Clinical impact of rapid bacterial identification by MALDI-TOF MS combined with the bêta-LACTA™ test on early antibiotic adaptation by an antimicrobial stewardship team in bloodstream infections

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 × 104 CFU/ml 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.

Download Full-text

Occurrence of the p019 gene in the blaKPC-harbouring plasmids: adverse clinical impact for direct tracking of KPC-producing Klebsiella pneumoniae by MALDI-TOF MS

Journal of Clinical Microbiology ◽

10.1128/jcm.00238-21 ◽

2021 ◽

Author(s):

Eva Gato ◽

Ignacio Pedro Constanso ◽

Bruno Kotska Rodiño-Janeiro ◽

Paula Guijarro-Sánchez ◽

Tyler Alioto ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Computational Analysis ◽

Direct Detection ◽

Clinical Impact ◽

Mass Peak ◽

Maldi Tof Ms ◽

Maldi Tof ◽

Direct Tracking ◽

Geographical Locations ◽

Tof Ms

MALDI-TOF MS has recently been used for the direct detection of KPC-producing isolates by analysis of the 11,109 Da mass peak representing the P019 protein. In this study we evaluate the presence of the 11,109 Da mass peak in a collection of 435 unduplicated K. pneumoniae clinical isolates. The prevalence of the P019 peak in the blaKPC K. pneumoniae isolates was 49.2% (32/65). The 11,109 Da mass peak was not observed in any of the other carbapenemase (319) or non carbapenemase producers (116). Computational analysis of the presence of the p019 gene was performed in the aforementioned carbapenemase-producing K. pneumoniae isolates fully characterized by WGS and in a further collection of 1,649 K. pneumoniae genomes included in EuSCAPE. Herein, we have demonstrated that the p019 gene is not exclusively linked to the pKpQil plasmid, but it is present in the following plasmids: IncFIB(K)/IncFII(K)/ColRNAI, IncFIB(pQil), IncFIB(pQil)/ColRNAI, IncFIB(pQil)/IncFII(K), IncFIB(K)/IncFII(K) and IncX3. Besides, we have proven the independent movement of the Tn4401 and the ISKpn31, of which the p019 gene is a component. The absence of the p019 gene was obvious in Col440I, Col(pHAD28), IncFIB(K)/IncX3/IncFII(K), IncFIB(K)/IncFII(K) plasmids. In addition, we also observed another plasmid in which neither Tn4401 nor ISKpn31 was found, IncP6. In the EuSCAPE, the occurrence of p019 varied from 0% to 100% among the different geographical locations. The adverse clinical impact of the diminished prevalence of the p019 gene within the plasmid encoding KPC-producing Klebsiella pneumoniae puts forward the need for reconsideration when applying this technique in a clinical setting.

Download Full-text

Ribosomal protein biomarkers provide root nodule bacterial identification by MALDI-TOF MS

Applied Microbiology and Biotechnology ◽

10.1007/s00253-015-6515-3 ◽

2015 ◽

Vol 99 (13) ◽

pp. 5547-5562 ◽

Cited By ~ 27

Author(s):

Dominik Ziegler ◽

Joël F. Pothier ◽

Julie Ardley ◽

Romain Kouakou Fossou ◽

Valentin Pflüger ◽

...

Keyword(s):

Ribosomal Protein ◽

Root Nodule ◽

Bacterial Identification ◽

Protein Biomarkers ◽

Maldi Tof Ms ◽

Maldi Tof ◽

Tof Ms

Download Full-text

Application of MALDI-TOF MS to assess clinical characteristics, risk factors, and outcomes associated with anaerobic bloodstream infection: a retrospective observational study

Annals of Clinical Microbiology and Antimicrobials ◽

10.1186/s12941-021-00449-4 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Tsuyoshi Watanabe ◽

Yuki Hara ◽

Yusuke Yoshimi ◽

Waka Yokoyama-kokuryo ◽

Yoshiro Fujita ◽

...

Keyword(s):

Risk Factors ◽

Hospital Mortality ◽

Multivariate Logistic Regression Analysis ◽

Bloodstream Infections ◽

Gram Positive ◽

Accurate Identification ◽

Maldi Tof Ms ◽

Maldi Tof ◽

Independent Risk Factors ◽

Tof Ms

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

Routine use of MALDI-TOF MS for anaerobic bacterial identification in clinical microbiology

Anaerobe ◽

10.1016/j.anaerobe.2018.07.001 ◽

2018 ◽

Vol 54 ◽

pp. 191-196 ◽

Cited By ~ 15

Author(s):

Samantha Shannon ◽

Daniel Kronemann ◽

Robin Patel ◽

Audrey N. Schuetz

Keyword(s):

Clinical Microbiology ◽

Bacterial Identification ◽

Maldi Tof Ms ◽

Maldi Tof ◽

Tof Ms

Download Full-text

An improved in-house lysis-filtration protocol for bacterial identification from positive blood culture bottles with high identification rates by MALDI-TOF MS

Journal of Microbiological Methods ◽

10.1016/j.mimet.2018.03.014 ◽

2018 ◽

Vol 148 ◽

pp. 40-45 ◽

Cited By ~ 6

Author(s):

Sachio Tsuchida ◽

Syota Murata ◽

Akiko Miyabe ◽

Mamoru Satoh ◽

Masaki Takiwaki ◽

...

Keyword(s):

Blood Culture ◽

Positive Blood Culture ◽

Bacterial Identification ◽

Maldi Tof Ms ◽

Maldi Tof ◽

Tof Ms

Download Full-text

Clinical Impact of MALDI-TOF MS Identification and Rapid Susceptibility Testing on Adequate Antimicrobial Treatment in Sepsis with Positive Blood Cultures

PLoS ONE ◽

10.1371/journal.pone.0156299 ◽

2016 ◽

Vol 11 (5) ◽

pp. e0156299 ◽

Cited By ~ 45

Author(s):

Alexia Verroken ◽

Lydwine Defourny ◽

Olivier le Polain de Waroux ◽

Leïla Belkhir ◽

Pierre-François Laterre ◽

...

Keyword(s):

Susceptibility Testing ◽

Antimicrobial Treatment ◽

Blood Cultures ◽

Clinical Impact ◽

Maldi Tof Ms ◽

Maldi Tof ◽

Tof Ms

Download Full-text

A Moldy Application of MALDI: MALDI-ToF Mass Spectrometry for Fungal Identification

Journal of Fungi ◽

10.3390/jof5010004 ◽

2019 ◽

Vol 5 (1) ◽

pp. 4 ◽

Cited By ~ 23

Author(s):

Robin Patel

Keyword(s):

Mass Spectrometry ◽

Filamentous Fungi ◽

Bacterial Identification ◽

Ionization Time ◽

Maldi Tof Ms ◽

Maldi Tof ◽

Flight Mass Spectrometry ◽

Fungal Identification ◽

Routine Identification ◽

Tof Ms

As a result of its being inexpensive, easy to perform, fast and accurate, matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-ToF MS) is quickly becoming the standard means of bacterial identification from cultures in clinical microbiology laboratories. Its adoption for routine identification of yeasts and even dimorphic and filamentous fungi in cultures, while slower, is now being realized, with many of the same benefits as have been recognized on the bacterial side. In this review, the use of MALDI-ToF MS for identification of yeasts, and dimorphic and filamentous fungi grown in culture will be reviewed, with strengths and limitations addressed.

Download Full-text