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Abstract：
Aim: To standardize MALDI-TOF-MS based identification and antifungal susceptibility (AFST) for yeasts directly from automated blood cultures to reduce turnaround time. Materials & methods: Direct-ID after lysis-centrifugation (0.5% SDS) standardized in 40 and validated in 250 yeast positive samples. Direct-AFST was standardized with fluconazole (28 samples) and evaluated (70 samples) for seven antifungals. Results: Direct-ID had a high sensitivity (97.2%) and specificity (94.3%). Correct species-level identification showed 100% in C. tropicalis, C. krusei, C. parapsilosis. Direct-AFST had a 100% categorical agreement with culture-AFST for posaconazole, anidulafungin and >90% categorical agreement for amphotericin B, voriconazole and fluconazole. Conclusion: Direct-ID and subsequent direct-AFST is a rapid and robust method to reduce the turnaround time for the diagnosis of invasive candidiasis.
摘要：
目的：将基于MALDI-TOF-MS的鉴定和抗真菌敏感性（AFST）标准化，以直接从自动血液培养物中获得酵母，以减少周转时间。材料和方法:裂解-离心后的直接ID(0.5%SDS)在40个酵母阳性样品中标准化并在250个酵母阳性样品中验证。用氟康唑（28个样品）对直接-AFST进行了标准化，并对7种抗真菌药进行了评估（70个样品）。结果：Direct-ID具有较高的敏感性（97.2％）和特异性（94.3％）。正确的物种水平鉴定在热带梭菌中显示100％，C.Krusei,C.近平滑。直接-AFST与泊沙康唑的培养-AFST有100%的绝对一致性，Anidulafungin和两性霉素B>90%的分类一致性，伏立康唑和氟康唑.结论：直接ID和随后的直接AFST是一种快速，可靠的方法，可以减少诊断侵袭性念珠菌病的周转时间。
