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Matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry ( MALDI ‐ TOF ) directly from positive blood culture flasks allows rapid identification of bloodstream infections in immunosuppressed hosts
Author(s) -
Egli A.,
Osthoff M.,
Goldenberger D.,
Halter J.,
Schaub S.,
Steiger J.,
Weisser M.,
Frei R.
Publication year - 2015
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12373
Subject(s) - blood culture , microbiology and biotechnology , matrix assisted laser desorption/ionization , medicine , fungemia , mass spectrometry , bloodstream infection , biology , chromatography , chemistry , antibiotics , antifungal , desorption , organic chemistry , adsorption
In immunosuppressed hosts, rapid identification of microorganisms of bloodstream infections is crucial to ensuring effective antimicrobial therapy. Conventional culture requires up to 72 h from sample collection to pathogen identification. Methods We used the SepsiTyper Kit and matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry ( MALDI ‐ TOF ; Microflex, Bruker) directly from positive blood culture (BacT/ ALERT 3D, FN / FA vials; bioMérieux) in comparison to standard culture methodology ( VITEK 2; bioMérieux) for species identification. Results A total of 62 consecutive positive blood cultures from immunosuppressed patients (solid organ or hematopoietic transplant recipients, or with febrile neutropenia) were analyzed. Culture yielded gram‐negative bacteria ( GNB ) in 27/62 (43.5%) and gram‐positive ( GPB ) in 35/62 (56.5%) vials. For GNB , the predominant species identified by MALDI ‐ TOF and confirmed by VITEK were E scherichia coli (16/16 correctly identified) and E nterobacter cloacae (4/4), with a sensitivity and specificity of 92.6% and 100%, respectively. For GPB , predominant species were S taphylococcus aureus (3/3), coagulase‐negative staphylococci (12/24), and E nterococcus faecium (6/6) with a sensitivity of 100%, 60%, and 100%, respectively. The median time from blood collection to species identification was 27.4 h with MALDI ‐ TOF identification and 46.6 h with conventional methodology. Conclusion Using MALDI ‐ TOF directly from positive blood cultures allowed a shorter time to identification with high sensitivity and specificity in immunosuppressed patients.