MALDI-ToF short incubation identification from blood cultures is associated with reduced length of hospitalization and a decrease in bacteremia associated mortality

Abstract

The purpose of this study was to assess the impact of MALDI-ToF identification and rapid short incubation MALDI-Tof identification protocol on patient care compared to conventional identification. By using a retrospective review we assessed the impact of a rapid Bruker MALDI-Tof identification protocol. Overall there was a 16.76-hour reduction in time to identification of the pathogen after the introduction of MALDI-TOF identification in 2013 (P<0.0001) and a further 15-hour reduction (P<9.37 E-05) after implementation of the short incubation MALDI-TOF identification protocol in 2014. Patients received appropriate therapy 20.25 hours earlier (P<0.002) in 2014 compared to the conventional identification group in 2012. Overall length in the patients needing optimization of antibiotic treatment was reduced by 6.87 days (P<0.042). In 2014 outcomes between the patients needing a change in their antibiotic compared to the patients where the empirical therapy was considered to be optimal were similar with respective difference in length of stay being reduced from 4.72 days (P<0.031) to 1.77 days (P<0.71) and an associated reduction in the absolute mortality risk of 3.79%. The all-cause mortality rate was twice as high in the group pre-implementation of the short incubation MALDI-TOF identification with an associated survival benefit in this patient population when 26 patients were treated. Rapid short incubation MALDI-ToF identification of bacterial pathogens in blood cultures is associated with a reduction in length of stay and mortality risk.

Método fenotípico automatizado versus método manual na identificação de micro-organismos isolados de hemoculturas: desfechos clínicos e microbiológicos

“…Adjustments in antimicrobial therapy after initial empirical therapy may result in better outcomes 25,26 . Huang et al 12 , Perez et al 5 and Delport et al 13 observed that reduction in time to identify microorganism resulted in rapid adjustments in antimicrobial treatment, however, as highlighted, the This work has some limitations. Data were collected in a single unit from a single institution, reducing the generalizability of the findings.…”

“…However, among the outstanding advantages, we observed some discrepancies with our data. However, an important difference observed is the automated microbiological identification method used by Huang et al 12 , Perez et al 5 and Delport et al 13 : matrix assisted laser desorption ionization-time of flight (MALDI-TOF). This methodology is technically superior to the VITEK® 2 compact 17,18 .…”

“…Despite the advantages related to automated microbiology, few studies have evaluated clinical outcomes 8 . As far as we know, some scholars compared the impact of automation implantation on patients and observed shorter hospitalization time, costs reduction, better therapeutic optimization and reduction in mortality 5,12,13 .…”

Factores pronósticos de mortalidad en niños con bacteriemias adquiridas en la comunidad (BAC) hospitalizados en un centro de referencia del Paraguay

“…Al valorar las variables clínicas y laboratoriales que inciden en la mortalidad en niños con (BAC), en relación a la edad, si bien la presencia de (BAC) fue significativamente mayor en los menores de 5 años de edad, la mortalidad fue semejante en ambos grupos (p=0,8), al establecer la relación entre las demás variables, la presencia de desnutrición, la infección a múltiples focos, la presencia de choque al ingreso, Glasgow <12, Saturación de Oxígeno menor a 94%, anemia severa y bacteriemia por Gram positivos se asociaron significativamente a mortalidad en la presente serie; siendo la mortalidad de la misma 16,5% similar a la mortalidad por (BAC) registrada en Estados Unidos y Europa 15 a 22% y menor a la mortalidad registrada en otros Países de (15,16,5) Latinoamérica 28 a 40%…”

Impact of short-incubation MALDI-TOF MS on empiric antibiotic therapy in bloodstream infections caused by Pseudomonas aeruginosa, Enterococcus spp. and AmpC-producing Enterobacteriaceae

“…In addition, combined with antimicrobial stewardship team intervention, it has been shown to be cost-effective (Patel et al, 2016;Perez et al, 2013). MALDI-TOF analysis combined with a short subculture time of positive blood cultures (si-MALDI-TOF) is an improvement of this technique, allowing even shorter time to pathogen identification with a positive effect on antibiotic therapy (Idelevich et al, 2014;Kohlmann et al, 2015), and is also associated with reduced length of hospital stay and mortality in patients with BSI (Delport et al, 2017).…”