Rapid identification of uropathogens is needed to determine appropriate antimicrobial therapy. This study evaluated performance of the Alfred 60 system combined with matrix-assisted laser desorption/ionization–time-of-flight mass spectrometry (MALDI-TOF MS) technology for rapid identification of uropathogens. The Alfred 60 system was used to screen urine cultures, followed by identifying the microbial pathogen in positive cultures using MALDI-TOF MS. The Alfred 60 detected positive cultures by measuring the turbidity of urine samples, which were transferred automatically to vials containing liquid medium and incubated for 3.5 h at 35 °C in the Alfred 60 system. Vials that showed growth were removed and centrifuged. The pellet was subjected to MALDI-TOF MS identification. In parallel, positive urine samples were inoculated onto agar plates for identification by conventional culture. The time required to detect positive urine cultures with Alfred 60 and identify the uropathogens with MALDI-TOF MS ranged from 15 min to 3.5 h. Among 146 positive urine samples tested, conventional cultures showed three culture groups: group 1 included 101 samples with growth of a single type of microorganism; group 2 included 34 samples with 2 types of microorganisms; and group 3 included 11 samples with ≥ 3 types of microorganisms. Direct identification by MALDI-TOF MS was concordant with 95% of the samples in group 1, 100% of the principal microorganism in group 2, but could not identify microorganisms in group 3. This combination of methods provides rapid, reliable microbial identification for most positive urine cultures.

需要快速鉴定尿路致病菌，以确定适当的抗菌治疗。这项研究评估了Alfred 60系统与基质辅助激光解吸/电离飞行时间质谱（MALDI-TOF MS）技术相结合，用于快速鉴定尿路致病菌的性能。使用Alfred 60系统筛选尿液培养物，然后使用MALDI-TOF MS鉴定阳性培养物中的微生物病原体。Alfred 60通过测量尿液样品的浊度来检测阳性培养物，将其自动转移到装有液体培养基的小瓶中，并在Alfred 60系统中于35°C孵育3.5 h。显示生长的小瓶被去除并离心。对沉淀进行MALDI-TOF MS鉴定。在平行下，将阳性尿液样品接种到琼脂平板上，以通过常规培养进行鉴定。用Alfred 60检测阳性尿培养物并用MALDI-TOF MS鉴定尿路致病菌所需的时间为15分钟至3.5小时。在146个测试的尿液阳性样本中，常规培养显示了3个培养组：第1组包括101种具有单一类型微生物生长的样品；第2组包括34种带有两种类型微生物的样品；第3组包括11种样品，其中微生物类型≥3种。MALDI-TOF MS进行的直接鉴定与第1组中95％的样品一致，第2组中100％的主要微生物，但无法鉴定第3组中的微生物。这种方法的结合为大多数微生物提供了快速，可靠的微生物鉴定尿培养阳性。