scholarly journals Rapid Identification of Pathogens in Positive Blood Culture of Patients with Sepsis: Review and Meta-Analysis of the Performance of the Sepsityper Kit

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Nils G. Morgenthaler ◽  
Markus Kostrzewa
Keyword(s):  
Blood Culture ◽  
Antibiotic Therapy ◽  
Positive Blood Culture ◽  
Blood Stream Infection ◽  
Meta Analysis ◽  
Extraction Methods ◽  
Blood Stream ◽  
Rapid Identification ◽  
Maldi Tof

Sepsis is one of the leading causes of deaths, and rapid identification (ID) of blood stream infection is mandatory to perform adequate antibiotic therapy. The advent of MALDI-TOF Mass Spectrometry for the rapid ID of pathogens was a major breakthrough in microbiology. Recently, this method was combined with extraction methods for pathogens directly from positive blood cultures. This review summarizes the results obtained so far with the commercial Sepsityper sample preparation kit, which is now approved forin vitrodiagnostic use. Summarizing data from 21 reports, the Sepsityper kit allowed a reliable ID on the species level of 80% of 3320 positive blood culture bottles. Gram negative bacteria resulted consistently in higher ID rates (90%) compared to Gram positive bacteria (76%) or yeast (66%). No relevant misidentifications on the genus level were reported at a log(score)cut-off of 1.6. The Sepsityper kit is a simple and reproducible method which extends the MALDI-TOF technology to positive blood culture specimens and shortens the time to result by several hours or even days. In combination with antibiotic stewardship programs, this rapid ID allows a much faster optimization of antibiotic therapy in patients with sepsis compared to conventional workflows.

scholarly journals Comparison of the Fully Automated FilmArray BCID Assay to a 4-Hour Culture Test Coupled to Mass Spectrometry for Day 0 Identification of Microorganisms in Positive Blood Cultures

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Paul O. Verhoeven ◽  
Cyrille H. Haddar ◽  
Josselin Rigaill ◽  
Nathalie Fonsale ◽  
Anne Carricajo ◽  
...  
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Bacterial Identification ◽  
Maldi Tof Ms ◽  
Maldi Tof ◽  
Negative Results ◽  
Culture Identification ◽  
Tof Ms

Rapid bacterial identification of positive blood culture is important for adapting the antimicrobial therapy in patients with blood stream infection. The aim of this study was to evaluate the performance of the multiplex FilmArray Blood Culture Identification (BCID) assay by comparison to an in-house protocol based on MALDI-TOF MS identification of microcolonies after a 4-hour culture, for identifying on the same day the microorganisms present in positive blood culture bottles. One hundred and fifty-three positive bottles from 123 patients were tested prospectively by the 3 techniques of bacterial identification: 11 bottles yielding negative results by the 3 tests were considered false positive (7.2%). The reference MALDI-TOF MS technique identified 134 monomicrobial (87.6%) and 8 double infections (5.2%), which resulted in a total of 150 microorganisms. Globally, 137 (91.3%) of these 150 pathogens were correctly identified by the fully automated multiplex FilmArray BCID system at the species or genus level on day of growth detection, versus 117 (78.8%) by MALDI-TOF MS identification on nascent microcolonies after a 4-hour culture (P < 0.01). By combining the two approaches, 140 (93.5%) of the positive bottles were identified successfully at day 0. These results confirm the excellent sensitivity of the FilmArray BCID assay, notably in case of multimicrobial infection. Due to the limited number of targets included into the test, it must be coupled to another identification strategy, as that presented in this study relying on MALDI-TOF MS identification of microcolonies obtained after a very short culture period.

scholarly journals Rapid Identification of Microorganisms from Positive Blood Culture by MALDI-TOF MS After Short-Term Incubation on Solid Medium

2016 ◽  
Vol 74 (1) ◽  
pp. 97-102 ◽  
Author(s):  
Antonio Curtoni ◽  
Raffaella Cipriani ◽  
Elisa Simona Marra ◽  
Anna Maria Barbui ◽  
Rossana Cavallo ◽  
...  
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Solid Medium ◽  
Rapid Identification ◽  
Short Term ◽  
Maldi Tof Ms ◽  
Maldi Tof ◽  
Tof Ms

scholarly journals Rapid identification of bacteria from positive blood culture bottles by MALDI-TOF MS following short-term incubation on solid media

2015 ◽  
Vol 64 (11) ◽  
pp. 1346-1352 ◽  
Author(s):  
Osman Altun ◽  
Silvia Botero-Kleiven ◽  
Sarah Carlsson ◽  
Måns Ullberg ◽  
Volkan Özenci
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Rapid Identification ◽  
Short Term ◽  
Maldi Tof Ms ◽  
Maldi Tof ◽  
Solid Media ◽  
Identification Of Bacteria ◽  
Tof Ms

scholarly journals An Evaluation Of Direct Identification Of Pathogens From Blood Cultures By Maldi-Tof Mass Spectrometry

2016 ◽  
Vol 26 (5) ◽  
pp. 69-73
Author(s):  
Lina Savickaitė ◽  
Jelena Kopeykinienė
Keyword(s):  
Mass Spectrometry ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Antimicrobial Therapy ◽  
Rapid Identification ◽  
Blood Cultures ◽  
Direct Identification ◽  
Maldi Tof Mass Spectrometry ◽  
Maldi Tof ◽  
Mass Spectrometry Identification

Rapid identification of the infecting organism may aid in choosing appropriate antimicrobial therapy. We used MALDI-TOF mass spectrometry to identify bacteria directly from the positive blood culture samples (n=21). 85,71 percent of these results was identified using of MALDI-TOF mass spectrometry. Identification time of bacteria directly from the blood culture takes more than 1 hour for 27,8 percent results.

Procalcitonin Level as a Surrogate for Catheter-Related Blood Stream Infection among Hemodialysis Patients

2017 ◽  
Vol 18 (6) ◽  
pp. 498-502 ◽  
Author(s):  
Mahmoud Hamada Imam ◽  
Eman Gamal
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Blood Stream Infection ◽  
Positive Culture ◽  
Blood Stream ◽  
Hemodialysis Patients ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Spearman Correlation Test ◽  
Time Of Presentation

Introduction Catheter-related bloodstream infection (CRBSI) is a frequent complication among hemodialysis patients who usually are presented with nonspecific signs such as fever, rigors, and hypotension. Blood culture will take up to 5 days and antimicrobials will be started. Procalcitonin (PCT) is a valid marker in sepsis. Our goal in this study is to evaluate its usefulness as a diagnostic marker in detecting CRBSI among hemodialysis patients who present with suspected CRBSI. Patients and methods Thirty-one hemodialysis patients with suspected CRBSI were enrolled in this study. PCT level was measured at the time of presentation. Patients were divided into two groups according to blood culture results: positive and negative groups. PCT level and other markers for inflammation: white blood cell count (WBC), C-reactive protein (CRP), and ferritin were compared between the two groups. Statistical analysis of variables was performed using the t-test or Mann-Whitney test together with Spearman correlation test. Results Thirty-one patients had median age 44.7 ± 2.1 years. They comprised 16 males (52%) and 15 females (48%). Sixteen patients had a positive blood culture result while in 15 it was negative. PCT level was significantly higher in the positive blood culture group (40.0 ± -21.9) (95% confidence interval [CI] 28.4-51.8) while its level was 1.1 ± 1 (95% CI 0.54-1.8) in the negative blood culture group [t(15) = -7, p<0.001). In the positive culture group, there was a correlation between CRP and ferritin (r = -0.58, p = 0.01, n = 16), while no correlation between PCT and other markers of inflammation. Conclusions PCT is a useful marker for diagnosis of CRBSI among hemodialysis patients.

scholarly journals 2559. Incidence and Clinical Impact of Discordant Genotypic and Phenotypic Categorization of Methicillin Susceptibility in Staphylococcus aureus Bacteremia

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S70-S70
Author(s):  
Jessica Gulliver ◽  
Brittney Jung-Hynes ◽  
Derrick Chen
Keyword(s):  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Rapid Identification ◽  
Clinical Impact ◽  
Staphylococcus Aureus Bacteremia ◽  
Oxacillin Resistance ◽  
Initial Hospitalization

Abstract Background Methicillin-susceptible/methicillin-resistant Staphylococcus aureus (MSSA/MRSA) can be directly identified from positive blood culture bottles using molecular methods. This provides faster results than traditional phenotypic testing, but discrepancies between the two are occasionally found. We sought to determine the incidence and clinical impact of such discrepancies. Methods Positive blood culture bottles are routinely tested in the hospital clinical laboratory for mecA via Xpert MRSA/SA BC (PCR), and antimicrobial susceptibility testing (AST) via MicroScan PC33 is performed on recovered S. aureus isolates; discrepancies between PCR and AST are resolved by repeat and supplemental (Kirby-Bauer) testing. A retrospective review of medical and laboratory data from January 2015 to December 2017 was performed on all patients that had discordant PCR and AST results. Results Approximately 1,200 PCR assays were performed from January 2015 to December 2017, and there were 5 (0.4%) cases with discordant AST Results. Four cases were classified as MSSA by PCR but MRSA by AST, and 1 case was classified as MRSA by PCR but MSSA by AST. For the former group, antimicrobial therapy was changed in 2 patients to cover MRSA and 1 patient was readmitted, while the remaining 2 patients were already being treated for MRSA; for the latter case, this patient was treated for MRSA during the initial hospitalization, but was readmitted with disseminated MSSA and subsequently deceased. Based on genetic targets identified by PCR and cefoxitin and oxacillin AST, discrepancies were likely due to borderline oxacillin resistance (BORSA) (n = 1), presence of an SCCmec variant not detected by PCR (n = 1), or undetermined (n = 3). Conclusion Rapid identification of MRSA bacteremia via PCR provides actionable information to direct empiric treatment. While highly accurate, PCR results are infrequently not corroborated by AST. This rare possibility should be considered when modifying therapy based on initial PCR results, and there should be close communication between the clinical team and laboratory for these challenging cases. Disclosures All authors: No reported disclosures.

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