Direct MALDI-TOF Mass Spectrometry Assay of Blood Culture Broths for Rapid Identification of Candida Species Causing Bloodstream Infections: an Observational Study in Two Large Microbiology Laboratories

Spanu, Teresa; Posteraro, Brunella; Fiori, Barbara; D’Inzeo, Tiziana; Campoli, Serena; Ruggeri, Alberto; Tumbarello, Mario; Canu, Giulia; Trecarichi, Enrico Maria; Parisi, Gabriella; Tronci, Mirella; Sanguinetti, Maurizio; Fadda, Giovanni

doi:10.1128/jcm.05742-11

Cited by 195 publications

(149 citation statements)

References 26 publications

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“…Este nuevo recurso permite la correcta identificación de especie superando a Vitek II 17 , y aún es posible esperar mayores beneficios si se usa directamente la sangre de la botella del frasco de hemocultivo logrando identificación en 30 min; con ello se alcanza una concordancia con los métodos tradicionales de 96% para C. albicans y 86% para C. no-albicans 17,18 .…”

Section: Discussionunclassified

Cambios clínicos y epidemiológicos de candidemias en pacientes adultos desde 2000 a 2013

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Legarraga

García

et al. 2017

Rev. chil. infectol.

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60 years, 77,5% had at least one co-morbidity. Candida albicans was the species most frequently identified 55%, followed by C. glabrata 18.3%, C. tropicalis 11.7% and C. parapsilosis 9.2%. Comparing 2000-2006 vs 2007-2013, increased the frequency of C. parapsilosis among non-albicans and echinocandins prescription. Patients with C. albicans showed higher APACHE-II, more requirement for invasive mechanical ventilation, greater association with CVC, and shorter incubation time compared with non-albicans species. The 30-day mortality was 31.7%. Conclusions: During this 14-years period we observed that C. albicans was the predominant specie and more recently a change among C. non-albicans increasing C. parapsilosis and decreasing C. glabrata 30-days and attributable mortality decreased together with more echinocandins prescription.]]>

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Section: Discussionunclassified

Cambios clínicos y epidemiológicos de candidemias en pacientes adultos desde 2000 a 2013

Siri

Legarraga

García

et al. 2017

Rev. chil. infectol.

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“…Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has overcome several of the shortcomings of conventional microbiology for the detection and identification of yeasts [30][31][32]. Turnaround times are 10-15 min after the growth of a fungal colony or a positive blood culture, and diagnostic accuracy is over 95%.…”

Section: Invasive Candidiasismentioning

confidence: 99%

Intensive care medicine research agenda on invasive fungal infection in critically ill patients

et al. 2017

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Purpose:To describe concisely the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to Candida and Aspergillus infections in non-neutropenic patients in the ICU setting. Methods:A systematic review of the medical literature taking account of national and international guidelines and expert opinion. Results:Severe invasive fungal infections (IFIs) are becoming increasingly frequent in critically ill patients. Approximately 80% of IFIs are due to Candida spp. and 0.3-19% to Aspergillus spp. Recent observations emphasize the necessity of building a worldwide sentinel network to monitor the emergence of new fungal species and changes in susceptibility. Robust data on the attributable mortality are essential for the design of clinical studies with mortality endpoints. Although early antifungal therapy for Candida has been recommended in patients with risk factors, sepsis of unknown cause, and positive Candida serum biomarkers [β-1 → 3-d-glucan (BDG) and Candida albicans germ tube antibody (CAGTA)], its usefulness and influence on outcome need to be confirmed. Future studies may specifically address the optimal diagnostic and therapeutic strategies for patients with abdominal candidiasis. Better knowledge of the pharmacokinetics of antifungal molecules and tissue penetration is a key issue for intensivists. Regarding invasive aspergillosis, further investigation is needed to determine its incidence in the ICU, its relationship with influenza outbreaks, the clinical impact of rapid diagnosis, and the significance of combination treatment. Conclusions:Fundamental questions regarding IFI have to be addressed over the next decade. The clinical studies described in this research agenda should provide a template and set priorities for the clinical investigations that need to be performed.

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“…Two manufacturers, bioMérieux (Marcy l'Etoile, France) and Bruker Daltonics (Bremen, Germany), are marketing efficient MALDI-TOF systems, the Vitek-MS and the Microflex LT, respectively, that allow the identification of bacteria and yeasts in a few minutes instead of the hours required by traditional methods. The practical use of MALDI-TOF MS for microorganism identification directly from positive blood culture specimens has been substantiated by a number of studies (9)(10)(11)(12)(13). Generally, studies have shown high identification rates for various types of organisms with the use of MALDI-TOF MS .…”

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confidence: 98%

Direct Bacterial Identification in Positive Blood Cultures by Use of Two Commercial Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry Systems

et al. 2013

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. Overall, the Biotyper system generated significantly more accurate identifications than the Vitek MS IVD system (P ‫؍‬ 0.016; 177 versus 167 out of 181 specimens). The Biotyper system identified the minority species among polymicrobial blood cultures. We also compared the performance of an in-house extraction method with that of the Sepsityper on both MALDI-TOF MS systems. The in-house method generated more correct identifications at the genus level than the Sepsityper (96.7% versus 93.5%) on the Biotyper system, whereas the two methods exhibited the same performance level (88.0% versus 88.0%) on the Vitek MS IVD system. Our study confirmed the practical advantages of MALDI-TOF MS, and our in-house extraction method reduced the reagent cost to $1 per specimen, with a shorter turnaround time of 3 h, which is highly cost-effective for a diagnostic microbiology service. Bloodstream infection is a condition associated with high morbidity and mortality (1, 2). The rapid identification of bloodstream pathogens is critical to clinical management and the choice of appropriate antibiotic treatments (3, 4). Currently, microbiologic diagnosis of bacteremia relies on subculture of positive blood culture broths on solid medium for an 18-to 24-h incubation period followed by biochemical tests or an automated preformed enzyme assay for identification of the bacteria (5). In general, laboratory diagnosis of common pathogens requires 18 to 48 h, while diagnosis of fastidious organisms requires longer incubation and identification procedures. Although the use of modern techniques such as fluorescence in situ hybridization and PCR can shorten the identification time (6), these operations require specialized equipment and technical expertise and the targeted pathogens are limited in a single run (7). Therefore, the introduction of a simple, rapid, broad-spectrum, and cost-effective system for the identification of blood culture pathogens is imperative.Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) was developed in the 1980s, and this technique had been widely used for biomolecule analysis in the chemical industry for over 10 years. In recent years, MALDI-TOF MS was introduced for bacterial identification, which revolutionized the diagnostic microbiology service (8). Two manufacturers, bioMérieux (Marcy l'Etoile, France) and Bruker Daltonics (Bremen, Germany), are marketing efficient MALDI-TOF systems, the Vitek-MS and the Microflex LT, respectively, that allow the identification of bacteria and yeasts in a few minutes instead of the hours required by traditional methods. The practical use of MALDI-TOF MS for microorganism identification directly from positive blood culture specimens has been substantiated by a number of studies (9-13). Generally, studies have shown high identification rates for various types of organisms with the use of MALDI-TOF MS . However, various organism isolation methods from blood were used in those studies and therefore method standardization is necessary. The...

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Direct MALDI-TOF Mass Spectrometry Assay of Blood Culture Broths for Rapid Identification of Candida Species Causing Bloodstream Infections: an Observational Study in Two Large Microbiology Laboratories

Cited by 195 publications

References 26 publications

Cambios clínicos y epidemiológicos de candidemias en pacientes adultos desde 2000 a 2013

Cambios clínicos y epidemiológicos de candidemias en pacientes adultos desde 2000 a 2013

Intensive care medicine research agenda on invasive fungal infection in critically ill patients

Direct Bacterial Identification in Positive Blood Cultures by Use of Two Commercial Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry Systems

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