1887

Abstract

Purpose. Bloodstream infections are major causes of morbidity and mortality among hospitalized patients worldwide. Early identification of micro-organisms from blood culture can facilitate earlier optimization of treatment. The objective of this study was to assess an in-house method based on a new matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) platform (Clin-TOF MS) for direct organism identification.

Methodology. We studied the performance of the in-house method for direct identification and the conventional sub-culture method in parallel. Identification from subcultures was analysed with Bruker MS as the reference method.

Results. A total of 666 blood cultures with a single micro-organism that flagged positive after no more than a 3-day incubation period were collected. The identification accuracy of the in-house Clin-TOF MS method for direct identification and the sub-culture method was 88.6 and 100 %, respectively. The in-house method exhibited better performance for Gram-negative bacteria than for Gram-positive bacteria (93.3 vs 81.6 %). The accuracy rate for anaerobes was 100 % (3/3). The lowest accurate identification rate was for yeast; this was only 20 %. Lytic Anaerobic/F (LAF) and Plus Aerobic/F (PAF) provided the highest accurate identification rates, and it was noteworthy that the accuracy rate for FAN Aerobic (FA) was 82 %, which is higher than previously reported and showed that the method was effective.

Conclusion. Our study provides an effective sample preparation method for the direct identification of pathogens from positive blood culture vials via Clin-TOF MS at a very low cost of about $0.5 per sample and with a short turnaround time of about 20 min. This will help clinicians make precise diagnoses and provide targeted prescriptions, reducing the risk of the potential development of resistance.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000866
2018-11-12
2024-04-23
Loading full text...

Full text loading...

/deliver/fulltext/jmm/68/1/41.html?itemId=/content/journal/jmm/10.1099/jmm.0.000866&mimeType=html&fmt=ahah

References

  1. 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 [View Article][PubMed]
    [Google Scholar]
  2. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 2013; 39:165–228 [View Article][PubMed]
    [Google Scholar]
  3. 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 [View Article][PubMed]
    [Google Scholar]
  4. Köck R, Kipp F, Ellger B. [Blood culture diagnostic-challenge or routine standard of care?]. Anasthesiol Intensivmed Notfallmed Schmerzther 2015; 50:124–131 [View Article][PubMed]
    [Google Scholar]
  5. Arroyo MA, Denys GA. Parallel evaluation of the MALDI sepsityper and verigene BC-GN assays for rapid identification of gram-negative bacilli from positive blood cultures. J Clin Microbiol 2017; 55:2708–2718 [View Article][PubMed]
    [Google Scholar]
  6. Zhou M, Yang Q, Kudinha T, Sun L, Zhang R et al. An improved in-house MALDI-TOF MS protocol for direct cost-effective identification of pathogens from blood cultures. Front Microbiol 2017; 8:8 [View Article][PubMed]
    [Google Scholar]
  7. Dubois D, Grare M, Prere MF, Segonds C, Marty N et al. Performances of the Vitek MS matrix-assisted laser desorption ionization-time of flight mass spectrometry system for rapid identification of bacteria in routine clinical microbiology. J Clin Microbiol 2012; 50:2568–2576 [View Article][PubMed]
    [Google Scholar]
  8. Wang H, Fan YY, Kudinha T, Xu ZP, Xiao M et al. A comprehensive evaluation of the bruker biotyper MS and vitek MS matrix-assisted laser desorption ionization-time of flight mass spectrometry systems for identification of yeasts, part of the national china hospital invasive fungal surveillance net (CHIF-NET) study, 2012 to 2013. J Clin Microbiol 2016; 54:1376–1380 [View Article][PubMed]
    [Google Scholar]
  9. Martinez RM, Bauerle ER, Fang FC, Butler-Wu SM. Evaluation of three rapid diagnostic methods for direct identification of microorganisms in positive blood cultures. J Clin Microbiol 2014; 52:2521–2529 [View Article][PubMed]
    [Google Scholar]
  10. 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 [View Article][PubMed]
    [Google Scholar]
  11. Caspar Y, Garnaud C, Raykova M, Bailly S, Bidart M et al. Superiority of SDS lysis over saponin lysis for direct bacterial identification from positive blood culture bottle by MALDI-TOF MS. Proteomics Clin Appl 2017; 11:1600131 [View Article][PubMed]
    [Google Scholar]
  12. Klein S, Zimmermann S, Köhler C, Mischnik A, Alle W et al. Integration of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry in blood culture diagnostics: a fast and effective approach. J Med Microbiol 2012; 61:323–331 [View Article][PubMed]
    [Google Scholar]
  13. Kohlmann R, Hoffmann A, Geis G, Gatermann S. MALDI-TOF mass spectrometry following short incubation on a solid medium is a valuable tool for rapid pathogen identification from positive blood cultures. Int J Med Microbiol 2015; 305:469–479 [View Article][PubMed]
    [Google Scholar]
  14. Schmidt V, Jarosch A, März P, Sander C, Vacata V et al. Rapid identification of bacteria in positive blood culture by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Eur J Clin Microbiol Infect Dis 2012; 31:311–317 [View Article][PubMed]
    [Google Scholar]
  15. Bourbeau PP, Pohlman JK. Three days of incubation may be sufficient for routine blood cultures with BacT/Alert FAN blood culture bottles. J Clin Microbiol 2001; 39:2079–2082 [View Article][PubMed]
    [Google Scholar]
  16. Han XY, Truant AL. The detection of positive blood cultures by the AccuMed ESP-384 system: the clinical significance of three-day testing. Diagn Microbiol Infect Dis 1999; 33:1–6 [View Article][PubMed]
    [Google Scholar]
  17. Seng P, Drancourt M, Gouriet F, La Scola B, Fournier PE et al. Ongoing revolution in bacteriology: routine identification of bacteria by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Clin Infect Dis 2009; 49:543–551 [View Article][PubMed]
    [Google Scholar]
  18. Zhang L, Xiao M, Wang H, Gao R, Fan X et al. Yeast identification algorithm based on use of the Vitek MS system selectively supplemented with ribosomal DNA sequencing: proposal of a reference assay for invasive fungal surveillance programs in China. J Clin Microbiol 2014; 52:572–577 [View Article][PubMed]
    [Google Scholar]
  19. Ferroni A, Suarez S, Beretti JL, Dauphin B, Bille E et al. Real-time identification of bacteria and Candida species in positive blood culture broths by matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol 2010; 48:1542–1548 [View Article][PubMed]
    [Google Scholar]
  20. X Xm F, Zp X, Zhang G, Xx X, Yc X. Evaluation of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry system Clin-TOF-II MS in identification of gram-negative bacteria]. Chin J Lab Med 2017; 40:41–45
    [Google Scholar]
  21. Ma Jh HH, Shen LW, Zhou HW, Yy H, Chen GX. Evaluation of the Clin-TOF matrix-assisted laser desorption / ionization time-of-flight mass spectrometry application in clinical pathogen identification]. Chin J Emerg Med 2018; 27:215–220
    [Google Scholar]
  22. Tsuchida S, Murata S, Miyabe A, Satoh M, Takiwaki M et al. An improved in-house lysis-filtration protocol for bacterial identification from positive blood culture bottles with high identification rates by MALDI-TOF MS. J Microbiol Methods 2018; 148:40–45 [View Article][PubMed]
    [Google Scholar]
  23. Farina C, Arena F, Casprini P, Cichero P, Clementi M et al. Direct identification of microorganisms from positive blood cultures using the lysis-filtration technique and matrix assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS): a multicentre study. New Microbiol 2015; 38:245–250[PubMed]
    [Google Scholar]
  24. Zhu J, Hu J, Mao YF, Chen FY, Zhu JY et al. [A multicenter, retrospective study of pathogenic bacteria distribution and drug resistance in febrile neutropenic patients with hematological diseases in Shanghai]. Zhonghua Xue Ye Xue Za Zhi 2017; 38:945–950[PubMed]
    [Google Scholar]
  25. 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; 2015:1–10 [View Article][PubMed]
    [Google Scholar]
  26. Zhou M, Yang Q, Kudinha T, Zhang L, Xiao M et al. Using matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) complemented with selected 16S rRNA and gyrB genes sequencing to practically identify clinical important viridans group streptococci (VGS). Front Microbiol 2016; 7:1328 [View Article][PubMed]
    [Google Scholar]
  27. Romero-Gómez MP, Mingorance J. The effect of the blood culture bottle type in the rate of direct identification from positive cultures by matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) mass spectrometry. J Infect 2011; 62:251–253 [View Article][PubMed]
    [Google Scholar]
  28. Meex C, Neuville F, Descy J, Huynen P, Hayette MP et al. Direct identification of bacteria from BacT/ALERT anaerobic positive blood cultures by MALDI-TOF MS: MALDI Sepsityper kit versus an in-house saponin method for bacterial extraction. J Med Microbiol 2012; 61:1511–1516 [View Article][PubMed]
    [Google Scholar]
  29. Wüppenhorst N, Consoir C, Lörch D, Schneider C. Direct identification of bacteria from charcoal-containing blood culture bottles using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry. Eur J Clin Microbiol Infect Dis 2012; 31:2843–2850 [View Article][PubMed]
    [Google Scholar]
  30. Jakovljev A, Bergh K. Development of a rapid and simplified protocol for direct bacterial identification from positive blood cultures by using matrix assisted laser desorption ionization time-of- flight mass spectrometry. BMC Microbiol 2015; 15:258 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.000866
Loading
/content/journal/jmm/10.1099/jmm.0.000866
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error