基質輔助雷射脫附游離飛行質譜儀(MALDI-TOF MS)鑑定臨床上常見非挑剔性革蘭氏陰性桿菌的效能

Performance of Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry in the Identification of Aerobic Non-fastidious Gram-Negative Bacilli Commonly Encountered in a Clinical Laboratory

陳云萱(Yun Syuan Chen) ； 歐宇祥(Yu-hsiang Ou) ； 蔡岳廷(Yueh-Ting Tsai) ； 蔡文城(Wen-cherng Tsai)

《檢驗及品保雜誌》 5卷4期 (2016/12) Pp. 123-131

https://doi.org/10.6573/JTQA.201612_5(4).01

摘要

近幾年來，基質輔助雷射脫附游離飛行質譜儀(Matrix-assisted laser desorption ionization-time of flight mass spectrometry，MALDI-TOF MS)常被作為臨床微生物鑑定的工具，由於嗜氧性非挑剔性革蘭氏陰性桿菌(GNB)為臨床上最常分離的臨床微生物，為了確認此儀器鑑定常見GNB 的實用性，本研究利用2011至2016 年所收集的GNB 共1,008 株（包括18 個菌種，分別屬於16 個菌屬）以Bruker MALDI-TOF MS進行鑑定，然後將結果與傳統鑑定方法進行正確性的比較，結果指出MALDI-TOF MS 鑑定至菌種層次的正確性為94.74%(955/1,008)，而至菌屬層次為99.8%(1,006/1,008) 。未能鑑定或錯誤鑑定的菌種包括Aeromonas、Burkholderia、Enterobacter 及Shigella，因此這些菌的正確鑑定需配合傳統鑑定方法如顯微鏡下的形態、菌落特徵、生理及生化試驗或血清分型試驗才能準確鑑定。根據本研究的發現，吾等認為使用MALDI-TOF MS 鑑定臨床上常見非挑剔性革蘭氏陰性桿菌，能提高鑑定效能，降低檢驗室的人力及物力，可作為檢驗室有效的微生物鑑定工具。

關鍵字

MALDI-TOF MS ； 非挑剔嗜氧性革蘭氏陰性桿菌

並列摘要

For the past five years, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has been implemented by many large laboratories as a tool for routine microbial identification. Aerobic and facultatively aerobic, non-fastidious Gram-negative bacilli (GNB) are the type of bacilli most commonly encountered in clinical laboratories, so their practical identification through the use of MALDI-TOF MS needs to be verified. In this study, a total of 1,008 strains of GNB (comprised of 18 species and 16 genera) isolated between 2011 and 2016 were subjected to identification by both the conventional and MALDI-TOF MS methods. The results obtained for both methods were then compared and analyzed. The results indicated that the accuracy of identification to the species level was 94.74% and genus level 99.8% (1,006/1,008) .Those GNB not identified correctly or for which the rates of incorrect identification were higher belonged to the Aero-monas, Burkholderia, Enterobacter and Shig ella genera. Therefore, their colonial and microscopic characteristics needed to be checked with physiological and biochemical follow-up tests in order to improve their rates of correct identification. Based on the above findings, we conclude that MALDI-TOF MS can be implemented for the identification of common GNB isolates obtained in clinical laboratories. The benefits of using MALDI-TOF MS were higher rates of correct identification, shorter laboratory turnaround times, and minimal laboratory waste materials.

並列關鍵字

Conventional and MALDI-TOF MS methods ； common GNB isolates