Work Flow Analysis of Around-the-clock Processing of Blood Culture Samples and Integrated MALDI-TOF Mass Spectrometry Analysis for the Diagnosis of Bloodstream Infections

Schneiderhan, Wilhelm; Grundt, Alexander; Wörner, Stefan; Findeisen, Peter; Neumaier, Michael

doi:10.1373/clinchem.2012.198218

Cited by 35 publications

(22 citation statements)

References 29 publications

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“…Benefits for patients and the healthcare system include decreased morbidity and mortality, fewer laboratory tests and procedures, reduced time to optimal antibiotic therapy, shorter hospital and intensive care unit stays and reduced costs [5,9,17,18,23]. Standard protocols for microbial identification and antimicrobial susceptibility testing (AST) involve blood culture in liquid medium using commercial systems, Gram staining and overnight sub-culturing of signalpositive samples on solid medium to obtain isolated colonies [4,20,21]. The isolated colonies are then used for identification and susceptibility testing.…”

Section: Introductionmentioning

confidence: 99%

“…Direct application of AST to blood culture, without the need for overnight culturing of isolated colonies, further reduce the turnaround time for reporting of AST results. Rapid direct microbial identification from blood cultures, for example by Matrix-Assisted Laser Desorption/Ionisation Time of Flight Mass Spectrometry (MALDI-TOF-MS) [12,21,23] serves the same purpose. Various direct blood culture testing methods have yielded microbial identification and AST results with comparable accuracy and error rates to routine isolated colony-based methods, with reduced inappropriate antimicrobial use and lower cost [9,12,19,22,23].…”

Section: Introductionmentioning

confidence: 99%

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Direct identification and susceptibility testing of positive blood cultures using high speed cold centrifugation and Vitek II system

Bazzi

Rabaan

Fawarah

et al. 2017

Journal of Infection and Public Health

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Compared to routine isolated colony-based methods, direct testing of bacterial pellets from positive blood cultures reduces turnaround time for reporting of antibiotic susceptibility. The aim of this study was to compare the accuracy, and precision, of a rapid method for direct identification and susceptibility testing of blood cultures with the routine method used in our laboratory, using Vitek 2. A total of 60 isolates were evaluated using the candidate and the routine method. The candidate method had 100% accuracy for the identification of Gram negative bacteria, Staphylococcus and Enterococcus, 50% for Streptococcus and 33.3% for Corynebacterium species. Susceptibility testing of Gram negative isolates yielded 98-100% essential agreement. For Staphylococcus and Enterococcus isolates, essential agreement was 100% for 17 antibiotics except for moxifloxacin. Direct testing of blood culture samples with Vitek 2 produced reliable identification and susceptibility results 18-24h sooner for aerobic/anaerobic facultative Gram-negative bacteria and Gram-positive Staphylococcus and Enterococcus strains.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Direct identification and susceptibility testing of positive blood cultures using high speed cold centrifugation and Vitek II system

Bazzi

Rabaan

Fawarah

et al. 2017

Journal of Infection and Public Health

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“…Newly introduced technologies such as PCR-based methods, fluorescence in situ hybridization and MALDI-TOF have expedited the causative pathogen identification (1,5,8,19). Also on the antimicrobial susceptibility testing (AST) scenario there are several chances to reduce the TAT: i) direct inoculation of automatic susceptibility testing instruments or use of young culture on agar media (12,13,17,20), and ii) use of liquid culture or time lapse microscopy based technologies (1,11,14).…”

Section: N O N -C O M M E R C I a L U S E O N L Ymentioning

confidence: 99%

Real life turnaround time of blood cultures in the clinical microbiology laboratory: results of the first Italian survey, May 2015

et al. 2016

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SummaryBackground and aims: Blood culture (BC) results are essential to guide antimicrobial chemotherapy for patients with sepsis. However, BC is a time-consuming exam, which can take several days. Reducing BCs turn around time (TAT) could impact on multiple outcome parameters and TAT monitoring is an important tool for measurement of microbiology laboratory performance. The aim of this study was to provide an overview of BC TATs among Italian microbiology laboratories.Materials and methods: Five laboratories collected and recorded, for a month period, date and time of the BC processing events. Cumulative TATs were analysed using the GraphPad software.Results: Participating laboratories reported data from 302 sepsis episodes. The median time from when the BC system produced a positive signal until Gram-stain results were reported was 7.6 hours. A rapid molecular identification and antimicrobial susceptibility testing (AST) was performed in 26.5% of BCs. Mean TAT for identification report was significantly lower when a molecular approach was adopted (12 vs. 28.7 hours, P<0.001). Similarly, results of the molecular AST were obtained more than 24 hours in advance compared with phenotypic AST (mean 13.2 vs. 47.6, P<0.001). TATs from BC positivity of laboratories opened 7 days/week were not significantly lower than those of laboratories opened 6 days/week.Conclusions: BC is a time-consuming exam, however, molecular identification and AST methods can drastically reduce time to results. The lack of difference between TATs observed for laboratories working 7 days/week and 6 days/week, coupled with a high rate of BCs turning positive during the night enable to conclude that the most urgent measure to reduce TATs is the expansion of laboratory regular duty hours. IntroductionSepsis is a severe disease associated with high morbidity and mortality (7). Although conflicting data exist, early administration of appropriate empirical antimicrobial therapy, coupled with supportive treatment, have been shown to have an important impact on outcome (6,9,10,16

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“…Although it identifies bacteria and yeasts within a few minutes, it requires isolated colonies, which takes 18-48 hr of incubation [17] . To reduce the time needed for identification and AST, some investigators tried to inoculate microorganisms present in positive blood culture bottles directly into MALDI-TOF MS system [18][19][20] . However, direct identification requires sample preparation steps since blood culture bottles contain proteins/debris which could interfere with the spectra of the microorganisms [21] .…”

Section: Introductionmentioning

confidence: 99%

Identification and antimicrobial susceptibility testing of microorganisms from positive blood cultures by a combined lysis-centrifugation method with MALDI-TOF MS and VITEK2 System

Rodio

Febbraro

Puggioni

et al. 2017

APALM

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Background: Rapid identification and the application of antimicrobial susceptibility testing (AST) to microorganisms causing bloodstream infections is pivotal to guide antimicrobial therapy. This study aims to: 1) utilize the Lysis-Centrifugation Method (LCM) not only for identification of microorganisms from positive blood culture bottles, but also for direct AST full panel by Vitek ® 2 system (bioMérieux, Inc. France) and by disc diffusion plate (Kirby Bauer Method) and 2) analyze the accuracy of these combined methods.Methods: 124 mono-microbial positive blood culture bottles were included in this study. An aliquot was subjected to LCM and used for the identification by the MALDI-TOF System. Moreover the microbial pellet was used for direct AST testing full panel by VITEK Results: 123 isolates were correctly identified to the species level and 1 isolate was identified to the genus level. Comparing the two utilized AST methods, it was observed that Gram-positive isolates showed an agreement rate of 96.6% (58/60). Enterococcus faecalis was the only microorganism with a major error rate of 0.6% (2/324) related to erythromycin. Among the Gram-negative, the overall agreement rate was 93.3 (56/60). Klebsiella pneumoniae, Escherichia coli and Enterobacter spp. were the major cause of minor error rates (0.6%, 4/709) and major error rates (1.1%, 8/709). Among the yeasts, results showed an agreement rate of 100% (4/4). Conclusions:Our simple and cost-effective sample preparation method is very useful for rapid identification as well as AST of microorganisms directly from positive blood culture bottles in a clinical setting.

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Work Flow Analysis of Around-the-clock Processing of Blood Culture Samples and Integrated MALDI-TOF Mass Spectrometry Analysis for the Diagnosis of Bloodstream Infections

Cited by 35 publications

References 29 publications

Direct identification and susceptibility testing of positive blood cultures using high speed cold centrifugation and Vitek II system

Direct identification and susceptibility testing of positive blood cultures using high speed cold centrifugation and Vitek II system

Real life turnaround time of blood cultures in the clinical microbiology laboratory: results of the first Italian survey, May 2015

Identification and antimicrobial susceptibility testing of microorganisms from positive blood cultures by a combined lysis-centrifugation method with MALDI-TOF MS and VITEK2 System

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