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应用基质辅助激光解吸电离飞行时间质谱技术直接从阳性血培养物中快速鉴定 6 岁发热患者的布鲁氏菌败血症/骨髓炎:病例报告。

Rapid identification of Brucella sepsis/osteomyelitis in a 6-year old febrile patient with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry directly from positive blood culture: a case report.

机构信息

Clinical laboratory department of Guangdong Women and Children's hospital, Xiaoping Mu, No.521 Xingnan Road, Panyu, 511400, Guagnzhou, China.

出版信息

BMC Infect Dis. 2019 Mar 11;19(1):240. doi: 10.1186/s12879-019-3864-z.

DOI:10.1186/s12879-019-3864-z
PMID:30871483
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6419399/
Abstract

BACKGROUND

Brucella is high-consequence pathogen and one of the most common seen laboratory- acquired infection pathogens. Quick and accurate detection of the pathogen will be of great important to reducing laboratory- acquired infection. Traditional biomedical reaction based method is time consumption, and mass spectrometry based method greatly reduces time consumption in pathogen identification. In the case presented here, we shared our experience in identification of Brucella directly from positive blood culture with mass spectrometry based method.

CASE PRESENTATION

The patient is a 6-year boy with a history of three weeks fever accompanied with sweating and a pain at right patella. The patient also has a history of thalassemia and blood transfusion was performed previously admitted to our hospital. Two bottles of marrow culture and one bottle of blood culture were positive, and direct mass spectrometry from positive culture material revealed Brucella infection within 1 h.

CONCLUSION

Clinical characters and laboratory findings of the patient presented here might help clinician in non-endemic region to made suspected brucellosis diagnose. Our experience in rapid identification of Brucella from positive blood culture with MALDI-TOF SP could help preventing laboratory-acquired infection of Brucella.

摘要

背景

布鲁氏菌是高后果病原体,也是最常见的实验室获得性感染病原体之一。快速准确地检测病原体对于减少实验室获得性感染非常重要。基于传统生物医学反应的方法耗时较长,而基于质谱的方法大大缩短了病原体鉴定的时间。在本例中,我们分享了使用基于质谱的方法直接从阳性血培养物中鉴定布鲁氏菌的经验。

病例介绍

患者为 6 岁男孩,发热 3 周,伴出汗和右髌骨疼痛。患者既往有地中海贫血病史,曾接受输血治疗,此次入院前骨髓培养两瓶阳性,一瓶血培养阳性,直接从阳性培养物进行基质辅助激光解吸电离飞行时间质谱(MALDI-TOF SP)分析 1 小时内提示布鲁氏菌感染。

结论

本例患者的临床特征和实验室检查结果有助于非流行地区的临床医生做出疑似布鲁氏菌病的诊断。我们使用 MALDI-TOF SP 从阳性血培养物中快速鉴定布鲁氏菌的经验有助于防止布鲁氏菌的实验室获得性感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8ef/6419399/e5b7f8a4e03e/12879_2019_3864_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8ef/6419399/e5b7f8a4e03e/12879_2019_3864_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8ef/6419399/e5b7f8a4e03e/12879_2019_3864_Fig1_HTML.jpg

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Development of a rapid and simplified protocol for direct bacterial identification from positive blood cultures by using matrix assisted laser desorption ionization time-of- flight mass spectrometry.开发一种快速且简化的方案,用于通过基质辅助激光解吸电离飞行时间质谱法直接从阳性血培养物中鉴定细菌。
BMC Microbiol. 2015 Nov 6;15:258. doi: 10.1186/s12866-015-0594-2.
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J Clin Microbiol. 2015 Oct;53(10):3349-52. doi: 10.1128/JCM.01493-15. Epub 2015 Jul 22.
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