关键词: 基质辅助激光解吸电离飞行时间质谱, 人工关节置换, 关节液, 病原菌, 快速鉴定

Abstract:

Objective To study the role of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry（MALDI-TOF MS） combined with HB&L system to rapidly determine the bacteria from artificial joint replacement infection. Methods The synovial fluid samples of 104 patients with artificial joint replacement infection were collected and inoculated into blood culture flasks and conventional culture agar plates. Positive blood cultures were directly or routinely identified by MALDI-TOF MS,and the type and time of identification were recorded. Results Both direct and conventional MALDI-TOF MS determined a positive result of 84.8%（84/99）,but only 60.6%（60/99） was isolated by plate culture. The determination rates of Gram-positive and Gram-negative bacteria by HB&L direct MALDI-TOF MS were 86.9% and 91.9%,respectively,which were higher than those by gel direct MALDI-TOF MS（78.3% and 83.8%） and plate culture（70.1% and 67.6%）. Among the positive results of HB&L direct MALDI-TOF MS group,the determination rates of Staphylococcus aureus,Staphylococcus epidermidis,Escherichia coli and Klebsiella pneumoniae were high. The identification time of HB&L direct MALDI-TOF MS was shortened to 5-14 h,which was different from 45.2 h of conventional MALDI-TOF MS or 54.3 h of conventional culture. Conclusions Compared with conventional culture,HB&L direct MALDI-TOF MS shortens the time for microbial identification and has an accuracy rate,which provides a reference for the rapid diagnosis of pathogens in artificial joint replacement.

Key words: Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, Artificial joint replacement, Synovial fluid, Rapid identification