核酸飞行时间质谱技术对结核与非结核分枝杆菌的菌种鉴定及耐药检测的应用

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Abstract Objective To evaluate the clinical value of nucleic acid time-of-flight mass spectrometry for the identification of mycobacterium tuberculosis (TB) or non-tuberculosis (NTM) and drug resistance detection. Methods A total of 199 patients with thoracic infectious diseases (excluding viral and fungal infections) admitted to our hospital from March 2020 to May 2022 were prospectively included. Sputum or bronchoalveolar lavage fluid were extracted for acid fast staining, colony culture and drug test, and nucleic acid mass spectrometry analysis, respectively, then to compare the diagnostic performance. Results According to clinical symptoms, imaging findings, colony culture and PCR results, 113 cases were confirmed to be TB positive, 51 cases were NTM positive and 35 cases were both negative. A total of 130 TB positive, 59 NTM positive and 10 negative were detected by nucleic acid mass spectrometry. The positive accuracy rate of TB detection by nucleic acid mass spectrometry was 88.4% [ (110+66) /199], sensitivity was 97.3% (110/113), specificity was 76.7% (66/86), positive predictive value was 84.6% (110/130), and negative predictive value was 95.7% (66/69). The positive accuracy of NTM detection was 92.0% [ (47+136) /199], sensitivity was 92.2% (47/51), specificity was 91.9% (136/148), positive predictive value was 79.7% (47/59), and negative predictive value was 97.1% (136/140). Compared with the other two detection methods, the failure rate of nucleic acid mass spectrometry was significantly lower, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of TB positive and NTM positive were significantly higher, and the detection time was significantly shorter (P<0.05). Nucleic acid mass spectrometry detected TB was mycobacterium tuberculosis complex, 9 kinds of NTM, 80 cases of TB resistance (70.8%, 80/113). Conclusion As a new technology for rapid identification of TB or NTM infection, nucleic acid mass spectrometry has a higher accuracy, sensitivity and specificity, which could provide detailed information of bacterial subtypes and drug resistance spectrum, and is of great significance in guiding clinical formulation of appropriate drug intervention programs and reducing the production of multi-drug resistant bacteria.

Key words： nucleic acid time-of-flight mass spectrometry mycobacterium tuberculosis non-tuberculous mycobacterium drug resistance

Received: 04 May 2023

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R446.5

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	RONG Xuesong
	YAO Chao
	HONG Qingqing

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RONG Xuesong,YAO Chao,HONG Qingqing. Application of nucleic acid time-of-flight mass spectrometry in the identification of mycobacterium tuberculosis or non-tuberculosis and drug resistance[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(4): 124-128.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2023/V20/I4/124

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