de Carvalho Filho É B, Marson F A L, Levy C E
Department of Pediatrics, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
Department of Medical Genetics, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
New Microbes New Infect. 2017 Sep 13;20:27-33. doi: 10.1016/j.nmni.2017.09.002. eCollection 2017 Nov.
Rare nonfermenting Gram-negative bacilli, such as and have clinical importance in nosocomial infections and cystic fibrosis (CF), and their identification is a challenge to microbiology laboratories. Thus, the objective of this study was to verify the performance of phenotypic and mass spectrometry (matrix-assisted desorption ionization-time of flight mass spectrometry, MALDI-TOF MS) methods to identify and In this context, the results obtained with phenotypic methods-namely manual biochemical and automated VITEK 2 (bioMérieux, Marcy l'Etoile, France) and Phoenix tests (Becton Dickinson (BD), San Diego, CA, USA)-and by MALDI-TOF MS-namely MALDI-TOF VITEK MS (MALDI-MS; bioMérieux) and MALDI-TOF BioTyper (MALDI-BD; BD)-of 22 isolates (blood cultures of patients with nosocomial infection (n = 15) and from patients with CF (n = 7)), initially identified as and were compared. As result, using the manual phenotypic method, it was possible to identify the species level in 18/22; no identification was found in 4/22. There was a low agreement level between manual and VITEK 2 automated phenotypic methods when considering the genus level. The greatest agreement for genus-level identification occurred in MALDI-TOF MS equipment (15/22). When comparing all methods to identify the 22 isolates, there was agreement of 4/22 at the genus level and of 4/22 at the species level. In conclusion, there is low agreement level among identification methods of and Although MALDI-TOF MS equipment shows a higher agreement level among them, results present low levels of confidence.
罕见的非发酵革兰氏阴性杆菌，如[具体菌名缺失]和[具体菌名缺失]，在医院感染和囊性纤维化（CF）中具有临床重要性，其鉴定对微生物实验室来说是一项挑战。因此，本研究的目的是验证表型和质谱（基质辅助激光解吸电离飞行时间质谱，MALDI-TOF MS）方法对[具体菌名缺失]和[具体菌名缺失]的鉴定性能。在此背景下，对通过表型方法（即手动生化鉴定以及自动化的VITEK 2（法国生物梅里埃公司，马西伊图瓦勒）和Phoenix检测（美国BD公司，加利福尼亚州圣地亚哥））以及MALDI-TOF MS（即MALDI-TOF VITEK MS（MALDI-MS；生物梅里埃公司）和MALDI-TOF BioTyper（MALDI-BD；BD公司））对22株最初鉴定为[具体菌名缺失]和[具体菌名缺失]的分离株（来自医院感染患者（n = 15）和CF患者（n = 7）的血培养物）所获得的结果进行了比较。结果显示，使用手动表型方法，在22株中有18株能够鉴定到种水平；22株中有4株未得到鉴定结果。在考虑属水平时，手动和VITEK 2自动化表型方法之间的一致性水平较低。在MALDI-TOF MS设备中，属水平鉴定的一致性最高（22株中有15株）。当比较所有方法对这22株分离株的鉴定结果时，在属水平上有4/22的一致性，在种水平上有4/22的一致性。总之，[具体菌名缺失]和[具体菌名缺失]的鉴定方法之间一致性水平较低。尽管MALDI-TOF MS设备在它们之中显示出较高的一致性水平，但结果的置信度较低。
