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RESEARCH PRODUCT

Improvement of a rapid direct blood culture microbial identification protocol using MALDI-TOF MS and performance comparison with SepsiTyper kit

David BongiornoGiuseppe StamponeSerena IndelicatoFrancesca Di GaudioMaria Rita TricoliSergio Indelicato

subject

0301 basic medicineMicrobiology (medical)Time FactorsComputer science030106 microbiologyBacteremiaClinical diagnostic laboratorySensitivity and SpecificityMicrobiology03 medical and health sciencesSpecies SpecificitymedicineHumansBlood cultureOverall performanceMolecular BiologyProtocol (science)Bacteriological TechniquesChromatographyBacteriamedicine.diagnostic_testDiagnostic Tests RoutineGold standard (test)Matrix-assisted laser desorption/ionizationIdentification (information)Blood CulturePathogens identificationSpectrometry Mass Matrix-Assisted Laser Desorption-IonizationPerformance comparisonCosts and Cost AnalysisGenus and species identificationMatrix- assisted laser desorption ionization time of flight mass spectrometry

description

Fast diagnosis of pathogens is critical to guarantee the most adequate therapy for infections; bacterial culture methods, which constitute the actual gold standard, are precise and sensitive but rather slow. Today, new methods have been made available to enable faster diagnosis, with the Matrix-Assisted Laser Desorption Ionization-Time Of Flight Mass Spectrometry (MALDI-TOF MS) technique being the most promising. Even if simpler and faster than traditional bacterial culture methods, analysis of positive blood cultures via MALDI-TOF MS requires a preliminary extraction process of samples. In this study, we compared two extraction protocols for bacterial identification directly from positive blood cultures using the Bruker MALDI Biotyper system (Bruker Daltonics, Billerica, MA). In particular, we evaluated the time employed and the overall performance for their accurate identification. In this work, the performances of a commercial extraction kit, named SepsiTyper™ Kit, and those of the protocol developed by Treibmann et al. were evaluated and proven to be similar. However, the SELTERS method represents the best compromise price/performance. Lastly, an in-house developed analysis protocol has been tested, and the introduced optimizations granted a performance level equal if not better than the SepsiTyper kit, a reduced processing time and reduced costs.

https://doi.org/10.1016/j.mimet.2018.10.015