MALDI—TOF MS检测产碳青霉烯酶肠杆菌科细菌的应用价值

Detection of carbapenem-producing Enterobacteriaceae by MALDI-TOF MS

目的评价基质辅助激光解析电离飞行时间质谱（MALDI-TOFMs）方法快速检测产碳青霉烯酶肠杆菌科细菌的价值。方法以34株产碳青霉烯酶肠杆菌科细菌及50株碳青霉烯类敏感肠杆菌科细菌为研究对象，美罗培南与细菌37℃孵育2h后，上清液进行MALDI-TOFMS检测。结果碳青霉烯类敏感肠杆菌科细菌的质谱峰有3个，质荷比（m／z）依次为384、406、428；而产碳青霉烯酶肠杆菌科细菌由于可以水解美罗培南，其质谱峰有6个，m／z依次为358、380、402、424、446、468，通过质谱峰的变化可以鉴定产碳青霉烯酶肠杆菌科细菌，MALDI—TOFMS法与测序法结果高度一致（P=1．000）。结论MALDI-TOFMS可以快速、准确检测产碳青霉烯酶的肠杆菌科细菌，指导临床合理使用抗生素。

Objective To evaluate a rapid matrix-assisted laser desorption ionization-time of flight mass spectrometry （MALDI-TOF MS） assay in detecting carbapenemase-producing Enterobacteriaceae. Methods Thirty-four carbapenemase-producing Enterobacteriaceae and 50 carbapenem susceptible Enterobacteriaceae clinical isolates were tested. After a 2-hour incubation of bacteria with meropenem, the mixtures were centrifuged and the supematants analyzed by MALDI-TOF MS. Results All spectra of carbapenem susceptible Enterobacteriaceae showed peaks of m/z 384,406,428 while those of carbapenemase-producing Enterobacteriaceae m/z 358, 380, 402, 424, 446, 468. And the assay of MALDI-TOF MS was highly consistent with sequencing （P = 1. 000 ）. Conclusion MALDI-TOF MS can detect carbapenemase- producing Enterobacteriaceae rapidly and accurately.