Impact of Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry on the Clinical Management of Patients With Gram-negative Bacteremia: A Prospective Observational Study

Clerc, Olivier; Prod’hom, Guy; Vogne, Christelle; Bizzini, Alain; Calandra, Thierry; Greub, Gilbert

doi:10.1093/cid/cis1204

Cited by 192 publications

(149 citation statements)

References 21 publications

(28 reference statements)

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“…By testing of positive blood culture bottles using MALDI-TOF MS, time to organism identification is reduced by a day or more (69 ). A limitation is that antimicrobial susceptibility is not provided.…”

Section: Testing Of Positive Blood Culture Bottlesmentioning

confidence: 99%

MALDI-TOF MS for the Diagnosis of Infectious Diseases

2015

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BACKGROUND:First introduced into clinical microbiology laboratories in Europe, MALDI-TOF MS is being rapidly embraced by laboratories around the globe. Although it has multiple applications, its widespread adoption in clinical microbiology relates to its use as an inexpensive, easy, fast, and accurate method for identification of grown bacteria and fungi based on automated analysis of the mass distribution of bacterial proteins.CONTENT: This review provides a historical perspective on this new technology. Modern applications in the clinical microbiology laboratory are reviewed with a focus on the most recent publications in the field. Identification of aerobic and anaerobic bacteria, mycobacteria, and fungi are discussed, as are applications for testing urine and positive blood culture bottles. The strengths and limitations of MALDI-TOF MS applications in clinical microbiology are also addressed.

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Section: Testing Of Positive Blood Culture Bottlesmentioning

confidence: 99%

MALDI-TOF MS for the Diagnosis of Infectious Diseases

2015

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“…The application of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) technology for the identification of microorganisms in clinical diagnostics has significantly improved the time it takes to obtain results. This is especially true for the use of MALDI-TOF MS in identifying pathogens in blood cultures (BCs), a procedure that has been well evaluated (9)(10)(11). However, with the emergence of multiresistant Gram-negative bacteria, valid prediction of susceptibility based on the species alone is no longer possible (12,13).…”

mentioning

confidence: 99%

Evaluation of Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry for Rapid Detection of β-Lactam Resistance in Enterobacteriaceae Derived from Blood Cultures

et al. 2014

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The identification of pathogens directly from blood cultures by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) can be a valuable tool for improving the treatment of patients with sepsis and bacteremia. However, the increasing incidence of multidrug-resistant Gram-negative bacteria makes it difficult to predict resistance patterns based only on pathogen identification. Most therapy regimens for sepsis caused by Gram-negative rods consist of at least one ␤-lactam antibiotic. Thus, it would be of great benefit to have an early marker of resistance against these drugs. In the current study, we tested 100 consecutive blood cultures containing Enterobacteriaceae for resistance against 3rd-generation cephalosporins in a MALDI-TOF MS ␤-lactamase assay. Escherichia coli was also tested for resistance against aminopenicillins. The results of the ␤-lactamase assay were compared with those of conventional methods. The assay permitted discrimination between E. coli strains that were resistant or susceptible to aminopenicillins with a sensitivity and a specificity of 100%. The same was true for resistance to 3rd-generation cephalosporins in Enterobacteriaceae that constitutively produced class C ␤-lactamases. Discrimination was more difficult in species expressing class A ␤-lactamases, as these enzymes can generate false-positive results. Thus, the sensitivity and specificity for this group were 100% and 91.5%, respectively. The test permitted the prediction of resistance within 2.5 h after the blood culture was flagged as positive.

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“…This technology allows identification of both Gram-positive and Gramnegative bacteria (to a species level) within a few minutes, with a relatively low bacterial load being necessary for identification. A recent large observational study has demonstrated clinical benefit for this quick turn-around time [9]. In fact, we would even suggest that to have such a system, to accurately give us which organism is our pathogen and its sensitivity as a point-of-care test, is an obvious holy grail for intensivists.…”

Section: Editorialmentioning

confidence: 99%

“…Another area of intense research is to identify causative organisms more timeously [4,8,9]. One of the most promising techniques is matrix-assisted laser desorption ionization time-of-flight mass spectrometry or MALDI-TOF MS (sometimes without the MS).…”

Section: Editorialmentioning

confidence: 99%