哥伦比亚四级医院采用 MALDI-TOF MS 进行早期血流感染诊断的内部方案和性能：充分利用该技术。
In-house protocol and performance of MALDI-TOF MS in the early diagnosis of bloodstream infections in a fourth-level hospital in Colombia: Jumping to full use of this technology.
机构信息
Unidad de Proteomica y Micosis Humanas, Grupo de Investigación en Enfermedades Infecciosas, Departamento de Microbiología, Pontificia Universidad Javeriana, Bogotá, Colombia; Grupo de Investigación en Enfermedades Infecciosas, Hospital Universitario San Ignacio, Colombia.
Laboratorio Clínico, Área de Microbiología, Hospital Universitario San Ignacio, Bogotá D.C, Colombia.
出版信息
Int J Infect Dis. 2020 Dec;101:85-89. doi: 10.1016/j.ijid.2020.09.1469. Epub 2020 Oct 1.
BACKGROUND
Bloodstream infections (BSIs) are a major cause of mortality in hospitalized patients. Rapid diagnosis is crucial because any delay in the antimicrobial treatment is associated with an increase in adverse patient outcomes. The application of matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) technology directly to blood cultures permits earlier identification of BSIs and facilitates treatment management.
METHODS
A total of 470 positive blood cultures from patient samples were analyzed using Standard Aerobic/F and Anaerobic/F blood culture media. Isolates were identified using conventional identification methods and by the direct method using the MALDI-TOF MS system.
RESULTS
In 470 blood cultures, the direct method showed good identification results (420/470, 89%); specifically, accurate species and genus identification in 283/470 (60%), and only correct genus identification in 137/470 (29%). The direct protocol had better performance for Gram-negative compared to Gram-positive bacteria (97% vs 76%) and was unable to identify the positive blood cultures for both yeasts and some bacteria, mostly Gram-positive (50/470).
CONCLUSIONS
The protocol used here gave good and reliable results, being available up to 24 h earlier, while also leading to better use of MALDI-TOF.
背景
血流感染（BSI）是住院患者死亡的主要原因。快速诊断至关重要，因为抗菌治疗的任何延迟都与患者不良预后的增加有关。将基质辅助激光解吸电离飞行时间（MALDI-TOF）技术直接应用于血培养可以更早地识别 BSI，并有助于治疗管理。
方法
使用标准需氧/F 和厌氧/F 血培养培养基对来自患者样本的 470 份阳性血培养物进行了分析。使用常规鉴定方法和 MALDI-TOF MS 系统的直接方法对分离物进行鉴定。
结果
在 470 份血培养物中，直接法显示出良好的鉴定结果（420/470，89%）；具体而言，在 283/470 份（60%）中进行了准确的种属鉴定，在 137/470 份（29%）中仅进行了正确的属鉴定。直接方案对革兰氏阴性菌的性能优于革兰氏阳性菌（97%对 76%），并且无法鉴定阳性血培养物中的酵母和某些细菌，主要是革兰氏阳性菌（50/470）。
结论
这里使用的方案给出了良好且可靠的结果，可提前 24 小时获得，同时也更好地利用了 MALDI-TOF。
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