was carried out using the fully automatic rapid microbial mass spectrometry detection system(VITEK MS).The results of identification review and antimicrobial susceptibility test(AST)for VitEK-2 Compact strain was used as the reference standard.The screening results and detection efficacy of two kinds of detection methods were compared.Results:In the 44 suspected CRE strains,31 CRE strains were screened out by MALDI-TOF MS detection,and 31 CRE stains were screened out by VITEK-2 Compact recheck detection.In them,one strain of Enterobacter cloacae was confirmed as negativity by the MALDI-TOF MS test,but it was confirmed as CRE by the VITEK-2 Compact test.One strain of Klebsiella pneumoniae was confirmed as positivity by the MALDITOF MS test,but it was confirmed as mediator for carbapenem drugs by the VITEK-2 Compact test.The tested results of VITEK-2 Compact was used as standard,the results of four-grid table(2×2 contingency table)statistical method indicated that the sensitivity,specificity,accuracy rate and Youden index(R)of MALDI-TOF MS were respectively 96.7%,92.3%,100%and 89.1%.Conclusion:The rapid detection method based on the MALDI-TOF MS platform for CRE drug resistance has simple operation process and high accuracy rate,which can provide a basis for the application of targeted antibacterial drugs at early stage.
作者
刘业琼
唐文鑫
张洪霖
严峰
徐炜新
Liu Yeqiong;Tang Wenxin;Zhang Honglin;Yan Feng;Xu Weixin(Department of Laboratory,Jiading District Central Hospital Affiliated to Shanghai University of Medicine&Health Sciences,Shanghai 201899,China;Department of Information,Jiading District Central Hospital Affiliated to Shanghai University of Medicine&Health Sciences,Shanghai 201899,China;BioMérieux Diagnostic Products(Shanghai)Co.,Ltd.,Shanghai 201315,China)
出处
《中国医学装备》
2025年第11期56-60,共5页
China Medical Equipment
基金
上海市嘉定区自然科学基金课题(JDKW-2022-0014)。
