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- Title
Direct MS-Based Bacterial Identification of Blood Cultures. Comparison of an In-House TritonX-Protocol with Bruker-Sepsityper<sup>TM</sup>.
- Authors
Kittel, Maximilian; Greulich, Anna; Findeisen, Peter; Haselmann, Verena; Burrer, Achim; Willem, Christian; Miethke, Thomas; Ahmad-Nejad, Parviz; Neumaier, Michael
- Abstract
Background: Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) revolutionized the identification of bacterial pathogens. Especially in time sensitive situations, such as blood stream infections this technique significantly reduced the turn-around times. The direct bacterial extraction of positive blood culture bottles and consecutive MALDI-TOF MS-based identification is able to provide the clinician actionable health information earlier than conventional microbiological identification techniques such as Vitek 2TM (bio- Mérieux). Methods: We developed an in-house extraction method for bacterial identification in blood culture flasks and compared this with the commercially available Bruker SepsityperTM kit. First, 40 clinical samples were processed with both sample preparation methods. Second, diagnostic performance as well as handling, assay time and extraction costs were compared. Finally, all results were validated by identification of the subcultured isolates from agar plates. Results: Even though we obtained slightly higher scores with the SepsityperTM kit, it was possible to identify 97.5% of all isolates by Bruker SepsityperTM kit and 92.5% by using the in-house assay with the standard cutoff value. By applying modified acceptance criteria, we were able to identify 100% by Bruker SepsityperTM kit and 97.5% of all isolates with the in-house assay. Most importantly, no misidentification occurred. The comparison of the extraction costs revealed, that the in-house assay is considerably less expensive (0.01 vs. 8.62) and offers shorter hands-on time (19 vs. 30 minutes). Conclusions: We have developed and validated an in-house extraction method with comparable performance to the Bruker SepsityperTM kit that reduces unit test cost and evaluation time leading to a cost benefit of 63.24% in this scenario.
- Subjects
MATRIX-assisted laser desorption-ionization; GRAM-negative bacteria; GRAM-positive bacteria; ANTIBIOTICS; ANTI-infective agents
- Publication
Clinical Laboratory, 2018, Vol 64, Issue 11/12, p1883
- ISSN
1433-6510
- Publication type
Article
- DOI
10.7754/Clin.Lab.2018.180522