Imai Minako, Kimura Yukio, Tanno Daiki, Saito Kyoichi, Honda Mutsuko, Takano Yukiko, Ohashi Kazutaka, Toyokawa Masahiro, Ohana Noboru, Yamadera Yukio, Shimura Hiroki
Department of Clinical Laboratory Medicine, Fukushima Medical University Hospital.
Department of Laboratory Medicine, Fukushima Medical University.
Fukushima J Med Sci. 2020 Aug 4;66(2):103-112. doi: 10.5387/fms.2020-09. Epub 2020 Jul 22.
In hospital microbial laboratories, morphological and biochemical analyses are performed to identify pathogenic microbes;however, these procedures lack rapidity and accuracy. Recently, Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) has been clinically utilized, and is expected to enable rapid and accurate microbial identification. We aimed to validate two MALDI-TOF MS devices available in Japan: the VITEK-MS (BioMérieux) and the Microflex LT (Bruker Daltonics). Clinically isolated bacteria, 100 samples in all, detected in blood cultures but incompletely identified by conventional procedures, were reanalyzed using the two devices. The VITEK-MS and Microflex LT, respectively, identified 49% (49/100) and 80% (80/100) of the tested bacteria at the species level, as well as 96% (96/100) and 95% (95/100) at the genus level. Among those reidentified strains, 26% (26/100) at the species level and 88% (88/100) at the genus level were concordant with each other, though three strains were unmatched. Moreover, four bacterial strains were unable to be identified using the VITEK-MS, versus five using the Microflex LT. MALDI-TOF MS devices can provide more rapid and accurate bacterial identification than ever before;however, the characteristics of each system were slightly different;therefore, it is necessary to understand the difference in performance of MALDI-TOF MS models.
在医院微生物实验室中，会进行形态学和生化分析以鉴定致病微生物；然而，这些方法缺乏快速性和准确性。最近，基质辅助激光解吸/电离飞行时间质谱（MALDI-TOF MS）已在临床中得到应用，并有望实现快速、准确的微生物鉴定。我们旨在验证日本现有的两种MALDI-TOF MS设备：VITEK-MS（生物梅里埃公司）和Microflex LT（布鲁克道尔顿公司）。对临床分离的细菌进行重新分析，这些细菌共100个样本，在血培养中检测到但通过传统方法未完全鉴定。分别使用这两种设备对其进行重新分析。VITEK-MS和Microflex LT在种水平上分别鉴定出49%（49/100）和80%（80/100）的测试细菌，在属水平上分别鉴定出96%（96/100）和95%（95/100）。在那些重新鉴定的菌株中，种水平上26%（26/100）和属水平上88%（88/100）彼此一致，不过有三株不匹配。此外，有四株细菌无法用VITEK-MS鉴定，而用Microflex LT无法鉴定的有五株。MALDI-TOF MS设备能够提供比以往更快速、准确的细菌鉴定；然而，每个系统的特性略有不同；因此，有必要了解MALDI-TOF MS不同型号在性能上的差异。
