In-house protocol and performance of MALDI-TOF MS in the early diagnosis of bloodstream infections in a fourth-level hospital in Colombia: Jumping to full use of this technology

Abstract Background Correctly identifying anaerobic bloodstream infections (BSIs) is difficult. However, a new technique, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), enables more accurate identification and appropriate treatment. Anaerobic BSIs identified by MALDI-TOF MS were retrospectively analyzed to determine the clinical and microbiological features and patient outcomes based on the anaerobic genera or group. Methods Medical records of patients with anaerobic BSIs were used to conduct a single-center retrospective cohort study from January 2016 to December 2020 in Nagoya, Japan. Multivariate logistic regression analysis was performed to determine the independent risk factors for in-hospital mortality. Results Of the 215 patients with anaerobic BSIs, 31 had multiple anaerobic organisms in the blood culture, including 264 total episodes of anaerobic BSIs. Bacteroides spp. were isolated the most (n = 74), followed by gram-positive non-spore-forming bacilli (n = 57), Clostridium spp. (n = 52), gram-positive anaerobic cocci (GPAC) (n = 27), and gram-negative cocci (n = 7). The median patient age was 76 years; 56.7% were male. The most common focal infection site was intra-abdominal (36.7%). The in-hospital mortality caused by anaerobic BSIs was 21.3%, and was highest with Clostridium spp. (36.5%) and lowest with GPAC (3.7%). Age, solid tumors, and Clostridium spp. were independent risk factors for in-hospital mortality. Conclusions We identified current anaerobic BSI trends using MALDI-TOF MS and reported that mortality in patients with anaerobic BSIs patients was highest with Clostridium spp. infections.

Download Full-text

Early Diagnosis of Irkut Virus Infection Using Magnetic Bead-Based Serum Peptide Profiling by MALDI-TOF MS in a Mouse Model

International Journal of Molecular Sciences ◽

10.3390/ijms15045193 ◽

2014 ◽

Vol 15 (4) ◽

pp. 5193-5198 ◽

Cited By ~ 4

Author(s):

Nan Li ◽

Ye Liu ◽

Zhuo Hao ◽

Shoufeng Zhang ◽

Rongliang Hu ◽

...

Keyword(s):

Virus Infection ◽

Early Diagnosis ◽

Mouse Model ◽

Magnetic Bead ◽

Maldi Tof Ms ◽

Maldi Tof ◽

Serum Peptide ◽

Tof Ms

Download Full-text

Impact of short-incubation MALDI-TOF MS on empiric antibiotic therapy in bloodstream infections caused by Pseudomonas aeruginosa, Enterococcus spp. and AmpC-producing Enterobacteriaceae

Diagnostic Microbiology and Infectious Disease ◽

10.1016/j.diagmicrobio.2018.11.009 ◽

2019 ◽

Vol 94 (1) ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Mika Halavaara ◽

Annika Nevalainen ◽

Timi Martelius ◽

Pentti Kuusela ◽

Veli-Jukka Anttila

Keyword(s):

Pseudomonas Aeruginosa ◽

Antibiotic Therapy ◽

Bloodstream Infections ◽

Empiric Antibiotic Therapy ◽

Maldi Tof Ms ◽

Maldi Tof ◽

Enterococcus Spp ◽

Empiric Antibiotic ◽

Tof Ms

Download Full-text

55. Impact of Testing Methodology and Reporting on Time to Preferred Antibiotic Therapy in Extended Spectrum Beta-Lactamase producing Enterobacteriaceae (ESBL-E) Bloodstream Infections

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.257 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S147-S147

Author(s):

Hanh Bui ◽

Frank Tverdek ◽

Stephanie Carnes ◽

Jeannie D Chan ◽

Andrew Bryan ◽

...

Keyword(s):

Blood Culture ◽

Medical Center ◽

Bloodstream Infections ◽

Blood Cultures ◽

Maldi Tof Ms ◽

Maldi Tof ◽

Definitive Therapy ◽

Significant Difference ◽

Carbapenem Antibiotic ◽

Tof Ms

Abstract Background Harborview Medical Center (HMC) identifies organisms and an ESBL genotype (CTX-M) via Verigene® Gram-Negative Blood Culture Nucleic Acid Test (BC-GN). University of Washington-Montlake (UWML) uses matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) for organism identification directly from positive blood cultures and ceftriaxone results by Kirby Bauer disk diffusion (KB) are reported 18 hours later. No ESBL comment is reported at UWML. We aimed to determine whether the methodology in identification and reporting of ESBL-E from blood cultures between two hospitals has an impact on time to preferred therapy with a carbapenem antibiotic. Methods Retrospective observational study conducted at UWML and HMC in Seattle, WA between 1/10/2015 and 9/15/2020. Adult patients were eligible if they had ≥1 positive blood culture with an Enterobacteriaceae isolate resistant to ceftriaxone and were on antibiotic treatment. The primary outcome was the difference in time to preferred definitive therapy with a carbapenem antibiotic in patients an ESBL-E bloodstream infection (BSI) identified by Verigene® vs. MALDI-TOF MS/KB. Results A total of 199 patients were screened; 67 were included for UWML and 68 at HMC. The average time to initiation of a carbapenem antibiotic was 42 ±26.5 hours at UWML and 28 ±19.7 hours at HMC. A t-test detected a difference in time to preferred therapy between a Verigene® vs. MALDI-TOF MS/KB tested ESBL-E BSI [95% confidence interval (CI), 5.3-22.9]. The hazard ratio to carbapenem initiation for HMC is 1.73643 [95% CI, 1.1405-2.644]. Conclusion A statistically significant difference in time to preferred definitive therapy among patients with an ESBL-E BSI processed by Verigene® was found compared to MALDI-TOF MS. The results suggest standardization in protocols between the UWML and HMC hospitals is warranted. Disclosures Andrew Bryan, MD, PhD, Shionogi Inc. (Grant/Research Support)

Download Full-text