质谱仪在真菌鉴定中的应用与评价

Application and evaluation of mass spectrometry in identification of fungal infection

目的探讨质谱仪在真菌感染中的应用,评价其鉴定真菌的能力。方法选取分离自我院住院患者的真菌菌株327株,用质谱仪进行快速鉴定,并与VITEK-2(酵母样真菌)和显微镜检查(丝状真菌)的鉴定结果进行比对,差异结果用分子生物学方法确认鉴定。结果依照质谱仪评分标准,227株酵母样真菌在种水平(>2.0)的鉴定率为90.31%,在属水平(>1.7)为98.68%;丝状真菌在种水平的鉴定率为74.00%,在属水平为94.00%。对临床常见的曲霉菌鉴定正确率可达96.74%。结论质谱仪在鉴定真菌的种属水平上都达到了令人满意的结果,尤其鉴定酵母菌和曲霉菌的能力更为突出,可作为临床实验室的常规检测方法。

Objective To investigate the application of mass spectrometry to the fungal infection, and to evaluate its ability to identify fungal infection. Methods Totally 327 strains of fungi isolated from the inpatients admitted to our hospital were selected, and identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry （MALDI-TOF MS）. The results were then compared with those of the identification by VITEK-2 （yeast-like fungi） and microscope （filamentous fungi）. Molecular biology methods were used to confirm the identification. Results The results of the identification by MALDI-TOF MS showed that identification rate of yeast-like fungi at species level （score〉2.0） was 90.31%, and that at the genus level （score〉1.7） was 98.68%;identification rate of fila-mentous fungi at species level was 74.00%, and that at the genus level was 94.00%. The accuracy of identification of Aspergillus could reach 96.74%. Conclusions Fungal species can be well identified by MALDI-TOF MS, especially yeasts and Aspergillus. The identifi-cation by MALDI-TOF MS can be used as routine detection method for clinical laboratory.