Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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Two-year Quaternary Isolation of Gram-positive Bacilli Using MALDI-TOF MS in Positive Blood Culture of a University Hospital

일개 대학병원의 혈액배양에서 MALDI-TOF MS를 이용한 Gram-positive Bacilli의 2년간 분기별 분리율

  • Choi, Jin-Un (Department of Laboratory Medicine, Chonnam National University Hospital) ;
  • Yu, Young-Bin (Department of Biomedical Laboratory Science, College of Medical Sciences, Konyang University) ;
  • Kim, Sang-Ha (Department of Laboratory Medicine, Konyang University Hospital) ;
  • Won, Seungho (Department of Mechanical Engineering, Konyang University) ;
  • Kim, Young-Kwon (Department of Biomedical Laboratory Science, College of Medical Sciences, Konyang University)
  • 최진언 (전남대학교병원 진단검사의학과) ;
  • 유영빈 (건양대학교 의과학대학 임상병리학과) ;
  • 김상하 (건양대학교병원 진단검사의학과) ;
  • 원승호 (건양대학교 기계공학과) ;
  • 김영권 (건양대학교 의과학대학 임상병리학과)
  • Received : 2018.08.18
  • Accepted : 2018.09.09
  • Published : 2018.12.31
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Abstract

In this study, Gram-positive bacilli (GPB) were identified by MALDI-TOF MS and analyzed according to the quaternary and microbial strains in the blood culture medium over a two year period at a university hospital. The results were as follows. The overall positive rate of blood culture was 9.97%. In 713 isolated GPB, 410 strains (57.5%) were identified using a microflex MALDI Biotyper. The positive rate of GPB among the blood culture positive bacteria was 8.2%, and the quarterly isolation rate was 9.8% in the third quarter of 2015, 8.7% in the second quarter of 2016, 8.1% in the third quarter of 2016, 8.1% in the first quarter of 2015, 7.9% in the first quarter of 2015, 7.9% in the second quarter of 2015, 6.8% in the first quarter of 2016, and 6.7% in the fourth quarter of 2015. The isolates were Corynebacterium striatum 89 (12.4%), Bacillus cereus 60 (8.4%), Bacillus subtilis 30 (4.2%), Paenibacillus urinalis 29 (4.1%), and Listeria monocytogenes 25 (3.5%). The results of 16S rRNA sequencing of 43 isolates (86.0%) were consistent with those of the other 50 isolates. Five out of the seven unmatched weeks were not identified by MALDI-TOF MS.

본 연구에서는 일개 대학병원에서 2년간 분리된 혈액배양 양성배지에서 MALDI-TOF MS system을 이용하여 Gram-positive bacilli를 동정한 결과를 균종별, 분기별로 분석하였다. Corynebacterium striatum은 총 89균주 중 66균주 (74.2%), Bacillus cereus는 60균주 중 44 균주 (73.3%), Listeria monocytogenes는 25균주 중 25균주 (100%)로 2.0이상의 높은 스코어에서 동정되었다. 미 동정 된 균주는 303균주 중 293균주는 혈액배양에서 1회 분리 균주로 감염균으로서의 의의가 없는 오염 균주로 간주되었다. 감염균으로서 의의가 있는 동일 환자 2회 이상 분리 균주 대상 16S-rRNA sequencing 비교결과 총 50균주 중 43균주가 일치해 86.0% 동정이 가능하였다. 일치하지 않은 7균주 중 5균주는 MALDI-TOF MS로도 동정이 되지 않았다. 결론적으로 혈액배양에서 Gram-positive bacilli가 동정되는 경우, 일차적으로 MALDI-TOF MS를 이용하여 동정해보고 이를 활용한다면 어렵고 비용이 많이 들던 Gram-positive bacilli 동정이 저비용으로 더욱 간편하고 정확해지며, Gram-positive bacilli에 의한 감염 진단에도 도움이 될 것으로 판단된다.

Keywords

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