Open AccessUsefulness of the MALDI-TOF MS technology with membrane filter protocol for the rapid identification of microorganisms in perioperative drainage fluids of hepatobiliary pancreatic surgery
Author(s) -
Kazuyuki Sogawa,
Shigetsugu Takano,
Takayuki Ishige,
Hideyuki Yoshitomi,
Shingo Kagawa,
Katsunori Furukawa,
Tsukasa Takayashiki,
Satoshi Kuboki,
Fumio Nomura,
Masayuki Ohtsuka
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0246002
Subject(s) - filtration (mathematics) , perioperative , bacteria , microbiology and biotechnology , chromatography , medicine , microorganism , surgery , chemistry , biology , statistics , mathematics , genetics
Surgical site infections (SSIs) are significant and frequent perioperative complications, occurring due to the contamination of the surgical site. The late detection of SSIs, especially organ/space SSIs which are the more difficult to treat, often leads to severe complications. An effective method that can identify bacteria with a high accuracy, leading to the early detection of organ/space SSIs, is needed. Ninety-eight drainage fluid samples obtained from 22 patients with hepatobiliary pancreatic disease were analyzed to identify microorganisms using matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) with a new membrane filtration protocol and rapid BACpro ® pretreatment compared to sole rapid BACpro ® pretreatment. The levels of detail of rapid BACpro ® pretreatment with or without filtration were also evaluated for the accuracy of bacterial identification. We found that reliable scores for E . coli and E . faecalis were obtained by inoculation with 1.0 × 10 4 CFU/m l after preparation of the membrane filter with rapid BACpro ® , indicating approximately 10-folds more sensitive compared to sole rapid BACpro ® pretreatment in drainage fluid specimens. Among 60 bacterial positive colonies in drainage fluid specimens, the MALDI-TOF MS and the membrane filtration with rapid BACpro ® identified 53 isolates (88.3%) with a significantly higher accuracy, compared to 25 isolates in the rapid BACpro ® pretreatment group (41.7%) (p < 0.001). Among the 78 strains, 14 enteric Gram-negative bacteria (93.0%) and 55 Gram-positive cocci (87.3%) were correctly identified by the membrane filtration with rapid BACpro ® with a high reliability. This novel protocol could identify bacterial species within 30 min, at $2-$3 per sample, thus leading to cost and time savings. MALDI-TOF MS with membrane filter and rapid BACpro ® is a quick and reliable method for bacterial identification in drainage fluids. The shortened analysis time will enable earlier selection of suitable antibiotics for treatment of organ/space SSIs to improve patients’ outcomes.