Ye Zhiyi, Zhu Jin, Liu Yang, Lu Jun
Department of Clinical Laboratory, Quzhou People's Hospital, the Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China.
Microb Biotechnol. 2025 Jun;18(6):e70184. doi: 10.1111/1751-7915.70184.
Use matrix-assisted laser desorption ionisation time-of-flight mass spectrometry (MALDI-TOF MS) to screen the specific mass peaks of carbapenem-resistant Klebsiella pneumoniae (CRKP), compare the differences in spectrum peaks between intestinal and bloodstream screening of CRKP, and assess the utility of MALDI-TOF MS in quickly identifying various CRKP sources. From 2014 to 2023, a total of 267 Klebsiella pneumoniae strains were collected at Quzhou People's Hospital, including 60 intestinal screening isolates from ICU patients and 207 bloodstream infection isolates. MALDI-TOF MS was used to profile peptides in CRKP and carbapenem-sensitive Klebsiella pneumoniae (CSKP), followed by analysis with flexAnalysis and ClinProTools 3.0. Statistically significant protein peaks were selected to build classification models, which were verified using non-duplicate strains. MALDI-TOF MS achieved > 99.9% accuracy in identifying Klebsiella pneumoniae. Characteristic peaks (2523.43, 3041.62, 4520.11, 10,079.18 Da) were used to develop resistance analysis models, with the optimal model (SNN) showing 90.08% sensitivity, 95.80% specificity and identification accuracies of 90% for CSKP and 89.66% for CRKP. Another model using peaks (8876, 8993, 9139 Da) differentiated CRKP origins, with the ideal model (QC) achieving 86.85% sensitivity, 88.46% specificity, and accuracies of 81.82% for bloodstream and 95.00% for intestinal CRKP.
使用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）筛选耐碳青霉烯类肺炎克雷伯菌（CRKP）的特异性质量峰，比较CRKP肠道筛查和血流筛查的谱峰差异，并评估MALDI-TOF MS在快速鉴定各种CRKP来源方面的效用。2014年至2023年，衢州市人民医院共收集了267株肺炎克雷伯菌，其中包括60株来自ICU患者的肠道筛查分离株和207株血流感染分离株。使用MALDI-TOF MS对CRKP和碳青霉烯类敏感肺炎克雷伯菌（CSKP）中的肽进行分析，随后用flexAnalysis和ClinProTools 3.0进行分析。选择具有统计学意义的蛋白质峰建立分类模型，并用非重复菌株进行验证。MALDI-TOF MS在鉴定肺炎克雷伯菌方面的准确率>99.9%。使用特征峰（2523.43、3041.62、4520.11、10079.18 Da）建立耐药性分析模型，最佳模型（SNN）的灵敏度为90.08%，特异性为95.80%，CSKP的鉴定准确率为90%，CRKP的鉴定准确率为89.66%。另一个使用峰（8876、8993、9139 Da）区分CRKP来源的模型，理想模型（QC）的灵敏度为86.85%，特异性为88.46%，血流CRKP的准确率为81.82%，肠道CRKP的准确率为95.00%。
