Implementation of short incubation MALDI-TOF MS identification from positive blood cultures in routine diagnostics and effects on empiric antimicrobial therapy
Abstract Background Results of blood culture (BC) diagnostics should be swiftly available to guide treatment of critically ill patients. Conventional BC diagnostics usually performs species identification of microorganisms from mature solid medium colonies. Species identification might be speed up b...
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| Format: | Article |
| Language: | English |
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BMC
2017-01-01
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| Series: | Antimicrobial Resistance and Infection Control |
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| Online Access: | http://link.springer.com/article/10.1186/s13756-017-0173-4 |
| _version_ | 1817993087992987648 |
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| author | Robin Köck Jörg Wüllenweber Dagmar Horn Christian Lanckohr Karsten Becker Evgeny A. Idelevich |
| author_facet | Robin Köck Jörg Wüllenweber Dagmar Horn Christian Lanckohr Karsten Becker Evgeny A. Idelevich |
| author_sort | Robin Köck |
| collection | DOAJ |
| description | Abstract Background Results of blood culture (BC) diagnostics should be swiftly available to guide treatment of critically ill patients. Conventional BC diagnostics usually performs species identification of microorganisms from mature solid medium colonies. Species identification might be speed up by using matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry (MS) of biomass from shortly incubated solid media. Methods This single-center analysis compared the applicability of MALDI-TOF-based species identification from shortly incubated cultures in laboratory routine vs. conventional diagnostics and assessed its effects of on empiric antibiotic therapy. Results Median time between detection of BCs as “positive” by incubators and further processing (e.g. microscopy) was 6 h 21 min. Median time between microscopy and result reporting to the ward was 15 min. Including 193 BCs, MALDI-TOF from shortly incubated biomass resulted in significantly faster (p > 0.001) species identification. Species results became available for clinicians after a median of 188 min (231 min for Gram-positive bacteria, 151 min for Gram-negative bacteria) compared to 909 min (n = 192 BCs) when conventional diagnostics was used. For 152/179 bacteremia episodes (85%) empiric antibiotic therapy had already been started when the microscopy result was reported to the ward; microscopy led to changes of therapies in 14/179 (8%). In contrast, reporting the bacterial species (without antibiogram) resulted in therapeutic adjustments in 36/179 (20%). Evaluating these changes revealed improved therapies in 26/36 cases (72%). Conclusions Species identification by MALDI-TOF MS from shortly incubated subcultures resulted in adjustments of empiric antibiotic therapies and might improve the clinical outcome of septic patients. |
| first_indexed | 2024-04-14T01:34:54Z |
| format | Article |
| id | doaj.art-8c08f2cef5da428bbc9a72379224bdbb |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-04-14T01:34:54Z |
| publishDate | 2017-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-8c08f2cef5da428bbc9a72379224bdbb2022-12-22T02:20:00ZengBMCAntimicrobial Resistance and Infection Control2047-29942017-01-01611710.1186/s13756-017-0173-4Implementation of short incubation MALDI-TOF MS identification from positive blood cultures in routine diagnostics and effects on empiric antimicrobial therapyRobin Köck0Jörg Wüllenweber1Dagmar Horn2Christian Lanckohr3Karsten Becker4Evgeny A. Idelevich5Institute of Medical Microbiology, University Hospital MünsterInstitute of Medical Microbiology, University Hospital MünsterPharmacy Department, University Hospital MünsterDepartment for Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital MünsterInstitute of Medical Microbiology, University Hospital MünsterInstitute of Medical Microbiology, University Hospital MünsterAbstract Background Results of blood culture (BC) diagnostics should be swiftly available to guide treatment of critically ill patients. Conventional BC diagnostics usually performs species identification of microorganisms from mature solid medium colonies. Species identification might be speed up by using matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry (MS) of biomass from shortly incubated solid media. Methods This single-center analysis compared the applicability of MALDI-TOF-based species identification from shortly incubated cultures in laboratory routine vs. conventional diagnostics and assessed its effects of on empiric antibiotic therapy. Results Median time between detection of BCs as “positive” by incubators and further processing (e.g. microscopy) was 6 h 21 min. Median time between microscopy and result reporting to the ward was 15 min. Including 193 BCs, MALDI-TOF from shortly incubated biomass resulted in significantly faster (p > 0.001) species identification. Species results became available for clinicians after a median of 188 min (231 min for Gram-positive bacteria, 151 min for Gram-negative bacteria) compared to 909 min (n = 192 BCs) when conventional diagnostics was used. For 152/179 bacteremia episodes (85%) empiric antibiotic therapy had already been started when the microscopy result was reported to the ward; microscopy led to changes of therapies in 14/179 (8%). In contrast, reporting the bacterial species (without antibiogram) resulted in therapeutic adjustments in 36/179 (20%). Evaluating these changes revealed improved therapies in 26/36 cases (72%). Conclusions Species identification by MALDI-TOF MS from shortly incubated subcultures resulted in adjustments of empiric antibiotic therapies and might improve the clinical outcome of septic patients.http://link.springer.com/article/10.1186/s13756-017-0173-4Antibiotic stewardshipMALDI-TOF MSSepsisDiagnosticsBlood culture |
| spellingShingle | Robin Köck Jörg Wüllenweber Dagmar Horn Christian Lanckohr Karsten Becker Evgeny A. Idelevich Implementation of short incubation MALDI-TOF MS identification from positive blood cultures in routine diagnostics and effects on empiric antimicrobial therapy Antimicrobial Resistance and Infection Control Antibiotic stewardship MALDI-TOF MS Sepsis Diagnostics Blood culture |
| title | Implementation of short incubation MALDI-TOF MS identification from positive blood cultures in routine diagnostics and effects on empiric antimicrobial therapy |
| title_full | Implementation of short incubation MALDI-TOF MS identification from positive blood cultures in routine diagnostics and effects on empiric antimicrobial therapy |
| title_fullStr | Implementation of short incubation MALDI-TOF MS identification from positive blood cultures in routine diagnostics and effects on empiric antimicrobial therapy |
| title_full_unstemmed | Implementation of short incubation MALDI-TOF MS identification from positive blood cultures in routine diagnostics and effects on empiric antimicrobial therapy |
| title_short | Implementation of short incubation MALDI-TOF MS identification from positive blood cultures in routine diagnostics and effects on empiric antimicrobial therapy |
| title_sort | implementation of short incubation maldi tof ms identification from positive blood cultures in routine diagnostics and effects on empiric antimicrobial therapy |
| topic | Antibiotic stewardship MALDI-TOF MS Sepsis Diagnostics Blood culture |
| url | http://link.springer.com/article/10.1186/s13756-017-0173-4 |
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