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Clinical utility of direct application of matrix-assisted laser desorption ionization time-of-flight mass spectrometry and rapid disk diffusion test in presumptive antimicrobial therapy for bacteremia
- Source :
- Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy. 24(11)
- Publication Year :
- 2018
-
Abstract
- Objective To study how and to what degree the rapid pathogen identification by MALDI-TOF MS coupled with rapid disk diffusion test improve the current clinical practice of patients with bacteremia in a tertiary teaching hospital with full-time ID consultation service. Patients and methods MALDI-TOF MS and 8H disk diffusion tests were directly applied to the positive blood cultures samples and the results were reflected on antimicrobial therapy (n = 119). The appropriateness of antimicrobial selection through these interventions was verified with conventional culture results in comparison with historical control (n = 129). The mortality of patients between the two periods was also compared. Results The appropriateness of antimicrobial selection was higher (99.2%) in the intervention than in the control group (93.8%) (p 0.024), but there was no difference in 28-day mortality between the two periods (16.8%, 14.8%) (p 0.668). The duration of presumptive antimicrobial therapy with anti-MRSA agents and carbapenem antibiotics did not differ between the two periods indicating that the intervention was not effective in decreasing the unnecessary antibiotics. On the other hand, some bacteremic patients with pathogens whose drug susceptibilities were invariably sensitive to the standard class of antibiotics definitely benefitted from the intervention. Conclusion The intervention utilizing MALDI-TOF MS and the rapid disk diffusion test may not demonstrate overall improvement in bacteremia mortality in the institution with full-time infectious disease consultants. Its utility has yet to be evaluated in different setting hospitals.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
Male
medicine.medical_specialty
Time Factors
medicine.drug_class
030106 microbiology
Antibiotics
Matrix assisted laser desorption ionization time of flight
Bacteremia
Bacterial Physiological Phenomena
Teaching hospital
03 medical and health sciences
0302 clinical medicine
Carbapenem Antibiotics
Disk Diffusion Antimicrobial Tests
Internal medicine
medicine
Humans
Pharmacology (medical)
030212 general & internal medicine
Aged
Bacteria
business.industry
Middle Aged
Antimicrobial
medicine.disease
Anti-Bacterial Agents
Clinical Practice
Infectious Diseases
Treatment Outcome
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
Female
Historical control
business
Subjects
Details
- ISSN :
- 14377780
- Volume :
- 24
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy
- Accession number :
- edsair.doi.dedup.....bbbf3d9e5ee47c05c3008e32d33e8d2a