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Clinical utility of rapid pathogen identification using matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry in ventilated patients with pneumonia: A pilot study
Author(s) -
Mok Jeong Ha,
Eom Jung Seop,
Jo Eun Jung,
Kim Mi Hyun,
Lee Kwangha,
Kim Ki Uk,
Park HyeKyung,
Yi Jongyoun,
Lee Min Ki
Publication year - 2016
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12677
Subject(s) - medicine , bronchoalveolar lavage , pneumonia , gastroenterology , lung
Background and objective We evaluated the clinical utility of rapid identification of microorganisms in bronchoalveolar lavage ( BAL ) fluid using matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry ( MALDI‐TOF MS ) in terms of the clinical outcomes of ventilated patients with pneumonia. Methods Patients for whom microorganisms were identified via MALDI‐TOF MS (from M arch 2013 to F ebruary 2014; post‐intervention group) were compared with patients for whom microorganisms were identified using conventional methods (from M arch 2012 to F ebruary 2013; pre‐intervention group). All pneumonia types (community‐acquired, hospital‐acquired, healthcare‐associated and ventilator‐associated pneumonia) were included in the analysis. Results In total, 77 patients (50 men, mean age 67.2 ± 12.5 years) were included (40 patients in the pre‐intervention group and 37 in the post‐intervention group). The time from BAL fluid collection to microorganism identification and the availability of antimicrobial susceptibility results was shorter in the post‐ compared with the pre‐intervention group (51.9 ± 11.3 vs 67.3 ± 17.4 h, P < 0.001). Also, the time from BAL fluid collection to adjustment of antibiotic therapy was shorter in the post‐intervention group (56.5 ± 10.9 vs 73.2 ± 18.5 h, P < 0.001). Microorganism identification via MALDI‐TOF MS was independently associated with a shorter intensive care unit ( ICU ) stay after BAL fluid was drawn (hazard ratio = 2.324, P = 0.007). Conclusion Rapid identification of microorganisms in BAL fluid via MALDI‐TOF MS was associated with adjustment of antibiotic therapy and a shorter ICU stay after BAL fluid was collected from ventilated patients with pneumonia.