中国现代医生2026，Vol.64Issue(22)：17-22,6.DOI:10.3969/j.issn.1673-9701.2026.22.005
基质辅助激光解吸电离飞行时间质谱法在结核分枝杆菌鉴定与耐药检测中的应用研究
Application of matrix-assisted laser desorption ionization time-of-flight mass spectrometry in the identification and drug resistance detection of Mycobaterium tuberculosis
摘要
Abstract
Objective To evaluate the value of matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS)for rapid identification of Mycobacterium tuberculosis complex(MTBC)and prediction of rifampicin(RIF)and isoniazid(INH)resistance.Methods A total of 150 clinical specimens from suspected tuberculosis patients at Wenzhou Central Hospital,Affiliated to Wenzhou Medical University from January 2024 to January 2025 were collected.Culture and phenotypic drug susceptibility testing were used as the gold standard.After pretreatment,MALDI-TOF MS was performed directly and after short-term culture enrichment.Using machine learning to analyze protein fingerprint patterns,a random forest prediction model for RIF and INH resistance was constructed.Results The success rate of MALDI-TOF MS direct method in identifying MTBC was 70.00%(91/130),after short-term culture,the identification success rate of MALDI-TOF MS for MTBC reached 96.15%(125/130),with a significant difference(P<0.001).Twenty-six resistance-associated protein peaks were identified.The random forest model predicted RIF resistance with an area under the curve(AUC)of 0.93(sensitivity 91.70%,specificity 89.30%)and INH resistance with an AUC of 0.88.The model predictions were highly consistent with genotypic resistance.Conclusion MALDI-TOF MS combined with short-term culture enables efficient identification of MTBC,and the machine learning model based on protein fingerprints accurately predicts RIF and INH resistance,providing a novel strategy for rapid tuberculosis diagnosis and resistance screening.关键词
基质辅助激光解吸电离飞行时间质谱法/结核分枝杆菌/耐药性/蛋白质组学/机器学习Key words
Matrix-assisted laser desorption ionization time-of-flight mass spectrometry/Mycobacterium tuberculosis/Drug resistance/Proteomics/Machine learning分类
医药卫生引用本文复制引用
潘宁,邱伟霞,吴正兴,刘赛朵..基质辅助激光解吸电离飞行时间质谱法在结核分枝杆菌鉴定与耐药检测中的应用研究[J].中国现代医生,2026,64(22):17-22,6.基金项目
浙江省温州市科研项目(Y2023384) （Y2023384）
