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Rapid identification by MALDI-TOF/MS and antimicrobial disk diffusion susceptibility testing for positive blood cultures after a short incubation on the WASPLab

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Abstract

The objectives of this study were to define the shortest incubation times on the WASPLab for reliable MALDI-TOF/MS-based species identification and for the preparation of a 0.5 McFarland suspension for antimicrobial disk diffusion susceptibility testing using short subcultures growing on solid culture media inoculated by positive blood cultures spiked with a wide range of pathogens associated with bloodstream infections. The 520 clinical strains (20 × 26 different species) included in this study were obtained from a collection of non-consecutive and non-duplicate pathogens identified at Geneva University Hospitals. After 4 h of incubation on the WASPLab, microorganisms’ growth allowed accurate identification of 73% (380/520) (95% CI, 69.1–76.7%) of the strains included in this study. The identification rate increased to 85% (440/520) (95% CI, 81.3–87.5%) after 6-h incubation. When excluding Corynebacterium and Candida spp., the microbial growth was sufficient to permit accurate identification of all tested species (100%, 460/460) (95% CI, 99.2–100%) after 8-h incubation. With the exception of Burkholderia cepacia and Haemophilus influenzae, AST by disk diffusion could be performed for Enterobacterales and non-fermenting Gram-negative bacilli after only 4 h of growth in the WASPLab. The preparation of a 0.5 McFarland suspension for Gram-positive bacteria required incubation times ranging between 3 and 8 h according to the bacterial species. Only Corynebacterium spp. required incubation times as long as 16 h. The WASPLab enables rapid pathogen identification as well as swift comprehensive AST from positive blood cultures that can be implemented without additional costs nor hands-on time by defining optimal time points for image acquisition.

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Acknowledgment

The authors would like to thank Stéfane MARQUES MELANCIA, Marc JACQUES VINCENT, and Adrien FISCHER for technical assistance.

Funding

This study was supported using internal funding.

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Authors and Affiliations

  1. Department of Diagnostics, Bacteriology Laboratory, Division of Laboratory Medicine, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1205, Geneva, Switzerland

    Abdessalam Cherkaoui, Gesuele Renzi, Nouria Azam, Didier Schorderet & Jacques Schrenzel

  2. Department of Diagnostics, Division of Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland

    Nicolas Vuilleumier

  3. Department of Medical Specialities, Division of Laboratory Medicine, Faculty of Medicine, Geneva, Switzerland

    Nicolas Vuilleumier

  4. Department of Medicine, Genomic Research Laboratory, Division of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland

    Jacques Schrenzel

Authors
  1. Abdessalam Cherkaoui
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  2. Gesuele Renzi
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  3. Nouria Azam
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  4. Didier Schorderet
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  5. Nicolas Vuilleumier
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  6. Jacques Schrenzel
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Correspondence to Abdessalam Cherkaoui.

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Conflict of interest

JS received restricted research grants and participated to advisory boards from BioMérieux and Debiopharm. NV received restricted research grants from Roche. This research was conducted in the absence of any commercial or financial relationships in the last 3 years that could be construed as a potential conflict of interest.

Ethical approval

In accordance with the local ethical committee (Commission cantonale d’éthique de la recherche, https://www.hug-ge.ch/ethique), routine clinical laboratories of our institution may use biological sample leftovers for method development after irreversible anonymization of the data.

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Cherkaoui, A., Renzi, G., Azam, N. et al. Rapid identification by MALDI-TOF/MS and antimicrobial disk diffusion susceptibility testing for positive blood cultures after a short incubation on the WASPLab. Eur J Clin Microbiol Infect Dis 39, 1063–1070 (2020). https://doi.org/10.1007/s10096-020-03817-8

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  • DOI: https://doi.org/10.1007/s10096-020-03817-8

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