各种基于基质辅助激光解吸电离飞行时间质谱（Maldi-Tof MS）的快速鉴定方法的准确性--作为印度南部血液培养实验室加强诊断管理的工具。

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology Pub Date : 2024-10-28 DOI:10.1016/j.ijmmb.2024.100747

Sonali Padhy , Ketan Priyadarshi , Sarumathi Dhandapani , Apurba Sankar Sastry

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引用次数: 0

摘要

背景：血流感染是一种与高发病率和高死亡率相关的医疗急症。直接从阳性血培养物中迅速鉴定出导致血流感染的微生物，可缩短病原体识别的周转时间，从而大大加强对病人的护理：方法：对 256 个新鲜标记阳性血培养瓶进行革兰氏染色。方法：共对 256 个新鲜的标记阳性血培养瓶进行革兰氏染色，然后采用溶解离心、溶解过滤和 VITEK® MS BC 试剂盒等样品制备技术直接进行 MALDI-TOF MS 分析，以直接鉴定阳性血培养物中的微生物。此外，还采用了 Choco spot 和微小菌落（8-10 小时）的短期培养方法。所有阳性培养瓶均采用实验室常规（参考）方法进行鉴定：结果：177 个分离菌株（69.14%）通过裂解离心法得到了正确鉴定，163 个分离菌株（63.67%）通过裂解过滤法得到了正确鉴定，206 个分离菌株（80.47%）通过巧克力斑点法得到了正确鉴定，250 个分离菌株（97.65%）通过菌落微量培养法（8-10 小时）得到了正确鉴定。在 162 个分离物中，115 个分离物（70.99%）被 VITEK® MS 血液培养试剂盒（生物梅里埃）正确鉴定。VITEK® MS BC试剂盒方法的卡帕值为0.697，比裂解离心法（0.672）和裂解过滤法（0.611）的卡帕值高：在通过 MALDI-TOF MS 分析从阳性血液培养物中直接正确鉴定细菌方面，溶菌离心法与 VITEK® MS BC 试剂盒法相当，而溶菌过滤法优于 VITEK® MS BC 试剂盒法。与过夜培养法相比，裂解离心法只需 10 分钟的处理时间，因此在临床实验室中，它是 VITEK® MS BC 试剂盒的廉价替代品。通过这项研究，我们已将基于 MALDI-TOF 的阳性 BC 直接鉴定纳入了日常诊断管理中。

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Accuracy of various matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)-based rapid identification methods—As a tool to augment diagnostic stewardship in blood culture laboratory, South India

Background

Blood stream infection is a medical emergency associated with high morbidity and mortality. Prompt identification of bloodstream infection-causing microorganisms directly from positive blood culture will significantly enhance patient care by reducing the turnaround time of pathogen recognition.

Methods

A total of 256 freshly flagged positive blood culture bottles were subjected to Gram staining. Direct MALDI-TOF MS analysis was performed following sample preparation techniques such as lysis centrifugation, lysis filtration and VITEK® MS BC kit to directly identify microorganisms from positive blood cultures. Along with these short-term incubation methods of Choco spot and minute colony(8–10h) were also performed. All those positive bottles were identified by the routine (reference) laboratory method.

Results

177 isolates (69.14 %) were correctly identified by Lysis centrifugation, 163 isolates (63.67 %) were correctly identified by Lysis filtration, 206 isolates (80.47 %) were correctly identified by Choco spot,250 isolates (97.65 %) were correctly identified from minute colony (8–10h) of incubation. Of 162 isolates,115 isolates (70.99 %) were correctly identified by VITEK® MS Blood culture kit, (BioMérieux). VITEK® MS BC kit method revealed higher agreement with the kappa value of 0.697 than lysis centrifugation (0.672) followed by lysis filtration (0.611).

Conclusions

In house method of lysis centrifugation is found to be equivalent to VITEK® MS BC kit method and superior to lysis filtration method in correct direct identification of bacteria from positive blood cultures by MALDI-TOF MS analysis. As lysis centrifugation requires only 10 min of processing time as compared to overnight incubation, thus it offers a less expensive substitute for the VITEK® MS BC kit in the clinical laboratory. As a consequence of this study, we have implemented direct MALDI-TOF-based identification from positive BCs in our daily routine diagnostic management.

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来源期刊

Indian Journal of Medical Microbiology IMMUNOLOGY-

CiteScore

2.20

自引率

0.00%

发文量

154

审稿时长

73 days

期刊介绍： Manuscripts of high standard in the form of original research, multicentric studies, meta analysis, are accepted. Current reports can be submitted as brief communications. Case reports must include review of current literature, clinical details, outcome and follow up. Letters to the editor must be a comment on or pertain to a manuscript already published in the IJMM or in relation to preliminary communication of a larger study. Review articles, Special Articles or Guest Editorials are accepted on invitation.