Clinical efficacy of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry in patients with multidrug-resistant bacteremia: a single-center study in Korea.
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents
/ therapeutic use
Bacteremia
/ diagnosis
Bacteria
/ drug effects
Drug Resistance, Multiple, Bacterial
Female
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Predictive Value of Tests
Republic of Korea
Retrospective Studies
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
Time Factors
Workflow
Drug resistance
Identification
Intensive care units
Spectrometry, mass, matrix-assisted laser desorption-ionization
Journal
The Korean journal of internal medicine
ISSN: 2005-6648
Titre abrégé: Korean J Intern Med
Pays: Korea (South)
ID NLM: 8712418
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
11
05
2018
accepted:
02
08
2018
pubmed:
11
5
2019
medline:
4
3
2020
entrez:
11
5
2019
Statut:
ppublish
Résumé
Matrix-assisted laser desorption/ionization time-of-f light mass spectrometry (MALDI-TOF MS) is a new diagnostic tool for microorganism identification. The clinical usefulness of this approach has not been widely examined in Korea. This retrospective pre-post-intervention quasi-experimental study examined the effect of MALDI-TOF MS on patients with multidrug-resistant (MDR) bacteremia in the intensive care unit (ICU). All consecutive patients with MDR bacteremia in the ICU of a tertiary care hospital between March 2011 and February 2013 and between March 2014 and February 2016 were enrolled. MALDI-TOF MS was introduced between these periods. In the pre-intervention and intervention groups, microorganisms were identified by conventional means and by MALDI-TOF MS, respectively. The groups were compared in terms of time from venipuncture to microorganism identification and antimicrobial susceptibility test results. In total, 187 patients (mean age, 61.0 years; 56.7% male) were enrolled. Of these, 97 and 90 were in the pre-intervention and intervention groups, respectively. The intervention group had a significantly shorter time from venipuncture to microorganism identification and antimicrobial susceptibility test results (82.5 ± 21.6 hours vs. 92.3 ± 40.4 hours, p = 0.038). The antibiotics were adjusted in 52 patients (26 each in the pre-intervention and intervention groups) based on these results. These groups did not differ in terms of time from venipuncture to antibiotic adjustment, and multivariate regression analysis showed that MALDI-TOF MS-based microorganism identification was not associated with 28-day mortality. Our study showed that MALDI-TOF MS accelerated microorganism identification in patients with MDR bacteremia, but did not inf luence 28-day mortality.
Sections du résumé
BACKGROUND/AIMS
OBJECTIVE
Matrix-assisted laser desorption/ionization time-of-f light mass spectrometry (MALDI-TOF MS) is a new diagnostic tool for microorganism identification. The clinical usefulness of this approach has not been widely examined in Korea. This retrospective pre-post-intervention quasi-experimental study examined the effect of MALDI-TOF MS on patients with multidrug-resistant (MDR) bacteremia in the intensive care unit (ICU).
METHODS
METHODS
All consecutive patients with MDR bacteremia in the ICU of a tertiary care hospital between March 2011 and February 2013 and between March 2014 and February 2016 were enrolled. MALDI-TOF MS was introduced between these periods. In the pre-intervention and intervention groups, microorganisms were identified by conventional means and by MALDI-TOF MS, respectively. The groups were compared in terms of time from venipuncture to microorganism identification and antimicrobial susceptibility test results.
RESULTS
RESULTS
In total, 187 patients (mean age, 61.0 years; 56.7% male) were enrolled. Of these, 97 and 90 were in the pre-intervention and intervention groups, respectively. The intervention group had a significantly shorter time from venipuncture to microorganism identification and antimicrobial susceptibility test results (82.5 ± 21.6 hours vs. 92.3 ± 40.4 hours, p = 0.038). The antibiotics were adjusted in 52 patients (26 each in the pre-intervention and intervention groups) based on these results. These groups did not differ in terms of time from venipuncture to antibiotic adjustment, and multivariate regression analysis showed that MALDI-TOF MS-based microorganism identification was not associated with 28-day mortality.
CONCLUSION
CONCLUSIONS
Our study showed that MALDI-TOF MS accelerated microorganism identification in patients with MDR bacteremia, but did not inf luence 28-day mortality.
Identifiants
pubmed: 31072077
pii: kjim.2018.169
doi: 10.3904/kjim.2018.169
pmc: PMC6718763
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1058-1067Subventions
Organisme : National Research Foundation of Korea
Organisme : Ministry of Science, ICT and Future Planning
ID : 2016R1C1B1008529
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