Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry（MALDI-TOF MS）2機種による血液培養分離菌の同定成績について

著者最終原稿版We compared the results of two bacterial identification methods: 1)a traditional method based on phenotypic identification of the causative organism using gram-staining, culture and biochemical markers and 2)matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). A total of 111 isolates, including 107 strains of common bacteria species and 4 strains of 3 yeast species, were tested by the traditional method and MALDI-TOF MS method (VITEK MS and Micro flex LT). Data obtained using MALDI-TOF MS were classified as Level 1 and Level 2 according to the confidence level of identification results from the VITEK MS ver. 1.0 database (VITEK MS) and MALDI Biotyper ver. 2.0 database (Microflex LT). The proportions of measured samples identified as Level 1 were 98.2% with the VITEK MS database and 87.4% with the MALDI Biotyper database. The concordance rates of the traditional method were 93.7% with the VITEK MS database and 82.0% with the MALDI Biotyper database. Identification results of five strains were mismatched between the traditional method and MALDI-TOF MS. Their ribosomal RNA sequences were identical to the results obtained from MALDI-TOF MS. We concluded that the performance of VITEK MS is superior to that of the traditional method and Microflex LT

術中大量出血時の外科、麻酔科、臨床検査部および輸血部の協力体制はいかにあるべきか(2) 術中大量出血に対して臨床検査部門ができること

著者最終原稿版The microvascular bleeding resulting from the dilutional coagulopathy can occur when patients with massive blood loss are treated by infusing a lot of crystalloids, colloids, and red blood cell concentrates. For the management of dilutional coagulopathy and the appropriate replacement therapy of with coagulation factors and platelets, we usually monitor the patient's course of with platelet count, conventional coagulation tests such as the prothrombin time, the activated partial prothrombin time, and the fibrinogen concentration. The central clinical laboratory has a responsibility for an accurate and quick report of these test results of patients with massive transfusion. Furthermore, use of point care testing is of clinical value to　fulfill a clinical demand in case with dilutional coagulopathy