Abstract：Objective: To explore the application of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) combined with tuberclebacillus- simultaneous amplification and testing (TB-SAT) in the diagnosis of non-tuberculous mycobacteria (NTM) pulmonary disease. Methods: A total of 152 suspected NTM lung disease patients admitted to Hebei Provincial Chest Hospital from January 2020 to December 2024 were selected for MALDI-TOF MS and TB-SAT examination of bronchoalveolar lavage fluid (BALF) specimens. The diagnostic criteria for NTM lung disease were used as the gold standard to analyze the efficacy of MALDI-TOF MS and TB-SAT in screening NTM lung disease and their consistency with the gold standard. The efficacy of MALDI-TOF MS and TB-SAT in jointly diagnosing NTM lung disease and the distribution of NTM lung bacteria species was analyzed. Results: Based on the diagnostic criteria for NTM lung disease, 80 cases (53.63%) were finally diagnosed, with 46.51% primarily involving Mycobacterium intracellulare; the positive rates of MALDI-TOF MS and TB-SAT for detecting NTM pulmonary disease were 81.25% and 78.75%, respectively. The Kappa values of the two detection techniques for consistency with the gold standard were 0.533 (95%CI: 0.376-0.691) and 0.538 (95%CI: 0.378-0.697), respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of MALDI-TOF MS and TB-SAT combined diagnosis were higher than those of single Screening (P<0.05). The consistency of the combined diagnosis of NTM pulmonary pathogen distribution and gold standard by MALDI-TOF MS and TB-SAT was 0.882 (95%CI: 0.757-1.007). Conclusion: The combined detection of MALDI-TOF MS and TB-SAT has good diagnostic value in NTM lung disease, which can improve diagnostic accuracy and provide strong support for accurate clinical diagnosis of NTM.
[1] Hashimoto M,Iwabuchi H,Satoh T.Improvement of ionization efficiency and application of structural analysis for MALDI-TOF MS by derivatization of polyacrylic acid[J].Mass Spectrom (Tokyo),2023,12(1):A0139. [2] Lee DH,Nwanochie E,Clayton KN,et al.Real-time visualization of HIV-1 RNA detection using loop-mediated isothermal amplification-enabled particle diffusometry[J].ACS Sens,2024,9(10):5541-5549. [3] 中华医学会结核病学分会.非结核分枝杆菌病诊断与治疗指南(2020年版)[J].中华结核和呼吸杂志,2020,43(11):918-946. [4] Epola Dibamba Ndanga M,Achimi Agbo Abdul JBP,Edoa JR,et al.Non-tuberculous mycobacteria isolation from presumptive tuberculosis patients in Lambarene,Gabon[J].Trop Med Int Health,2022,27(4):438-444. [5] Hashemzadeh M,Dezfuli AA,Khosravi AD,et al.Molecular identification of non-tuberculous mycobacterial species isolated from extrapulmonary samples using real-time PCR and rpoB sequence analysis[J].AMB Express,2023,13(1):43. [6] Zweijpfenning SMH,Aarnoutse R,Boeree MJ,et al.Safety and efficacy of clofazimine as an alternative for rifampicin in mycobacterium avium complex pulmonary disease treatment:outcomes of a randomized trial[J].Chest,2024,165(5):1082-1092. [7] Martin EC,Limousin L,Renaux C,et al.Evaluation of the mycobacteria MBT kit for identification of nontuberculous mycobacteria by MALDI-TOF Biotyper (Bruker)[J].Diagn Microbiol Infect Dis,2023,107(3):116044. [8] 欧维正,雷毅娜,王琼,等.三种分子诊断技术对肺外结核诊断价值的比较[J].贵州医药,2021,45(3):406-408. [9] 高绪胜,丁彩红,王庆,等.核酸基质辅助激光解吸电离飞行时间质谱技术在痰涂片阴性非结核分枝杆菌肺病中的诊断价值[J].中华临床感染病杂志,2024,17(1):58-63. [10] Zhao X,Cui K,Bai L,et al.Diagnostic value of SAT-TB in smear-negative pulmonary tuberculosis:a diagnostic accuracy study[J].Medicine (Baltimore),2024,103(50):40907. [11] Ishikawa S,Ozeki Y,Suga S,et al.Monitoring IgG against mycobacterium tuberculosis proteins in an Asian elephant cured of tuberculosis that developed from long-term latency[J].Sci Rep,2022,12(1):4310. [12] Maboni G,Prakash N,Moreira MAS.Review of methods for detection and characterization of non-tuberculous mycobacteria in aquatic organisms[J].Vet Diagn Invest,2024,36(3):299-311.
2025, Vol. 31 
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