Application of MALDI-TOF MS in rapid identification of positive pathogens from blood culture in Children

doi:10.3877/cma.j.issn.2095-5820.2021.01.011

Abstract

Abstract:

Objective

To establish a rapid and accurate method for the identification of pathogens from positive blood culture in children, shorten the identification time ofbloodstream infection, and evaluate the feasibility of clinical trials.

Methods

The bacteria were enriched and purified directly from positive blood culture bottle by separation gel tube. Pre-treated blood culture positive samples were identified using MALDI-TOF MS. The coincidence rate of MALDI-TOF MS rapid identification was compared with pure culture of pathogenic.

Results

Among 100 blood culture positive samples, except 3 false positive samples and 3 mixed infection samples, the total coincidence rate of MALDI-TOF MS and pure culture was 89.0% by using the revised scoring standard for rapid identification, while Gram-positive cocci and Gram-negative bacilli were 96.2% (50/52) and 92.6% (25/27) respectively, only 3 of 7 fungi were identified consistent (42.9%) according to the adjusted scoring criteria.

Conclusion

The rapid identification method of MALDI-TOF MS for positive samples from blood culture of children has high accuracy and short time consumption for the identification of pathogenic bacteria in bloodstream infection, which is feasible for clinical application, and can meet the requirements of early and rapid diagnosis of pathogenic bacteria in bloodstream infection. However, the pretreatment for fungal samples needs to be improved.

Key words: MALDI-TOF MS, Bloodstream infection, Rapid identification, Children

Shuhui Wang, Siqi Liu, Qiulian Deng, Huamin Zhong, Xiaoshan Guan, Lianfen Huang, Kankan Gao, Haiying Liu. Application of MALDI-TOF MS in rapid identification of positive pathogens from blood culture in Children[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2021, 09(01): 53-58.

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References 25

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菌名	株数(%)	标准截断值		无法鉴定鉴定错误	株数(%)	修正截断值		无法鉴定鉴定错误
		鉴定到种	鉴定到属			鉴定到种	鉴定到种
		评分≥2.0	评分≥1.7			评分≥1.8	评分≥1.5
表皮葡萄球菌	11(90.9)	4(36.4)	6(54.5)	1(9.1)	11(90.9)	9(81.8)	1(9.1)	1(9.1)
金黄色葡萄球菌	12(100)	12(100)	0	0	12(100)	12(100)	0	0
头状葡萄球菌	3(100)	1(33.3)	2(66.7)	0	3(100)	2(66.7)	1(33.3)	0
人型葡萄球菌	9(100)	3(33.3)	6(66.7)	0	9(100)	8(88.9)	1(11.1)	0
溶血性葡萄球菌	2(50)	1(50)	0	1(50)	2(100)	1(50)	1(50)	0
沃式葡萄球菌i	2(100)	1(50)	1(50)	0	2(100)	2(100)	0	0
山羊葡萄球菌	1(100)	0	1(100)	0	1(100)	1(100)	0	0
粪肠球菌	3(100)	2(66.7)	1(33.3)	0	3(100)	3(100)	0	0
屎肠球菌	1(100)	1(100)	0	0	1(100)	1(100)	0	0
无乳链球菌	3(100)	3(100)	0	0	3(100)	3(100)	0	0
肺炎链球菌	4(100)	4(100)	0	0	4(100)	4(100)	0	0
缓症链球菌	1(0)	0	0	1(100)	1(0)	0	0	1(100)
合计	52	32(61.5)	17(32.7)	3(5.8)	52	46(88.5)	4(7.7)	2(3.8)

菌名	株数(%)	标准截断值		无法鉴定鉴定错误	株数(%)	修正截断值		无法鉴定鉴定错误
		鉴定到种	鉴定到属			鉴定到种	鉴定到种
		评分≥2.0	评分≥1.7			评分≥1.8	评分≥1.5
表皮葡萄球菌	11(90.9)	4(36.4)	6(54.5)	1(9.1)	11(90.9)	9(81.8)	1(9.1)	1(9.1)
金黄色葡萄球菌	12(100)	12(100)	0	0	12(100)	12(100)	0	0
头状葡萄球菌	3(100)	1(33.3)	2(66.7)	0	3(100)	2(66.7)	1(33.3)	0
人型葡萄球菌	9(100)	3(33.3)	6(66.7)	0	9(100)	8(88.9)	1(11.1)	0
溶血性葡萄球菌	2(50)	1(50)	0	1(50)	2(100)	1(50)	1(50)	0
沃式葡萄球菌i	2(100)	1(50)	1(50)	0	2(100)	2(100)	0	0
山羊葡萄球菌	1(100)	0	1(100)	0	1(100)	1(100)	0	0
粪肠球菌	3(100)	2(66.7)	1(33.3)	0	3(100)	3(100)	0	0
屎肠球菌	1(100)	1(100)	0	0	1(100)	1(100)	0	0
无乳链球菌	3(100)	3(100)	0	0	3(100)	3(100)	0	0
肺炎链球菌	4(100)	4(100)	0	0	4(100)	4(100)	0	0
缓症链球菌	1(0)	0	0	1(100)	1(0)	0	0	1(100)
合计	52	32(61.5)	17(32.7)	3(5.8)	52	46(88.5)	4(7.7)	2(3.8)

菌名	株数(%)	标准截断值		无法鉴定鉴定错误	株数(%)	修正截断值		无法鉴定鉴定错误
		鉴定到种	鉴定到属			鉴定到种	鉴定到种
		评分≥2.0	评分≥1.7			评分≥1.8	评分≥1.5
大肠杆菌	9(100)	9(100)	0	0	9(100)	9(100)	0	1(9.1)
肺炎克雷伯氏菌	4(100)	4(100)	0	0	4(100)	4(100)	0
铜绿假单胞菌	5(100)	5(100)	0	0	5(100)	5(100)	0
鲍曼不动杆菌	1(100)	1(100)	0	0	1(100)	1(100)	0
嗜麦芽窄食单胞菌	1(100)	0	1(100)	0	1(100)	1(100)	0
马耳他布鲁菌	2(100)	2(100)	0	0	2(100)	2(100)	0
皮特不动杆菌	1(100)	1(100)	0	0	1(100)	1(100)	0
猪霍乱沙门菌	1(100)	1(100)	0	0	1(100)	1(100)	0
产气肠杆菌	1(100)	1(100)	0	0	1(100)	1(100)	0
奥斯陆莫拉菌	2(0)	0	0	2(100)	2(0)	0	0	2(100)
合计	27	24(88.9)	1(3.7)	2(7.4)	27	25(92.6)	0	2(7.4)

菌名	株数(%)	标准截断值		无法鉴定鉴定错误	株数(%)	修正截断值		无法鉴定鉴定错误
		鉴定到种	鉴定到属			鉴定到种	鉴定到种
		评分≥2.0	评分≥1.7			评分≥1.8	评分≥1.5
大肠杆菌	9(100)	9(100)	0	0	9(100)	9(100)	0	1(9.1)
肺炎克雷伯氏菌	4(100)	4(100)	0	0	4(100)	4(100)	0
铜绿假单胞菌	5(100)	5(100)	0	0	5(100)	5(100)	0
鲍曼不动杆菌	1(100)	1(100)	0	0	1(100)	1(100)	0
嗜麦芽窄食单胞菌	1(100)	0	1(100)	0	1(100)	1(100)	0
马耳他布鲁菌	2(100)	2(100)	0	0	2(100)	2(100)	0
皮特不动杆菌	1(100)	1(100)	0	0	1(100)	1(100)	0
猪霍乱沙门菌	1(100)	1(100)	0	0	1(100)	1(100)	0
产气肠杆菌	1(100)	1(100)	0	0	1(100)	1(100)	0
奥斯陆莫拉菌	2(0)	0	0	2(100)	2(0)	0	0	2(100)
合计	27	24(88.9)	1(3.7)	2(7.4)	27	25(92.6)	0	2(7.4)

菌名	株数(%）	标准截断值		无法鉴定鉴定错误	株数(%）	修正截断值		无法鉴定鉴定错误
		鉴定到种	鉴定到属			鉴定到种	鉴定到种
		评分≥2.0	评分≥1.7			评分≥1.8	评分≥1.5
合计	5	0	3(60）	2(40）	5	2(40）	1(20）	2(40）
短小芽胞杆菌	1(100）	0	1(100）	0	1(100）	1(100）	0	0
极小棒状杆菌	1(0）	0	0	1(100）	1(0）	0	0	1(100）
蜡样芽胞杆菌	1(0）	0	0	1(100）	1(0）	0	0	1(100）
人皮杆菌	1(100）	0	1(100）	0	1(100）	0	1(100）	0
纹带棒杆菌	1(100）	0	1(100）	0	1(100）	1(100）	0	0

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