Document Detail


Identification of blood culture isolates directly from positive blood cultures by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry and a commercial extraction system: analysis of performance, cost, and turnaround time.
MedLine Citation:
PMID:  22875888     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry represents a revolution in the rapid identification of bacterial and fungal pathogens in the clinical microbiology laboratory. Recently, MALDI-TOF has been applied directly to positive blood culture bottles for the rapid identification of pathogens, leading to reductions in turnaround time and potentially beneficial patient impacts. The development of a commercially available extraction kit (Bruker Sepsityper) for use with the Bruker MALDI BioTyper has facilitated the processing required for identification of pathogens directly from positive from blood cultures. We report the results of an evaluation of the accuracy, cost, and turnaround time of this method for 61 positive monomicrobial and 2 polymicrobial cultures representing 26 species. The Bruker MALDI BioTyper with the Sepsityper gave a valid (score, >1.7) identification for 85.2% of positive blood cultures with no misidentifications. The mean reduction in turnaround time to identification was 34.3 h (P < 0.0001) in the ideal situation where MALDI-TOF was used for all blood cultures and 26.5 h in a more practical setting where conventional identification or identification from subcultures was required for isolates that could not be directly identified by MALDI-TOF. Implementation of a MALDI-TOF-based identification system for direct identification of pathogens from blood cultures is expected to be associated with a marginal increase in operating costs for most laboratories. However, the use of MALDI-TOF for direct identification is accurate and should result in reduced turnaround time to identification.
Authors:
Philippe R S Lagacé-Wiens; Heather J Adam; James A Karlowsky; Kimberly A Nichol; Paulette F Pang; Jodi Guenther; Amanda A Webb; Crystal Miller; Michelle J Alfa
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2012-08-08
Journal Detail:
Title:  Journal of clinical microbiology     Volume:  50     ISSN:  1098-660X     ISO Abbreviation:  J. Clin. Microbiol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-14     Completed Date:  2013-01-09     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  7505564     Medline TA:  J Clin Microbiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3324-8     Citation Subset:  IM    
Affiliation:
Department of Medical Microbiology and Infectious Diseases, University of Manitoba. Winnipeg, Manitoba, Canada. plagacewiens@dsmanitoba.ca
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MeSH Terms
Descriptor/Qualifier:
Bacteremia / diagnosis*,  microbiology
Blood / microbiology*
Costs and Cost Analysis
Fungemia / diagnosis*,  microbiology
Humans
Microbiological Techniques / economics,  methods*
Specimen Handling / methods
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / economics,  methods*
Time Factors
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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