Journal article
Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) directly from positive blood culture flasks allows rapid identification of bloodstream infections in immunosuppressed hosts.
- Egli A Division of Clinical Microbiology, University Hospital Basel, Basel, Switzerland.
- Osthoff M Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
- Goldenberger D Division of Clinical Microbiology, University Hospital Basel, Basel, Switzerland.
- Halter J Hematology, University Hospital Basel, Basel, Switzerland.
- Schaub S Division of Nephrology and Transplant Immunology, University Hospital Basel, Basel, Switzerland.
- Steiger J Division of Nephrology and Transplant Immunology, University Hospital Basel, Basel, Switzerland.
- Weisser M Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
- Frei R Division of Clinical Microbiology, University Hospital Basel, Basel, Switzerland.
- 2015-02-24
Published in:
- Transplant infectious disease : an official journal of the Transplantation Society. - 2015
MALDI-TOF
bacteria
blood culture
chemotherapy
immunosuppression
neutropenia
oncology
sepsis
transplantation
Bacteremia
Cohort Studies
Communicable Diseases
Gram-Negative Bacteria
Gram-Positive Bacteria
Humans
Immunocompromised Host
Sensitivity and Specificity
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
Time Factors
English
INTRODUCTION
In immunosuppressed hosts, rapid identification of microorganisms of bloodstream infections is crucial to ensuring effective antimicrobial therapy. Conventional culture requires up to 72 h from sample collection to pathogen identification.
METHODS
We used the SepsiTyper Kit and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF; Microflex, Bruker) directly from positive blood culture (BacT/ALERT 3D, FN/FA vials; bioMérieux) in comparison to standard culture methodology (VITEK 2; bioMérieux) for species identification.
RESULTS
A total of 62 consecutive positive blood cultures from immunosuppressed patients (solid organ or hematopoietic transplant recipients, or with febrile neutropenia) were analyzed. Culture yielded gram-negative bacteria (GNB) in 27/62 (43.5%) and gram-positive (GPB) in 35/62 (56.5%) vials. For GNB, the predominant species identified by MALDI-TOF and confirmed by VITEK were Escherichia coli (16/16 correctly identified) and Enterobacter cloacae (4/4), with a sensitivity and specificity of 92.6% and 100%, respectively. For GPB, predominant species were Staphylococcus aureus (3/3), coagulase-negative staphylococci (12/24), and Enterococcus faecium (6/6) with a sensitivity of 100%, 60%, and 100%, respectively. The median time from blood collection to species identification was 27.4 h with MALDI-TOF identification and 46.6 h with conventional methodology.
CONCLUSION
Using MALDI-TOF directly from positive blood cultures allowed a shorter time to identification with high sensitivity and specificity in immunosuppressed patients.
In immunosuppressed hosts, rapid identification of microorganisms of bloodstream infections is crucial to ensuring effective antimicrobial therapy. Conventional culture requires up to 72 h from sample collection to pathogen identification.
METHODS
We used the SepsiTyper Kit and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF; Microflex, Bruker) directly from positive blood culture (BacT/ALERT 3D, FN/FA vials; bioMérieux) in comparison to standard culture methodology (VITEK 2; bioMérieux) for species identification.
RESULTS
A total of 62 consecutive positive blood cultures from immunosuppressed patients (solid organ or hematopoietic transplant recipients, or with febrile neutropenia) were analyzed. Culture yielded gram-negative bacteria (GNB) in 27/62 (43.5%) and gram-positive (GPB) in 35/62 (56.5%) vials. For GNB, the predominant species identified by MALDI-TOF and confirmed by VITEK were Escherichia coli (16/16 correctly identified) and Enterobacter cloacae (4/4), with a sensitivity and specificity of 92.6% and 100%, respectively. For GPB, predominant species were Staphylococcus aureus (3/3), coagulase-negative staphylococci (12/24), and Enterococcus faecium (6/6) with a sensitivity of 100%, 60%, and 100%, respectively. The median time from blood collection to species identification was 27.4 h with MALDI-TOF identification and 46.6 h with conventional methodology.
CONCLUSION
Using MALDI-TOF directly from positive blood cultures allowed a shorter time to identification with high sensitivity and specificity in immunosuppressed patients.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1111/tid.12373
- PMID 25704776
- Persistent URL
- https://sonar.ch/global/documents/94004
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