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Reducing time to identification of positive blood cultures with MALDI-TOF MS analysis after a 5-h subculture

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Abstract

Speeding up the turn-around time of positive blood culture identifications is essential in order to optimize the treatment of septic patients. Several sample preparation techniques have been developed allowing direct matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) identification of positive blood cultures. Yet, the hands-on time restrains their routine workflow. In this study, we evaluated an approach whereby MALDI-TOF MS identification without any additional steps was carried out on short subcultured colonies from positive blood bottles with the objective of allowing results reporting on the day of positivity detection. Over a 7-month period in 2012, positive blood cultures detected by 9 am with an automated system were inoculated onto a Columbia blood agar and processed after a 5-h incubation on a MALDI-TOF MicroFlex platform (Bruker Daltonik GmbH). Single-spotted colonies were covered with 1 μl formic acid and 1 μl matrix solution. The results were compared to the validated identification techniques. A total of 925 positive blood culture bottles (representing 470 bacteremic episodes) were included. Concordant identification was obtained in 727 (81.1 %) of the 896 monomicrobial blood cultures, with failure being mostly observed with anaerobes and yeasts. In 17 episodes of polymicrobic bacteremia, the identification of one of the two isolates was achieved in 24/29 (82.7 %) positive cultures. Routine implementation of MALDI-TOF MS identification on young positive blood subcultures provides correct results to the clinician in more than 80 % of the bacteremic episodes and allows access to identification results on the day of blood culture positivity detection, potentially accelerating the implementation of targeted clinical treatments.

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Acknowledgments

This study was supported, in part, by a research grant from Fondation Saint-Luc, Cliniques universitaires Saint-Luc, UCL, Bruxelles.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Institut de recherche expérimentale et clinique (IREC), pôle de microbiologie (MBLG), Université catholique de Louvain, Brussels, Belgium

    A. Verroken & M. Delmée

  2. Laboratoire de microbiologie, Cliniques universitaires Saint-Luc—Université catholique de Louvain, Brussels, Belgium

    A. Verroken, L. Defourny, L. Lechgar, A. Magnette & M. Delmée

  3. National Reference Centre for Monitoring of Antimicrobial Resistance in Gram-negative bacteria, CHU Dinant Godinne | UCL Namur, Yvoir, Belgium

    Y. Glupczynski

Authors
  1. A. Verroken
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  2. L. Defourny
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  3. L. Lechgar
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Correspondence to A. Verroken.

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Verroken, A., Defourny, L., Lechgar, L. et al. Reducing time to identification of positive blood cultures with MALDI-TOF MS analysis after a 5-h subculture. Eur J Clin Microbiol Infect Dis 34, 405–413 (2015). https://doi.org/10.1007/s10096-014-2242-4

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  • DOI: https://doi.org/10.1007/s10096-014-2242-4

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