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

Diagn Microbiol Infect Dis. 2019 May;94(1):1-6. doi: 10.1016/j.diagmicrobio.2018.11.009. Epub 2018 Nov 22.

Abstract

The impact of the short-incubation matrix-assisted laser desorption ionization time-of-flight (si-MALDI-TOF) mass spectrometry technique was evaluated in the treatment of bloodstream infections (BSIs) caused by Pseudomonas aeruginosa, Enterococcus spp., and Amp-C producing Enterobacteriaceae. A total of 124 bacteremia episodes were divided into 2 groups: i) si-MALDI-TOF group (n = 69) and ii) control group (n = 55). Identification by si-MALDI-TOF resulted in 12.8% increase in cases receiving appropriate antibiotic treatment within 48 h from blood culture draw. The importance of the rapid identification was emphasized in BSIs caused by enterococci (n = 62), where si-MALDI-TOF led to appropriate antibiotic treatment in 87.9% of cases (versus control group 65.5%, P = 0.036). Implementation of si-MALDI-TOF technology for microbial identification was associated with increased proportion of patients receiving effective antibiotic treatment within 48 h from blood culture draw. The effect was most significant in BSIs caused by enterococcal species and in a subgroup of immunosuppressed patients.

Keywords: Bacteremia; Bloodstream infection; Empiric antibiotic treatment; MALDI-TOF; Short incubation.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteriological Techniques / methods
  • Diagnostic Tests, Routine / methods
  • Enterobacteriaceae / chemistry
  • Enterobacteriaceae / growth & development
  • Enterobacteriaceae / isolation & purification*
  • Enterobacteriaceae Infections / diagnosis
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / microbiology
  • Enterococcus / chemistry
  • Enterococcus / growth & development
  • Enterococcus / isolation & purification*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pseudomonas Infections / diagnosis
  • Pseudomonas Infections / drug therapy
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / chemistry
  • Pseudomonas aeruginosa / growth & development
  • Pseudomonas aeruginosa / isolation & purification*
  • Retrospective Studies
  • Sepsis / diagnosis
  • Sepsis / drug therapy*
  • Sepsis / microbiology
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / methods*
  • Streptococcal Infections / diagnosis
  • Streptococcal Infections / drug therapy
  • Streptococcal Infections / microbiology
  • Time Factors

Substances

  • Anti-Bacterial Agents