目的 利用基质辅助激光解吸电离飞行时间质谱系统(VITEK-MS)对体液培养阳性瓶进行直接鉴定,探索快速诊断临床致病菌的新策略。方法 收集体液培养阳性瓶,不经琼脂平板培养,直接利用VITEK-MS进行鉴定,并与传统生化鉴定的方法进行比较分析。结果 50例体液培养阳性瓶中,传统细菌鉴定法检出47株阳性菌,3例阴性;而VITEK-MS直接鉴定法检出31株阳性菌,同样3例阴性。VITEK-MS直接鉴定法灵敏度达65.96%,特异度为100%,临床符合率为68%。鉴定时间从24小时缩短到2小时。结论 利用VITEK-MS质谱系统直接鉴定体液培养阳性标本中的病原菌,能有效缩短细菌鉴定时间,准确快速地诊断临床致病菌。

Objective To find a fast method for detection of pathogens in positive culture bottles by using the VITEK-MS system. Methods VITEK-MS microbial identification system was used to directly identify the bacteria in the positive culture bottles, without culture on agar plates. The identification results were further compared with those by the traditional biochemical identification. Results Forty-seven bacterial strains were identified by traditional biochemical methods among 50 positive culture bottles, and 3 of them were negative. Of these 50 samples, thirty-one bacterial strains were identified by VITEK-MS and 3 were also negative. The sensitivity and specificity for direct VITEK-MS identification were 65.96% and 100%, and the clinical coincidence rate was 68%. The turn around time for identification was reduced from 24 to 2 hours. Conclusion Direct identification of bacterial pathogens in positive culture bottles by VITEK-MS could reduce turn around time, and lead to accurate and fast diagnosis.