MALDI-TOF-MS技术在肉芽肿性乳腺炎脓液棒状杆菌检测中的应用研究

Application of MALDI-TOF-MS Technique in the Detection of Corynebacterium in the Pus of Granulomatous Mastitis

目的:研究拟通过基质辅助激光解吸电离飞行时间质谱(MALDI-TOF-MS)技术在脓液克氏棒状杆菌(CK)鉴定过程中的应用探索,为临床微生物实验室对CK的准确鉴定提供帮助。方法:无菌条件下分别采集2019年1月-2021年7月镇江市妇幼保健院乳腺科门诊及病房30例经病理确诊为肉芽肿性乳腺炎(GM)患者手术中获取的新鲜脓肿穿刺液标本,用于细菌、真菌、结核菌涂片检查及需氧菌、厌氧菌培养。结果:采用梅里埃VITEK2compact全自动细菌鉴定仪进行生化鉴定,结果表明,23株菌鉴定为CK,其余7株菌均鉴定失败或错误。布鲁克MALDIBiotyper质谱仪鉴定结果27株为CK,仅3株菌鉴定失败,该结果与16SrRNA测序结果一致性较高,但是27份标本中鉴定为CK的质量分数相对较低。结论:MALDI-TOF-MS技术在棒状杆菌属细菌鉴定方面的应用可以为临床诊治GM方面提供病原学理论依据。

Objective:To explore the application of stroma-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF-MS)in the identification of corynebacterium kroppenstedtii in the clinical microbiology laboratory,in order to improve the ability of accurate identification of corynebacterium kroppenstedtii(CK).Methods:Under aseptic conditions,fresh abscess puncture fluid samples from 30 patients with pathologically confirmed granulomatous mastitis(GM)in the hospital from Jan.2019 to Jul.2021were collected from the outpatient department and wards of the breast department.The samples were used for smear examination of bacteria,fungi and tuberculosis bacteria and culture of aerobe and anaerobic bacteria.Results:23 strains were identified as Ck by Meriere VITEK2 compact automatic identification,and the remaining seven strains were all identified with failure or error.27 strains were identified as CK by Brooke MALDI Biotyper mass spectrometer,and only 3 strains failed to be identified.This result was in high agreement with the results of 16S r RNA sequencing,but the mass fraction of CK was relatively low in the 27 samples.Conclusion:The application of MALDI-TOF-MS technique in the identification of corynebacterium can provide theoretical basis for the clinical diagnosis and treatment of GM.