MALDI-TOF技术在重症肺炎痰液样本病原菌检测和鉴定中的应用

Application of MALDI-TOF technique in the detection and identification of pathogenic bacteria in sputum samples of severe pneumonia

目的:观察基质辅助激光解吸电离飞行时间(Matrix-assisted laser desorption ionization-time of flight,MALDI-TOF)技术在重症肺炎痰液样本病原菌检测和鉴定中的应用效果。方法:选取我院2021年7月至2021年12月收治的214例重症肺炎患者为研究对象,分别采用MALDI-TOF技术、VITEK-2 Compact全自动微生物鉴定系统(VITEK 2 Compact automatic microbial analyze,VITEK-2)和基因测序法对患者痰液样本进行病原菌检测和鉴定,以基因测序法为金标准,比较两种检测方法对病原菌的鉴定结果,对比其他两种检测技术对病原菌的鉴定率以及鉴定结果差异。结果:214例重症肺炎痰液样本中,包括金黄葡萄球菌46例、表皮葡萄球菌33例、头部葡萄球菌7例、孔氏葡萄球菌6例、粪肠球菌4例、铜绿假单胞杆菌38例、肺炎克雷伯杆菌14例、不动杆菌12例、大肠埃希菌37例、阴沟肠杆菌7例、嗜麦芽杆菌3例、其他类型病菌7例。MALDI-TOF技术对重症肺炎痰液样本病原菌鉴定准确率明显高于VITEK-2技术(P<0.05)。两组检测技术漏诊率比较差异无统计学意义(P>0.05),MALDI-TOF技术对重症肺炎痰液样本病原菌误诊率明显低于VITEK-2技术(P<0.05)。结论:MALDI-TOF技术在重症肺炎痰液样本病原菌检测和鉴定中,能快速且准确鉴定出病原菌信息,为临床诊治提供可靠依据。

Objective:To observe the application effects of matrix-assisted laser desorption ionization-time of flight(MALDI-TOF)mass spectrometry in the detection and identification of pathogenic bacteria in sputum samples of severe pneumonia.Methods:214 patients with severe pneumonia treated in the hospital between July 2021 and December 2021 were selected as the research subjects.MALDI-TOF technique,VITEK 2 Compact automatic microbial analyze(VITEK-2)technique and gene sequencing method were used to detect and identify the pathogenic bacteria in sputum samples of patients.The gene sequencing method as the gold standard,the identification results of the two detection methods for pathogenic bacteria were compared,and the differences in identification rate and identification results of the other two detection techniques were compared.Results:Among the sputum samples from 214 patients with severe pneumonia,there were 46 cases of Staphylococcus aureus,33 cases of Staphylococcus epidermidis,7 cases of Staphylococcus cephalica,6 cases of Staphylococcus cohnii,4 cases of Enterococcus faecalis,38 cases of Pseudomonas aeruginosa,14 cases of Klebsiella pneumoniae,12 cases of Acinetobacter,37 cases of Escherichia coli,7 cases of Enterobacter cloacae,3 cases of Bacillus maltophilia and 7 cases of other types of pathogenic bacteria.The identification accuracy rate of pathogenic bacteria in sputum samples of severe pneumonia by MALDI-TOF technique was significantly higher than that by VITEK-2 technique(P<0.05).There was no statistical significance in the missed diagnosis rate between the two groups(P>0.05),and the misdiagnosis rate of pathogenic bacteria identification in sputum samples of severe pneumonia by MALDI-TOF technique was significantly lower compared with that by VITEK-2 technique(P<0.05).Conclusion:MALDI-TOF technique can quickly and accurately identify pathogenic bacteria in the detection and identification of pathogenic bacteria in sputum samples of severe pneumonia,and provide a reliable basis for clinical diagnosis and treatment.