Lallemand Elise, Arvieux Cédric, Coiffier Guillaume, Polard Jean-Louis, Albert Jean-David, Guggenbuhl Pascal, Jolivet-Gougeon Anne
EA 1254 Microbiologie/INSERM NUMECAN, Université de Rennes 1, 2, avenue du Pr Léon Bernard, 35043 Rennes, France; Pole Biologie, Rennes University Hospital, 35043 Rennes, France.
Service des Maladies Infectieuses, Rennes University Hospital, 2 rue Henri Le Guilloux, 35043 Rennes, France; Centre de Référence en Infections Ostéo-Articulaires du Grand Ouest (CRIOGO), France.
Res Microbiol. 2017 Feb-Mar;168(2):122-129. doi: 10.1016/j.resmic.2016.09.005. Epub 2016 Sep 24.
Advantages of MALDI-TOF MS (MS) were evaluated for diagnosis of bone and joint infections after enrichment of synovial fluid (SF) or crushed osteoarticular samples (CSs). MS was performed after enrichment of SF or crushed osteoarticular samples CS (n = 108) in both aerobic and anaerobic vials. Extraction was performed on 113 vials (SF: n = 47; CS: n = 66), using the Sepsityper kit prior identification by MS. The performances of MS, score and reproducibility results on bacterial colonies from blood agar and on pellets after enrichment in vials, were compared. MS analysis of the vial resulted in correct identification of bacteria at a species and genus level (80.5% and 92% of cases, respectively). The reproducibility was superior for aerobic Gram-positive bacteria (Staphylococci and Gram-positive bacilli: 100% colonies), as compared to aerobic Gram-negative bacilli (89.7%), anaerobes (83.3%) and Streptococcus/Enterococcus (58.8%). MS performance was significantly better for staphylococci than for streptococci on all identification parameters. For polymicrobial cultures, identification (score>1.5) of two species by MS was acceptable in 92.8% of cases. Use of MS on enrichment pellets of bone samples is an accurate, rapid and robust method for bacterial identification of clinical isolates from osteoarticular infections, except for streptococci, whose identification to species level remains difficult.
在对滑液（SF）或粉碎的骨关节样本（CS）进行富集后，评估基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS，简称MS）在诊断骨与关节感染方面的优势。在需氧和厌氧小瓶中对SF或粉碎的骨关节样本CS（n = 108）进行富集后开展MS检测。在通过MS进行鉴定之前，使用Sepsityper试剂盒对113个小瓶（SF：n = 47；CS：n = 66）进行提取。比较了MS在血琼脂上的细菌菌落以及小瓶富集后的沉淀上的性能、评分和重复性结果。对小瓶进行MS分析可在种属水平正确鉴定细菌（分别为80.5%和92%的病例）。与需氧革兰氏阴性杆菌（89.7%）、厌氧菌（83.3%）和链球菌/肠球菌（58.8%）相比，需氧革兰氏阳性菌（葡萄球菌和革兰氏阳性杆菌：100%菌落）的重复性更佳。在所有鉴定参数上，MS对葡萄球菌的性能明显优于链球菌。对于混合菌培养，MS对两种菌的鉴定（评分>1.5）在92.8%的病例中是可接受的。除链球菌外，对骨关节感染临床分离株进行细菌鉴定时，使用MS对骨样本富集沉淀进行检测是一种准确、快速且可靠的方法，而链球菌的种水平鉴定仍然困难。
