MATRIX-ASSISTED LASER DESORPTION IONIZATION-TIME OF FLIGHT MASS SPECTROMETRY FOR THE IDENTIFICATION OF BACTERIA AND YEASTS IN A CLINICAL MICROBIOLOGICAL LABORATORY: A REVIEW
MATRIX-ASSISTED LASER DESORPTION IONIZATION-TIME OF FLIGHT MASS SPECTROMETRY FOR THE IDENTIFICATION OF BACTERIA AND YEASTS IN A CLINICAL MICROBIOLOGICAL LABORATORY: A REVIEW
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临床微生物实验室中用于鉴定细菌和酵母的基质辅助激光解吸电离时间飞行质谱法：综述
DOI：
10.2143/acb.66.4.2062567
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发表时间：
2011
影响因子：
1.6
通讯作者：
K. Lagrou
中科院分区：
文献类型：
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作者：
D. Steensels;J. Verhaegen;K. Lagrou
摘要最近，专为临床实验室设计的MALDI-TOF MS设备已在世界各地的各大中心进行了商业推广。所有已发表的研究都得出结论，MALDI-TOF MS可以方便地用于临床微生物实验室中细菌和酵母菌的常规鉴定。尽管所有数据表明，MALDI-TOF MS正确识别了绝大多数常规处理的分离物，但它还不能识别每一个这样的分离物。直到今天，MALDI-TOF MS仍不适用于志贺氏菌属、肺炎链球菌和绿色链球菌的鉴定。数据库升级和样品浓缩是改进MALDI-TOF MS技术的关键因素，使该方法能够增强其能力。对于很大比例的酵母的鉴定，在质谱仪分析之前必须采用提取方法来获得适当的光谱。由于MALDI-TOF MS的低边际成本和极高的速度，该技术可以在鉴定方案的早期使用时提高实验室效率。MALDI-TOF女士可以将更长、更劳力密集和更昂贵的技术保留给少数未经MALDI-TOF高置信度鉴定的菌株。MALDI-TOF MS还有可能直接鉴定生物液体中的病原体，如尿样和血液培养。然而，对于这一应用，有必要进行进一步的精心设计的前瞻性研究。在血清型或菌株水平进行鉴定的潜力，以及在几分钟内进行抗生素耐药性分析，使MALDI-TOF质谱仪成为临床微生物学实验室正在进行的一场革命。
Abstract Recently, MALDI-TOF MS devices designed for use in clinical laboratories have been commercially introduced in various large centres worldwide. All published studies conclude that MALDI-TOF MS can be implemented easily for routine identification of bacteria and yeasts in a clinical microbiological laboratory. Although all data show that MALDI-TOF MS correctly identifies the great majority of isolates processed routinely, it cannot yet identify every such isolate. Until today, MALDI-TOF MS is inappropriate for the identification of Shigella species, pneumococci and viridans streptococci. Database upgrades and sample enrichment are essential elements to refine the MALDI-TOF MS technique, allowing the method to increase its power. For the identification of a significant proportion of yeasts, an extraction method prior to analysis in the mass spectrometer is mandatory to obtain appropriate spectra. Because of the low marginal costs, and the extreme speed of MALDI-TOF MS, the technique can improve laboratory efficiency when used early in identification protocols. Lengthier, more labour-intensive, and costlier techniques can be reserved for the minority of isolates not identified with high confidence by MALDI-TOF MS. MALDI-TOF MS also has the potential to directly identify pathogens in biological fluids, such as urine samples and blood cultures. For this application however, further well-designed prospective studies are warranted. The potential for identification at the serotype or strain level, and antibiotic resistance profiling within minutes make MALDI-TOF mass spectrometry an ongoing revolution in the clinical microbiology laboratory.