Direct matrix-assisted laser desorption ionization time-of-flight mass spectrometry and real-time PCR in a combined protocol for diagnosis of bloodstream infections: a turnaround time approach

Quiles, Marcos G.; Boettger, Bruno Cruz; Inoue, Fernanda Matsiko; Monteiro, Jussimara; Santos, Daniel Wagner de Castro Lima; Ponzio, Vinícius; Carlesse, Fabianne; Cappellano, Paola; Carvalhaes, Cecília G; Pignatari, Antônio Carlos Campos

doi:10.1016/j.bjid.2019.05.005

Cited by 7 publications

(3 citation statements)

References 40 publications

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“…Had the samples been repeated, we could have obtained even better results in identifying bacteria. In addition, our results were similar to those of other studies that performed rapid identification directly from blood culture bottles containing Gram-negative bacilli; 10 , 16 , 17 , 22 this indicates that our protocol is a viable technique for reducing the turnaround time of blood cultures.…”

Section: Discussionsupporting

confidence: 87%

Rapid bacterial identification by MALDI-TOF MS directly from blood cultures and rapid susceptibility testing: A simple approach to reduce the turnaround time of blood cultures

Barth

Roesch

Lutz

et al. 2023

The Brazilian Journal of Infectious Diseases

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Section: Discussionsupporting

confidence: 87%

Rapid bacterial identification by MALDI-TOF MS directly from blood cultures and rapid susceptibility testing: A simple approach to reduce the turnaround time of blood cultures

Barth

Roesch

Lutz

et al. 2023

The Brazilian Journal of Infectious Diseases

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“…Patients who had been administered with antibiotics (such as some postoperative or transferred patients) were excluded from the study. In this study, the observation unit was an episode of suspected BSI, the results were evaluated as follows: once a bacterial or fungal pathogen was isolated from at least one blood culture, a positive BSI episode was recorded, and the consecutive duplicate results were merged; a BSI episode was considered new if it was detected at least 14 days from the previous infection with positive blood culture or if a different microorganism was isolated from a new blood sample (Quiles et al, 2019); consecutive repeated negative blood culture results from one patient during one hospitalization was recorded as a negative BSI episode. A total of 2,763 patients with 2,844 consecutive new episodes of suspected BSIs were recruited.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Real-Time PCR Coupled With Multiplex Probe Melting Curve Analysis for Pathogen Detection in Patients With Suspected Bloodstream Infections

Xiao

Shen

Zhao

et al. 2019

Front. Cell. Infect. Microbiol.

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Background: This study aimed to evaluate real-time polymerase chain reaction coupled with multiplex probe melting curve analysis (PCR-MCA) for pathogen detection in patients with suspected bloodstream infections (BSIs).Methods: A PCR-MCA assay was developed for simultaneous identification of 28 kinds of the most common pathogens and two resistance genes within a few hours. The diagnostic performance of the PCR-MCA assay was determined and compared to the results of blood culture.Results: A total of 2,844 consecutive new episodes of suspected BSIs in 2,763 patients were included in this study. There were 269 episodes of pathogens identified by blood culture. For all the pathogens tested, the PCR-MCA assay exhibited a sensitivity of 88.8% (239/269), specificity of 100% (2,575/2,575), and agreement of 98.9% (2,814/2,844). For the pathogens on the PCR-MCA list, the PCR-MCA results had a sensitivity of 99.2% (239/241), specificity of 100% (2,575/2,575), and agreement of 99.9% (2,814/2,816) compared with the results of blood culture. For seven samples with multiple pathogens identified simultaneously during one blood culture investigation, the PCR-MCA assay verified the results of the blood culture, with an agreement rate of 100% for each.Conclusion: The PCR-MCA assay could discover 88.8% of the pathogens in clinical practice, showing excellent diagnostic performance vs. that of blood culture for pathogen detection in patients with suspected BSIs, and would contribute to rapid diagnosis and correct antibiotic administration.

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“…An extensive variety in therapeutic regimens was discerned among all patients, highlighting the complexity and individualized nature of the treatment approaches. Aside from therapeutic decisions, the upcoming of faster microbiological diagnostic tools represents a promising approach, allowing prompt therapeutical adjustments and treatment optimization [51].…”

Section: Plos Onementioning

confidence: 99%

Carbapenem-resistant Klebsiella pneumoniae bloodstream infections in haematological malignances and hematopoietic stem cell transplantation: Clinical impact of combination therapy in a 10-year Brazilian cohort

de Souza,

Cappellano,

Ferreira

et al. 2024

PLoS ONE

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Bacterial bloodstream infections (BSI) are a common threat among patients with haematological malignancies (HM) and hematopoietic stem cell transplant recipients (HSCT). The purpose of this research was to describe clinical and microbiological aspects of BSI caused by carbapenem-resistant Klebsiella pneumoniae (CRKp) and assess risk factors associated with 30-day mortality in a 10-year cohort of haematological patients. A total of 65 CRKp-BSI episodes occurring in HM patients and HSCT recipients and CRKp-BSI between January 2010 and December 2019 were retrospectively studied. Acute leukemias were the most frequently observed underlying disease (87.7%) and 18 patients (27.7%) received HSCT. Mucosal barrier injury in the gastrointestinal tract was the primary cause of bacteremia (86.1%). Also, 14 individuals (21.6%) had an Invasive Fungal Disease (IFD) throughout the episode. Regarding treatment, in 31 patients (47.7%) empirical therapy was deemed appropriate, whereas 33 (50.8%) patients received a combination therapy. Microbiological data revealed that the majority of isolates (53–58%) had the Polymyxin B co-resistance phenotype, while amikacin resistance was less common (16 samples, or 24.7%). The mortality rates at 14 and 30 days were 32.3% and 36.9%, respectively. In a multivariate Cox regression analysis, prompt appropriate antibiotic administration within three days was associated with a better outcome (Adjusted Hazard Ratio [aHR]: 0.33; 95% Confidence Interval [CI]: 0.14–0.76; p = 0.01), whereas hypotension at presentation (aHR: 3.88; 95% CI: 1.40–10.74; p = 0.01) and concurrent IFD (aHR: 2.97; 95% CI: 1.20–7.37; p = 0.02) were independently associated with death within 30 days. Additionally, a favorable correlation between combination therapy and overall survival was found (aHR: 0.18; 95%CI: 0.06–0.56; p = 0.002). In conclusion, 30-day mortality CRKp-BSI was elevated and most of the isolates were polymyxin B resistant. Early appropriate antimicrobial treatment and the use of combination therapy were linked to a better outcome.

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Direct matrix-assisted laser desorption ionization time-of-flight mass spectrometry and real-time PCR in a combined protocol for diagnosis of bloodstream infections: a turnaround time approach

Cited by 7 publications

References 40 publications

Rapid bacterial identification by MALDI-TOF MS directly from blood cultures and rapid susceptibility testing: A simple approach to reduce the turnaround time of blood cultures

Rapid bacterial identification by MALDI-TOF MS directly from blood cultures and rapid susceptibility testing: A simple approach to reduce the turnaround time of blood cultures

Evaluation of Real-Time PCR Coupled With Multiplex Probe Melting Curve Analysis for Pathogen Detection in Patients With Suspected Bloodstream Infections

Carbapenem-resistant Klebsiella pneumoniae bloodstream infections in haematological malignances and hematopoietic stem cell transplantation: Clinical impact of combination therapy in a 10-year Brazilian cohort

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