基质辅助激光解析电离飞行时间质谱对常见细菌直接药物敏感性试验的可行性

李秀娥1 ，王双云2 ，王禺1

（1.西安市第一医院，陕西 西安，710002；2.西安咸阳国际机场急救中心，陕西 咸阳，712000）

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摘要：

目的 探讨基质辅助激光解析电离飞行时间质谱（MALDI-TOF MS）对常见细菌直接药物敏感性试验的可行性，以期缩短常见细菌直接药物敏感性试验报告的周转时间。方法 采用MALDI-TOF MS对阳性血培养中的细菌进行直接鉴定，对可准确鉴定的常见菌行纸片扩散法（K-B 法）直接药敏试验。同时将其转至培养基过夜后获得纯菌落后再行K-B 法常规药敏试验。观察两种不同的药敏试验结果。结果 革兰阳性球菌K-B法直接药敏试验与常规药敏试验比较符合率为98.04%，小误差和大误差分别为0.58%、0.67%；革兰阴性球菌K-B法直接药敏试验与常规药敏试验比较符合率为96.67%，小误差和大误差分别为1.42%、0.67%；两组试验结果比较，无显著差异（P>0.05）。直接药敏试验报告的周转时间约24 h，显著短于常规药敏试验报告的48 h。结论 在MALDI-TOF MS直接鉴定结果的基础上对常见细菌行直接药敏试验与常规药敏试验结果高度相符，且能显著缩短药敏试验报告的周转时间，值得推广。

关键词：MALDI-TOF MS；常见细菌；药敏试验；报告周转时间

中图分类号：R446.5文献标志码：A文章编号：2096-1413(2017)16-0154-02

Feasibility analysis of the matrix assisted laser desorption ionization time of flight mass spectrometry in direct drug sensitivity test in common bacteria
LI Xiu-e 1, WANG Shuang-yun 2, WANG Yu 1
(1. Xi`an No.1 Hospital, Xi`an 710002; 2. Emergency Center, Xi`an Xianyang International Airport, Xianyang 712000, China)

ABSTRACT: Objective To investigate the feasibility of the matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS) in direct drug sensitivity test in common bacteria, in order to shorten the cycling time of the report of the MALDI-TOF-MS in direct drug sensitivity test in common bacteria. Methods The bacteria in positive blood culture were authenticated directly by MALDI-TOF-MS, after the MALDI-TOF detection, the bacteria which can authenticated precisely by MALDI-TOF-MS were proceeded Kirby-Bauer and the bacteria also were cultured overnight and then were proceeded Kirby-Bauer. The results of two drug sensitive tests were compared. Results Compared with the conventional drug susceptibility test, the coincidence rate, minimum error and big error of Kirby-Bauer was 98.04%, 0.58% and 0.67% in gram positive bacteria and was 96.67%, 1.42% and 0.67% in gram negative bacteria; there was no significant difference between the results of direct drug sensitivity test and convention drug sensitivity test (P>0.05). The report cycling time in direct drug sensitivity test was 24 h, which was significantly shorter than 48 h in conventional drug sensitivity test (P <0.05). Conclusion On the basis of the result of MALDI -TOF -MS, the results of direct drug sensitivity test and conventional drug sensitivity test on common bacteria was highly consistent, and also can shorten the report cycling time significantly, so it is worth to be popularized.
KEYWORDS: MALDI-TOF-MS; common bacteria; drug sensitive test; report cycling time

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