MALDI-TOF MS在呼吸道感染丝状真菌鉴定中的应用

The application of MALDI - TOF MS technique for the identification of filamentous fungi from respiratory tract infection

目的用MALDI—TOFMS技术和形态学方法对139株丝状真菌进行鉴定，评估MALDI—TOFMS技术在丝状真菌鉴定中的应用。方法将从临床呼吸道标本培养分离出来的139株丝状真菌，经过预处理后，用法国梅里埃公司生产的质谱仪（VITEKMs）进行鉴定，并将结果与传统形态学鉴定方法结果进行对比。结果质谱仪对139株丝状真菌正确鉴定率为82．7％（115／139）；对曲霉属的鉴定正确率达到90．8％（108／119），其中烟曲霉和黄曲霉的鉴定正确率均为1。0％（77／77、21／21），黑曲霉的鉴定正确率50．0％（8／16），其他曲霉菌的鉴定正确率为40．0％（2／5）；对青霉属的鉴定正确率为58．3％（7／12）；对毛霉菌的正确鉴定率为0％（0／3）。呼吸道感染丝状真菌以曲霉菌属为主（89．2％），其中又以烟曲霉（55．4％）、黄曲霉（15．1％）和黑曲霉（11．5％）多见。结论MALDI—TOFMS技术能快速准确鉴定常见丝状真菌，为丝状真菌的鉴定带来革命性突破，但对少见丝状真菌的鉴定仍有待于数据库的进一步完善。

Objective Using MALDI - TOF MS technique and morphological method to identify filamentous fungi isolated from respiratory tract,and to evaluate the role of mass spectrometry analysis for the identification of filamentous fungi. Methods 139 strains filamentous fungi isolated from clinical respiratory specimens were identified by the mass spectrometer（VITEK MS） of Bi- oMerieux after pretreatment,and the results were compared with the results of traditional morphological method. Results The correct identification rate of the mass spectrometer to 139 strains filamentous fungi was 82.70%（115/139）% the accuracy of Aspergillus reached 90.8% （108/119） ,the accuracy of Aspergillus fumigatus and Aspergillus flavus were both 100%（77/77.21/21） ,Aspergil- lus niger was 50.0^（8/16） ,and other aspergillus was 40.0%（2/5）; the accuracy of penicillium was 58.3%（7/12） ; the accuracy of mucor; was 0K （0/3）. The most strains of filamentous fungi causing respiratory tract infection is aspergillus species（89.2%） ,in order to Aspergillus fumigatus（55.4%）,Aspergillus flavus（15.1%） and aspergillus Niger （11.5%）. Conclusion MALDI - TOF MS technology can accurately identify common filamentous fungi quickly, bring a revolutionary breakthrough for identification of filamentous fungi, but the database for identification of rare filamentous fungi are still to be improved.