MALDI‐TOF mass spectrometry rapid pathogen identification and outcomes of patients with bloodstream infection: A systematic review and meta‐analysis
Abstract There was inconsistent evidence regarding the use of matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry (MALDI‐TOF MS) for microorganism identification with/without antibiotic stewardship team (AST) and the clinical outcome of patients with bloodstream infections (...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-10-01
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| Series: | Microbial Biotechnology |
| Online Access: | https://doi.org/10.1111/1751-7915.14124 |
| _version_ | 1811265406048927744 |
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| author | Chia‐Hung Yo Yi‐Hsuan Shen Wan‐Ting Hsu Rania A. Mekary Zi Rong Chen Wan‐Ting J. Lee Shyr‐Chyr Chen Chien‐Chang Lee |
| author_facet | Chia‐Hung Yo Yi‐Hsuan Shen Wan‐Ting Hsu Rania A. Mekary Zi Rong Chen Wan‐Ting J. Lee Shyr‐Chyr Chen Chien‐Chang Lee |
| author_sort | Chia‐Hung Yo |
| collection | DOAJ |
| description | Abstract There was inconsistent evidence regarding the use of matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry (MALDI‐TOF MS) for microorganism identification with/without antibiotic stewardship team (AST) and the clinical outcome of patients with bloodstream infections (BSI). In a systematic review and meta‐analysis, we evaluated the effectiveness of rapid microbial identification by MALDI‐TOF MS with and without AST on clinical outcomes. We searched PubMed and EMBASE databases from inception to 1 February 2022 to identify pre–post and parallel comparative studies that evaluated the use of MALDI‐TOF MS for microorganism identification. Pooled effect estimates were derived using the random‐effects model. Twenty‐one studies with 14,515 patients were meta‐analysed. Compared with conventional phenotypic methods, MALDI‐TOF MS was associated with a 23% reduction in mortality (RR = 0.77; 95% CI: 0.66; 0.90; I2 = 35.9%; 13 studies); 5.07‐h reduction in time to effective antibiotic therapy (95% CI: −5.83; −4.31; I2 = 95.7%); 22.86‐h reduction in time to identify microorganisms (95% CI: −23.99; −21.74; I2 = 91.6%); 0.73‐day reduction in hospital stay (95% CI: −1.30; −0.16; I2 = 53.1%); and US$4140 saving in direct hospitalization cost (95% CI: $‐8166.75; $‐113.60; I2 = 66.1%). No significant heterogeneity sources were found, and no statistical evidence for publication bias was found. Rapid pathogen identification by MALDI‐TOF MS with or without AST was associated with reduced mortality and improved outcomes of BSI, and may be cost‐effective among patients with BSI. |
| first_indexed | 2024-04-12T20:22:06Z |
| format | Article |
| id | doaj.art-edc193736bb1429cbb4365a5c76f4a35 |
| institution | Directory Open Access Journal |
| issn | 1751-7915 |
| language | English |
| last_indexed | 2024-04-12T20:22:06Z |
| publishDate | 2022-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Microbial Biotechnology |
| spelling | doaj.art-edc193736bb1429cbb4365a5c76f4a352022-12-22T03:17:58ZengWileyMicrobial Biotechnology1751-79152022-10-0115102667268210.1111/1751-7915.14124MALDI‐TOF mass spectrometry rapid pathogen identification and outcomes of patients with bloodstream infection: A systematic review and meta‐analysisChia‐Hung Yo0Yi‐Hsuan Shen1Wan‐Ting Hsu2Rania A. Mekary3Zi Rong Chen4Wan‐Ting J. Lee5Shyr‐Chyr Chen6Chien‐Chang Lee7Department of Emergency Medicine Far Eastern Memorial Hospital New Taipei City TaiwanDepartment of Family Medicine Taipei City Hospital Yangming Branch, Taipei TaiwanDepartment of Epidemiology Harvard TH Chan School of Public Health Boston Massachusetts USADepartment of Pharmaceutical Business and Administrative Sciences MCPHS University Boston Massachusetts USACollege of Medicine National Taiwan University Taipei TaiwanFaculty of Medicine The University of Queensland St. Lucia Queensland AustraliaDepartment of Emergency Medicine Far Eastern Memorial Hospital New Taipei City TaiwanDepartment of Emergency Medicine National Taiwan University Hospital Taipei TaiwanAbstract There was inconsistent evidence regarding the use of matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry (MALDI‐TOF MS) for microorganism identification with/without antibiotic stewardship team (AST) and the clinical outcome of patients with bloodstream infections (BSI). In a systematic review and meta‐analysis, we evaluated the effectiveness of rapid microbial identification by MALDI‐TOF MS with and without AST on clinical outcomes. We searched PubMed and EMBASE databases from inception to 1 February 2022 to identify pre–post and parallel comparative studies that evaluated the use of MALDI‐TOF MS for microorganism identification. Pooled effect estimates were derived using the random‐effects model. Twenty‐one studies with 14,515 patients were meta‐analysed. Compared with conventional phenotypic methods, MALDI‐TOF MS was associated with a 23% reduction in mortality (RR = 0.77; 95% CI: 0.66; 0.90; I2 = 35.9%; 13 studies); 5.07‐h reduction in time to effective antibiotic therapy (95% CI: −5.83; −4.31; I2 = 95.7%); 22.86‐h reduction in time to identify microorganisms (95% CI: −23.99; −21.74; I2 = 91.6%); 0.73‐day reduction in hospital stay (95% CI: −1.30; −0.16; I2 = 53.1%); and US$4140 saving in direct hospitalization cost (95% CI: $‐8166.75; $‐113.60; I2 = 66.1%). No significant heterogeneity sources were found, and no statistical evidence for publication bias was found. Rapid pathogen identification by MALDI‐TOF MS with or without AST was associated with reduced mortality and improved outcomes of BSI, and may be cost‐effective among patients with BSI.https://doi.org/10.1111/1751-7915.14124 |
| spellingShingle | Chia‐Hung Yo Yi‐Hsuan Shen Wan‐Ting Hsu Rania A. Mekary Zi Rong Chen Wan‐Ting J. Lee Shyr‐Chyr Chen Chien‐Chang Lee MALDI‐TOF mass spectrometry rapid pathogen identification and outcomes of patients with bloodstream infection: A systematic review and meta‐analysis Microbial Biotechnology |
| title | MALDI‐TOF mass spectrometry rapid pathogen identification and outcomes of patients with bloodstream infection: A systematic review and meta‐analysis |
| title_full | MALDI‐TOF mass spectrometry rapid pathogen identification and outcomes of patients with bloodstream infection: A systematic review and meta‐analysis |
| title_fullStr | MALDI‐TOF mass spectrometry rapid pathogen identification and outcomes of patients with bloodstream infection: A systematic review and meta‐analysis |
| title_full_unstemmed | MALDI‐TOF mass spectrometry rapid pathogen identification and outcomes of patients with bloodstream infection: A systematic review and meta‐analysis |
| title_short | MALDI‐TOF mass spectrometry rapid pathogen identification and outcomes of patients with bloodstream infection: A systematic review and meta‐analysis |
| title_sort | maldi tof mass spectrometry rapid pathogen identification and outcomes of patients with bloodstream infection a systematic review and meta analysis |
| url | https://doi.org/10.1111/1751-7915.14124 |
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