MALDI-TOF MS与TB-SAT联合检测在非结核分枝杆菌病诊断中的应用

doi:10.3969/j.issn.1006-6233.2025.09.027

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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.

Key words： MALDI-TOF MS TB-SAT Non-tuberculous mycobacteria diseases Diagnosis

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.09.027 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I9/1563

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