UMR CNRS, IRD, IFR, Université de la Méditerranée, Marseille, France.
Clin Microbiol Infect. 2010 Nov;16(11):1620-5. doi: 10.1111/j.1469-0691.2010.03290.x.
Matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry (MS) initiated a revolution in the identification of organisms grown on solid medium, including bacteria and fungi. Rapid identification of organisms responsible for septicaemia, which are typically grown in broth, is now expanding the field of application. Despite the fact that there are fewer than ten reports in the literature, published data indicate that MALDI-TOF MS yields accurate identification of blood-borne organisms in ≥80% of cases for inocula of >10⁷ organisms/mL. A major current limitation is failure to accurately identify Streptococcus pneumoniae among viridans steptococci. Identification is achieved in <2 h, sharply reducing the turn-around time for communication of identification to the clinician. Further progress in handling protocols and automation, and extraction of antibiotic resistance data from the MALDI-TOF MS spectra, will further push this emerging approach as the standard one in the laboratory diagnosis of septicaemia, paving the way to application in further clinical situations and clinical specimens.
基质辅助激光解吸电离飞行时间（MALDI-TOF）质谱（MS）在鉴定固体培养基上生长的生物体方面引发了一场革命，包括细菌和真菌。快速鉴定引起败血症的生物体的能力正在扩展其应用领域，这些生物体通常在肉汤中生长。尽管文献中不到 10 份报告，但已发表的数据表明，对于接种物>10⁷个/mL 的血液来源生物体，MALDI-TOF MS 在≥80%的情况下产生准确的鉴定结果。目前的一个主要限制是无法准确鉴定草绿色链球菌中的肺炎链球菌。鉴定可在 2 小时内完成，大大缩短了将鉴定结果传达给临床医生的周转时间。在处理方案和自动化方面的进一步进展，以及从 MALDI-TOF MS 谱中提取抗生素耐药性数据，将进一步推动这种新兴方法成为败血症实验室诊断的标准方法，为在进一步的临床情况和临床标本中的应用铺平道路。
