Advantages of Using Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry as a Rapid Diagnostic Tool for Identification of Yeasts and Mycobacteria in the Clinical Microbiological Laboratory
Advantages of Using Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry as a Rapid Diagnostic Tool for Identification of Yeasts and Mycobacteria in the Clinical Microbiological Laboratory
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DOI：
10.1128/jcm.01437-13
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发表时间：
2013-12-01
影响因子：
9.4
通讯作者：
Yuen, Kwok-Yung
中科院分区：
文献类型：
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作者：
Chen, Jonathan H. K.;Yam, Wing-Cheong;Yuen, Kwok-Yung
酵母菌和分枝杆菌可引起免疫功能低下患者和正常宿主的感染。这些微生物的快速鉴定可以显著改善病人的护理。利用基质辅助激光解吸电离飞行时间质谱法（MALDI-TOF MS）快速鉴定酵母菌和分枝杆菌的研究越来越多。然而，对Bruker Biotyper和bioMerieux Vitek MS系统在酵母和分枝杆菌鉴定方面的直接比较研究还很有限。本研究比较了两种系统对98株酵母菌和102株分枝杆菌分离株的鉴定性能。在98株酵母菌分离株中，这两种系统在bbb70 %的标本中都产生了种水平的鉴定，其中白色念珠菌是最常见的培养种。在属水平鉴定中，Biotyper系统比Vitek MS系统鉴定出更多的念珠菌（分别为75/78[96.2%]和68/78 [87.2%],P = 0.0426）和非念珠菌（分别为18/20[90.0%]和7/20 [35.0%],P = 0.0008）。对于分枝杆菌鉴定，Biotyper系统在固体培养基上分别对89株（87.3%）和64株（62.8%）临床分离株在属和种水平上进行了可靠的鉴定，而Vitek MS系统没有产生任何可靠的鉴定。尽管16S rRNA基因测序未发现脓肿分枝杆菌与chelonae分枝杆菌之间存在分化，但MS方法区分了12/21个临床种。总之，MALDI-TOF质谱法为酵母和分枝杆菌的鉴定提供了较短的周转时间和标准化的工作方案。我们的研究表明，MALDI-TOF质谱适合作为临床实验室酵母和分枝杆菌鉴定的一线检测方法。
Yeast and mycobacteria can cause infections in immunocompromised patients and normal hosts. The rapid identification of these organisms can significantly improve patient care. There has been an increasing number of studies on using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for rapid yeast and mycobacterial identifications. However, studies on direct comparisons between the Bruker Biotyper and bioMerieux Vitek MS systems for the identification of yeast and mycobacteria have been limited. This study compared the performance of the two systems in their identification of 98 yeast and 102 mycobacteria isolates. Among the 98 yeast isolates, both systems generated species-level identifications in >70% of the specimens, of which Candida albicans was the most commonly cultured species. At a genus-level identification, the Biotyper system identified more isolates than the Vitek MS system for Candida (75/78 [96.2%] versus 68/78 [87.2%], respectively; P = 0.0426) and non-Candida yeasts (18/20 [90.0%] versus 7/20 [35.0%], respectively; P = 0.0008). For mycobacterial identification, the Biotyper system generated reliable identifications for 89 (87.3%) and 64 (62.8%) clinical isolates at the genus and species levels, respectively, from solid culture media, whereas the Vitek MS system did not generate any reliable identification. The MS method differentiated 12/21 clinical species, despite the fact that no differentiation between Mycobacterium abscessus and Mycobacterium chelonae was found by using 16S rRNA gene sequencing. In summary, the MALDI-TOF MS method provides short turnaround times and a standardized working protocol for the identification of yeast and mycobacteria. Our study demonstrates that MALDI-TOF MS is suitable as a first-line test for the identification of yeast and mycobacteria in clinical laboratories.