Rapid Species Identification of <i>Candida</i> Directly from Blood Culture Broths by Sepsityper-Maldi-Tof Mass Spectrometry: Impact on Antifungal Therapy

Bal, Abhijit M.; McGill, Mackenzie

doi:10.4997/jrcpe.2018.203

Cited by 14 publications

(13 citation statements)

References 26 publications

(34 reference statements)

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“…Importantly, the use of specific MBT-Sepsityper module had a very significant impact on yeast identification rate as it increased identification rates by 38% for RS + FA and SS protocols. While in previous studies SS results ranged from 56% to 65.9% reliable identification rates using MBT-Compass-IVD database, we obtained similar identifications rates while requiring only 10 min turnaround time with the RS + FA protocol (58.6%) when using the MBT-Sepsityper module and significantly higher results with the SS protocol and the MBT-Sepsityper module (89.7%) [30,[70][71][72][73]. Some limitations of our study have to be highlighted.…”

Section: Discussionsupporting

confidence: 55%

Evaluation of Rapid Sepsityper® protocol and specific MBT-Sepsityper module (Bruker Daltonics) for the rapid diagnosis of bacteremia and fungemia by MALDI-TOF-MS

Ponderand

Pavèse

Maubon

et al. 2020

Ann Clin Microbiol Antimicrob

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During bloodstream infections, rapid adaptation of empirical treatment according to the microorganism identified is essential to decrease mortality. The aim of the present study was to assess the microbiological performances of a new rapid version of the Sepsityper® kit (Bruker Daltonics) allowing identification of bacteria and yeast by MALDI-TOF mass spectrometry directly from positive blood cultures in 10 min and of the specific MBT-Sepsityper module for spectra analysis, designed to increase identification performance. Identification rates were determined prospectively on 350 bacterial and 29 fungal positive blood cultures, and compared to conventional diagnostic method. Our rapid diagnosis strategy (Rapid Sepsityper® protocol: one spot with and one without formic acid extraction step) combined to MBT-Sepsityper module provided 65.4%, 78.9% and 62% reliable identification to the species level of monomicrobial positive blood cultures growing respectively Gram-positive, Gram-negative bacteria or yeast. Importantly, identification rates of Gram-positive bacteria were higher in anaerobic than in aerobic bottles (77.8% vs 22.2%; p = 0.004), if formic acid extraction step was performed (60.8% vs 39.2%; p = 1.8e−6) and if specific MBT-Sepsityper module was used (76.2% vs 61.9%, p = 0.041) while no significant differences were observed for Gram-negative bacteria. For yeasts identification, formic acid extraction step improved rapid identification rate by 37.9% while the specific MBT-Sepsityper module increased overall performances by 38%, providing up to 89.7% reliable identification if associated with the standard Sepsityper® protocol. These performances, associated with a reduce turnaround time, may help to implement a rapid identification strategy of bloodstream infections in the routine workflow of microbiology laboratories.

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Section: Discussionsupporting

confidence: 55%

Evaluation of Rapid Sepsityper® protocol and specific MBT-Sepsityper module (Bruker Daltonics) for the rapid diagnosis of bacteremia and fungemia by MALDI-TOF-MS

Ponderand

Pavèse

Maubon

et al. 2020

Ann Clin Microbiol Antimicrob

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“…The choice between echinocandins and fluconazole may have been dictated by patient factors, existing guidelines, and, from 2014 onwards, by the rapid identification of species directly from the blood culture fluid. If C parapsilosis was identified by rapid testing, fluconazole was chosen over an echinocandin 15 . Although fluconazole is favoured in the treatment of C parapsilosis , 16 we awarded 0 points for this quality indicator in order to maintain consistency in our audit.…”

Section: Discussionmentioning

confidence: 99%

Candidaemia in the elderly: Epidemiology, management and adherence to the European Confederation of Medical Mycology quality indicators

Bal

Palchaudhuri

2020

Mycoses

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Summary Background Candidaemia in the elderly has not been extensively investigated. Objectives We compared the management of candidaemia in the elderly patients (age ≥65 years) and the very elderly subgroup of patients (age ≥75 years) with those belonging to the younger group (age <65 years) using the European Confederation of Medical Mycology (ECMM) Quality (EQUAL) standard. Patients & Methods Over a 10‐year period (April 2011‐March 2020), patients with candida bloodstream infection were identified. Data pertaining to demographics, clinical risk factors, antifungal treatment, central venous catheter and investigations such as echocardiogram and fundoscopy were obtained from electronic sources and medical case notes. Results A total of 174 episodes of candidaemia were recorded, comprising of 74 episodes in younger patients and 100 in the elderly, of whom 56 were in the very elderly patients. Of the 177 Candida species recovered, 79 were Candida albicans. EQUAL scores were analysed for 148 patients. The mean score was significantly lower in the elderly (10.4) and the very elderly (9.7) patients compared to the patients in the younger age group (12.19) (P < .01). In particular, this was due to lower blood culture volume drawn (P < .01) and, in the very elderly group, significantly lower scores for the quality indicators pertaining to echocardiogram and fundoscopy (P = .03). The overall mean EQUAL score was 11.16 (median 11; interquartile range 8‐14). The 30‐day survival was 68% and was similar between all groups. Conclusions Areas of improvement were identified in the management of candidaemia in the elderly patients.

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“…involving the central part of the hard palate and the alveolar ridges [5,[90][91][92]. The granular type is often seen in association with the generalized simple type.…”

Section: Figure 2 Chronic Mucocutaneous Candidosis (Cmc) (Abmentioning

confidence: 99%

Oral Candidosis: Pathophysiology and Best Practice for Diagnosis, Classification, and Successful Management

2021

JoF

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Oral candidosis is the most common fungal infection that frequently occurs in patients debilitated by other diseases or conditions. No candidosis happens without a cause; hence oral candidosis has been branded as a disease of the diseased. Prior research has identified oral candidosis as a mark of systemic diseases, such as hematinic deficiency, diabetes mellitus, leukopenia, HIV/AIDS, malignancies, and carbohydrate-rich diet, drugs, or immunosuppressive conditions. An array of interaction between Candida and the host is dynamic and complex. Candida exhibits multifaceted strategies for growth, proliferation, evasion of host defenses, and survival within the host to induce fungal infection. Oral candidosis presents a variety of clinical forms, including pseudomembranous candidosis, erythematous candidosis, angular cheilitis, median rhomboid glossitis, cheilocandidosis, juxtavermillion candidosis, mucocutaneous candidosis, hyperplastic candidosis, oropharyngeal candidosis, and rare suppurative candidosis. The prognosis is usually favorable, but treatment failure or recurrence is common due to either incorrect diagnosis, missing other pathology, inability to address underlying risk factors, or inaccurate prescription of antifungal agents. In immunocompromised patients, oropharyngeal candidosis can spread to the bloodstream or upper gastrointestinal tract, leading to potentially lethal systemic candidosis. This review therefore describes oral candidosis with regard to its pathophysiology and best practice for diagnosis, practical classification, and successful management.

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Rapid Species Identification of Candida Directly from Blood Culture Broths by Sepsityper-Maldi-Tof Mass Spectrometry: Impact on Antifungal Therapy

Cited by 14 publications

References 26 publications

Evaluation of Rapid Sepsityper® protocol and specific MBT-Sepsityper module (Bruker Daltonics) for the rapid diagnosis of bacteremia and fungemia by MALDI-TOF-MS

Evaluation of Rapid Sepsityper® protocol and specific MBT-Sepsityper module (Bruker Daltonics) for the rapid diagnosis of bacteremia and fungemia by MALDI-TOF-MS

Candidaemia in the elderly: Epidemiology, management and adherence to the European Confederation of Medical Mycology quality indicators

Oral Candidosis: Pathophysiology and Best Practice for Diagnosis, Classification, and Successful Management

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