两种细菌鉴定仪对临床分离细菌鉴定结果的比较

Identification of clinical isolates with two bacterial identification systems： a comparative study

目的比较并评价两种细菌鉴定仪，基质辅助激光解吸电离飞行时间质谱Bruker MALDI Biotyper系统和Vitek 2 Compact在临床分离菌株鉴定中的应用。方法收集2015年8-9月海军总医院分离自血液、尿液、脑脊液、分泌物和痰液等临床标本的常见细菌558株，应用Vitek 2 Compact和Bruker Biotyper两种细菌鉴定仪对其进行鉴定，比较两种仪器的鉴定结果。结果对于558株临床分离菌，Bruker Biotyper鉴定结果为28个属，Vitek 2 Compact鉴定结果为24个属，两仪器菌属鉴定一致的有22个属；鉴定结果菌种一致的符合率占91．0％（508株），菌属一致的符合率占94．8％（529株），其中沙门氏菌属占0．2％（1株）两种仪器只鉴定到属；革兰阴性菌鉴定到种的符合率与革兰阳性菌和真菌无明显差异（P〉0．05）。结论BrukerBiotyper系统鉴定细菌快速、准确、操作简单、成本低，适合于临床细菌的常规鉴定，但数据库仍需进一步完善。

Objective Two identification systems, Matrix assisted laser desorption ionization time of flight mass spectrometry system and VITEK 2 Compact were compared for the efficiency of identification of clinically relevant bacteria. Methods The 558 selected clinical isolates tested in this study were isolated from clinical samples of blood, urine, eerebrospinal fluid ,secretion, sputum et al, and were obtained from the navy general hospital from Aug 2015 to Sep 2015,then the isolated strains were identification with the use of Bruker Biotyper bacterial identification system and VITEK 2 Compact bacterial identification system at the same time, at last the identification result identified by the ＂two devices were compared. Results the 558 strains bacteria from clinical samples were divided into 28 genuses by Bruker Biotyper and were divided into 24 genuses by VITEK 2 Compact. There are 22 genera that were identified by both two devices, among the result of two devices, the agreement rate of identification of species reached 91.0%, the agreement rate of identification of genus reached 94.8%.While, the salmonella which take a rate of 0.2% in clinical isolates are identified to genus by both two instrument. The agreement rate of identification of species of gram-negative bacteria was not significantly more than gram-positive bacteria and fungus （P 〉0.05）. Conclusion The Bruker Biotyper system is rapid, accurate, and convenient, low cost in the identification and diagnosis in the clinical laboratory. Still, the database needs to be further improved.