Improved clinical laboratory identification of human pathogenic yeasts by matrix-assisted laser desorption ionization time-of-flight mass spectrometry
Improved clinical laboratory identification of human pathogenic yeasts by matrix-assisted laser desorption ionization time-of-flight mass spectrometry
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DOI：
10.1111/j.1469-0691.2010.03398.x
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发表时间：
2011-09-01
影响因子：
14.2
通讯作者：
Kuhns, M.
中科院分区：
文献类型：
--
作者：
Bader, O.;Weig, M.;Kuhns, M.
酵母菌感染治疗成功的关键是尽早开始抗真菌治疗并采用适当的药物治疗方案。为此，酵母种类鉴定是必要的，但传统的生化和形态学方法非常耗时。最近在常规诊断实验室中出现的生物物理方法，例如基质辅助激光解吸电离飞行时间质谱 (MALDI-TOF MS)，有望显着加快这一过程。在这项研究中，使用来自不同地理位置的 1192 种临床酵母和酵母样分离株，对两种市售 MALDI-TOF MS 物种鉴定系统在临床诊断中的应用进行了评估。将结果与基于微观和生化特征的经典分化方案的结果进行比较。对于 95.1% 的分离株，所有三种程序均一致地给出了正确的物种鉴定，但两种 MALDI-TOF MS 系统中的错误分类率均大大降低。此外，一些密切相关的物种（例如念珠菌 orthopsilosis/metapsilosis/parapsilosis 或念珠菌 glabrata/bracarensis）可以通过两种 MALDI-TOF MS 系统来解析，但不能通过生化方法来解析。观察到 MALDI-TOF MS 相对于生物化学在识别系统新颖的分离株方面具有显着优势。尽管两个 MALDI-TOF MS 系统在数据库结构中采用了不同的方法，并且对数据库条目中的错误表现出不同的敏感性，但就临床实用性而言，这些都是可以忽略不计的。与生化鉴定相比，MALDI-TOF MS 具有节省时间的优势，将大大改善真菌诊断和患者治疗。
The key to therapeutic success with yeast infections is an early onset of antifungal treatment with an appropriate drug regimen. To do this, yeast species identification is necessary, but conventional biochemical and morphological approaches are time-consuming. The recent arrival of biophysical methods, such as matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS), in routine diagnostic laboratories holds the promise of significantly speeding up this process. In this study, two commercially available MALDI-TOF MS species identification systems were evaluated for application in clinical diagnostics, using a geographically diverse collection of 1192 clinical yeast and yeast-like isolates. The results were compared with those of the classical differentiation scheme based on microscopic and biochemical characteristics. For 95.1% of the isolates, all three procedures consistently gave the correct species identification, but the rate of misclassification was greatly reduced in both MALDI-TOF MS systems. Furthermore, several closely related species (e. g. Candida orthopsilosis/metapsilosis/parapsilosis or Candida glabrata/bracarensis) could be resolved by both MALDI-TOF MS systems, but not by the biochemical approach. A significant advantage of MALDI-TOF MS over biochemistry in the recognition of isolates novel to the system was observed. Although both MALDI-TOF MS systems employed different approaches in the database structure and showed different susceptibilities to errors in database entries, these were negligible in terms of clinical usefulness. The time-saving benefit of MALDI-TOF MS over biochemical identification will substantially improve fungal diagnostics and patient treatment.