Update on Matrix Assisted Laser Desorption Ionization Mass Spectrometry (MALDI-TOF MS) in the Clinical Microbiology Laboratory

最新質譜儀在臨床微生物實驗室應用

自2009年基質輔助雷射解離飛行時間質譜法（MALDI-TOF MS，簡稱質譜儀）引入臨床微生物實驗室的應用後，質譜儀已徹底改變了微生物的鑑定。與傳統的生化鑑定方法相比，質譜儀提供了多個優勢，包括易於使用、快速、準確和價格合理。這項技術有潛力克服許多與細菌和真菌鑑定相關的困難。此外，多年來不斷更新的數據庫，診斷醫學技術持續的研發，解決了許多問題。抗生素敏感性測試、亞型分類、微生物脂質分析、病毒學鑑定以及其他應用也獲得了顯著進展。這些優勢為傳染性疾病提供高質量診斷數據，最終將有助於患者的治療和預後。此外，快速鑑定微生物對於醫院內和社區感染以及傳染病爆發流行病學的問題極為重要。本文將探討使用質譜儀進行細菌、分枝桿菌和真菌臨床鑑定的挑戰，並討論這一技術在臨床微生物學實驗室中的應用和現狀。

Since its introduction into clinical microbiology laboratories in 2009, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has revolutionized the field. Compared to traditional biochemical identification methods, MALDI-TOF MS offers several advantages, including ease of use, speed, accuracy, and affordability. This technology has the potential to overcome many of the barriers associated with bacterial and fungal identification. Moreover, the database has been continuously updated over the years, and many limitations have been addressed through ongoing research in diagnostic medicine. Besides, antibiotic susceptibility testing, subtyping, microbial lipid analysis, virological identification, and other applications have also made significant progress as well. These advantages provide high-quality diagnostic data for infectious diseases, ultimately benefiting patient treatment and prognosis. Additionally, the rapid identification of microorganisms is crucial for addressing epidemiological issues, such as nosocomial and community infections, and outbreaks of infectious diseases. This review will explore the challenges of using MALDI-TOF MS for clinical identification of bacteria, mycobacteria, and fungi. We also discuss the technology’s applications and status in the clinical microbiology laboratory.