MALDI-TOF MS在常规标本病原菌鉴定和细菌耐药性检测中的应用及进展

Application and progress of MALDI-TOF MS in pathogenic bacterial identification and bacterial drug-resistant detetction in routine samples

病原菌能够入侵宿主体内并产生致病物质造成宿主感染,耐药菌的出现更是严重影响了患者的生活质量和临床微生物的检验、治疗进程。本文就基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)在常规标本病原菌鉴定和耐药菌检测中的应用及进展进行总结,概述了MALDI-TOF MS对血培养阳性标本、尿路感染标本和呼吸道感染标本中病原菌的鉴定,并将耐药菌的检测按是否借助抗菌药物分为直接检测和间接检测两方面,检测耐药菌的特征峰、所产酶和细胞组分的方法为直接检测,通过加入抗菌药物以检测耐药菌的方法为间接检测。MALDI-TOF MS在病原菌鉴定和耐药菌检测方面有良好的效果,凭借其操作简便、省时、精确、高通量、低成本等优势,在未来同样具备很大的潜力。各实验室应建立符合自己实验室的MALDI-TOF MS检测体系,规范标本前处理、基质选择等,缩短检测周转时间,为临床提供准确的检验报告,指导感染患者的救治。

Pathogenic bacteria can invade the host body and produce the pathogenic substances to cause host infection,and the emergence of drug-resistant bacteria has seriously affected the quality of life of the patients and the process of clinical microbiological examination and treatment.The application and progress of matrix-assisted laser desorption ionization time of flight mass spectrometry(MALDI-TOF MS)in identification of pathogenic bacteria and detection of drug-resistant bacteria in conventional specimens are reviewed in this paper.The identification of pathogenic bacteria in blood culture positive specimens,urinary tract infection specimens and respiratory tract infection specimens by MALDI-TOF MS is summarized,and the detection of drug-resistant bacteria is divided into the direct detection and indirect detection according to whether using the help of the antibacterial drugs.The method of detecting the characteristic peaks,produced enzymes and cell components of drug-resistant bacteria is the direct detection.The indirect detection is performed by adding antibacterial drugs to detect the resistant bacteria.MALDI-TOF MS has good effect in the aspects of the pathogenic bacterial detection and drug-resistant bacterial detection.With its advantages of simple operation,time-saving,precision,high throughput and low cost,it also has great potential in the future.Each laboratory should establish the MALDI-TOF MS detection system suitable for own laboratory,standardize the specimen pre-treatment,matrix selection,etc.,shorten the test turnaround time to provide the accurate test reports to the clinic and guide the treatment of the patients.