目的评价基质辅助激光解析电离飞行时间质谱技术(MALDI-TOF MS)对耐甲氧西林金黄色葡萄球菌(MRSA)分子分型的应用价值。方法收集2009年1月-2012年3月来自上海、重庆、广州、沈阳、乌鲁木齐、北京6个城市共270株MRSA,经多位点序列分析(MLST)表型主要为St239、St5、St59、St45 4个基因型,使用ClinProTools软件建立模型,并用剩余菌株验证得出模型的敏感性和特异性;随机选取试验组35株St239,对照组43株包括20株St5、15株St59、8株St45构建模型St239;随机选取试验组8株St45,对照组35株包括11株St5、8株St59、16株St239构建模型St45。结果 154株St239、72株St5、30株St59、14株St45经检测显示,模型St239、St45、St5的交叉效度和可接受度均为100.0%,仅模型St59的交叉效度为90.5%,其可接受度也为100.0%;模型St45能正确区分出St45的敏感性和特异性均为100.0%,模型St239能正确区分出St239的敏感性是95.8%以及特异性为93.2%,模型St59能正确区分出St59的敏感性为86.7%以及特异性为91.7%,模型St5能正确区分出St5的敏感性为50.0%以及特异性为95.8%。结论 MALDI-TOF MS分型与MLST具有较好的一致性,且具有操作简便、快速、低成本、重复性好、稳定性高的优点。 Objective To evaluate the value of matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) for molecular typing of methicillin-resistant Staphylococcus aureus (MRSA). Methods January 2009 - March 2012 from Shanghai, Chongqing, Guangzhou, Shenyang, Urumqi, Beijing six cities a total of 270 MRSA, by sequence analysis of multiple sites (MLST) phenotype mainly St239, St5, St59, St45. 4 genotypes using ClinProTools software model, and the model of the sensitivity and specificity obtained with a residual strain verification; 35 randomly selected test group ST239, the control group 43 comprises 20 lines St59,8 strain St45 St5,15 St239 was constructed; St45 was randomly selected from the experimental group, and 35 strains from the control group included 11 strains of St5, 8 strains of St59 and 16 strains of St239, St45. Results 154 St239,72 St5,30 strain strain strain St45 detected St59,14 display, model ST239, St45, cross validity and acceptability of 100.0% St5 are cross St59 model validity only 90.5% their acceptability is also 100.0%; model correctly distinguish St45 St45 sensitivity and specificity are both 100%, model St239 St239 correctly distinguish the sensitivity was 95.8% and the specificity was 93.2%, the model can St59 The sensitivity and specificity of St59 were 86.7% and 91.7% respectively. St5 was able to correctly distinguish St5 with 50.0% and 95.8% respectively. Conclusion MALDI-TOF MS classification has good consistency with MLST, and has the advantages of simple operation, fast, low cost, good repeatability and high stability.