1887

Abstract

Several studies have used matrix-assisted laser desorption ionization-time of flight MS (MALDI-TOF) with a serum separator tube (SST) to perform rapid identification of microorganisms directly from positive blood cultures (BCs), with different performances and methodologies.

The use of TSS could significantly reduce the time of identification of microorganisms that produce bacteremia.

Our goals were to evaluate bacterial identification by MALDI-TOF using a method based on an SST and compare it with MALDI-TOF after subculture for 18–24 h.

BCs no more than 1 h after a positive growth signal were included in the study. Analysis of results was expressed as a score. Information about time to a positive signal and number of microorganisms was collected.

In total, 253 BCs were analysed; 45.5 % gave a reliable result, 23.3 % an unreliable result and 31.2 % an error in identification. In gram-negative and gram-positive bacteria, the percentages of reliable results were 83.5 and 21.8 %, respectively. According to time to positive signal, the percentages of correct identification and mean score were 81.1 % (99/122) and 1.89±0.30 in Group 1 (<15 h); and 57.2 % (75/131) and 1.70±0.32 in Group 2 (>15 h), respectively ( <0.001). According to the number of microorganisms, the corresponding percentages of correct identification and mean scores were: Group 1 [≤50 microorganisms observed per field (MOF)], 50/94 (53.19 %) and 1.72±0.32; Group 2 (51–100 MOF): 44/66 (66.67 %) and 1.85±0.34; Group 3 (>100 MOF): 79/93 (84.94 %) and 1.84±0.31.

This method allowed us to obtain a high percentage of the aetiological agent of bacteraemia in less than 30 min after a positive BC.

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2020-11-23
2021-01-19
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References

  1. WHO | Sepsis 2018; WHO [Internet]. https://www.who.int/sepsis/en/
  2. Garnacho-Montero J, Ortiz-Leyba C, Herrera-Melero I, Aldabó-Pallás T, Cayuela-Dominguez A et al. Mortality and morbidity attributable to inadequate empirical antimicrobial therapy in patients admitted to the ICU with sepsis: a matched cohort study. J Antimicrob Chemother 2008; 61:436–441 [CrossRef][PubMed]
    [Google Scholar]
  3. Kumar A, Roberts D, Wood KE, Light B, Parrillo JE et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 2006; 34:1589–1596 [CrossRef][PubMed]
    [Google Scholar]
  4. Kumar A, Ellis P, Arabi Y, Roberts D, Light B et al. Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest 2009; 136:1237–1248 [CrossRef][PubMed]
    [Google Scholar]
  5. Harbarth S, Garbino J, Pugin J, Romand JA, Lew D et al. Inappropriate initial antimicrobial therapy and its effect on survival in a clinical trial of immunomodulating therapy for severe sepsis. Am J Med 2003; 115:529–535 [CrossRef][PubMed]
    [Google Scholar]
  6. Perez KK, Olsen RJ, Musick WL, Cernoch PL, Davis JR et al. Integrating rapid pathogen identification and antimicrobial stewardship significantly decreases hospital costs. Arch Pathol Lab Med 2013; 137:1247–1254 [CrossRef][PubMed]
    [Google Scholar]
  7. Ibrahim EH, Sherman G, Ward S, Fraser VJ, Kollef MH. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest 2000; 118:146–155 [CrossRef][PubMed]
    [Google Scholar]
  8. Bazzi AM, Rabaan AA, El Edaily Z, John S, Fawarah MM et al. Comparison among four proposed direct blood culture microbial identification methods using MALDI-TOF MS. J Infect Public Health 2017; 10:308–315 [CrossRef][PubMed]
    [Google Scholar]
  9. Doern GV, Vautour R, Gaudet M, Levy B. Clinical impact of rapid in vitro susceptibility testing and bacterial identification. J Clin Microbiol 1994; 32:1757–1762 [CrossRef]
    [Google Scholar]
  10. Keys CJ, Dare DJ, Sutton H, Wells G, Lunt M et al. Compilation of a MALDI-TOF mass spectral database for the rapid screening and characterisation of bacteria implicated in human infectious diseases. Infect Genet Evol 2004; 4:221–242 [CrossRef]
    [Google Scholar]
  11. Sauer S, Freiwald A, Maier T, Kube M, Reinhardt R et al. Classification and identification of bacteria by mass spectrometry and computational analysis. PLoS One 2008 Jul 30; 3:e2843 [CrossRef]
    [Google Scholar]
  12. Maurer FP, Christner M, Hentschke M, Rohde H. Advances in rapid identification and susceptibility testing of bacteria in the clinical microbiology laboratory: implications for patient care and antimicrobial stewardship programs. Infect Dis Rep 2017 Mar 30; 9: [CrossRef]
    [Google Scholar]
  13. Christner M, Rohde H, Wolters M, Sobottka I, Wegscheider K et al. Rapid identification of bacteria from positive blood culture bottles by use of matrix-assisted laser desorption-ionization time of flight mass spectrometry fingerprinting. J Clin Microbiol 2010; 48:1584–1591 [CrossRef]
    [Google Scholar]
  14. La Scola B, Raoult D. Direct identification of bacteria in positive blood culture bottles by matrix-assisted laser desorption ionisation time-of-flight mass spectrometry. PLoS One 2009 Nov 25; 4:e8041 [CrossRef]
    [Google Scholar]
  15. Ferreira L, Sánchez-Juanes F, Porras-Guerra I, García-García MI, García-Sánchez JE et al. Microorganisms direct identification from blood culture by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Clin Microbiol Infect 2011; 17:546–551 [CrossRef]
    [Google Scholar]
  16. Morgenthaler NG, Kostrzewa M. Rapid identification of pathogens in positive blood culture of patients with sepsis: review and meta-analysis of the performance of the Sepsityper kit. Int J Microbiol 2015; 2015:827416 [CrossRef]
    [Google Scholar]
  17. Azrad M, Keness Y, Nitzan O, Pastukh N, Tkhawkho L et al. Cheap and rapid in-house method for direct identification of positive blood cultures by MALDI-TOF MS technology. BMC Infect Dis 2019; 19:72 [CrossRef]
    [Google Scholar]
  18. Wu S, Xu J, Qiu C, Xu L, Chen Q et al. Direct antimicrobial susceptibility tests of bacteria and yeasts from positive blood cultures by using serum separator gel tubes and MALDI–TOF MS. J Microbiol Methods 2019; 157:16–20 [CrossRef]
    [Google Scholar]
  19. Chen Y, Porter V, Mubareka S, Kotowich L, Simor AE. Rapid identification of bacteria directly from positive blood cultures by use of a serum separator tube, Smudge plate preparation, and matrix-assisted laser desorption Ionization–Time of flight mass spectrometry. J Clin Microbiol 2015; 53:3349–3352 [CrossRef]
    [Google Scholar]
  20. Fuglsang-Damgaard D, Nielsen CH, Mandrup E, Fuursted K. The use of gram stain and matrix-assisted laser desorption ionization time-of-flight mass spectrometry on positive blood culture: synergy between new and old technology. APMIS 2011; 119:681–688 [CrossRef]
    [Google Scholar]
  21. Freimann S, Shapira M, Athamna A. Serum separator tube method for matrix-assisted laser desorption/ionization time-of-flight analysis. Access Microbiol 2019; 1: [CrossRef]
    [Google Scholar]
  22. Moussaoui W, Jaulhac B, Hoffmann A-M, Ludes B, Kostrzewa M et al. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry identifies 90% of bacteria directly from blood culture vials. Clin Microbiol Infect 2010; 16:1631–1638 [CrossRef]
    [Google Scholar]
  23. Florio W, Morici P, Rizzato C, Barnini S, Tavanti A. Diagnosis of bloodstream infections by mass spectrometry: present and future. Mass Spectrom Purif Tech 2015; 01:106 [CrossRef]
    [Google Scholar]
  24. Barberino MG, Silva MdeO, Arraes ACP, Correia LC, Mendes AV. Direct identification from positive blood broth culture by matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS). Brazilian J Infect Dis 2017; 21:339–342 [CrossRef]
    [Google Scholar]
  25. Zhou M, Yang Q, Kudinha T et al. An improved in-house MALDI-TOF MS protocol for direct cost-effective identification of pathogens from blood cultures. Front Microbiol 1824; 2017:8
    [Google Scholar]
  26. Axelsson C, Rehnstam-Holm A-S, Nilson B. Rapid detection of antibiotic resistance in positive blood cultures by MALDI-TOF MS and an automated and optimized MBT-ASTRA protocol for Escherichia coli and Klebsiella pneumoniae. Infect Dis 2020; 52:45–53 [CrossRef]
    [Google Scholar]
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