Early bacterial identification and carbapenemase detection from positive blood culture by mass spectrometry and Blue-Carba test

Yıl 2020, Cilt: 6 Sayı: 2, 154 - 162, 04.03.2020

María Eugenia Cattani Sandra Cogut Sara C. Kaufman

https://doi.org/10.18621/eurj.469655

Öz

Objectives:
In this study, we evaluated a rapid and simple protocol for direct
identification of microorganisms with Matrix-Assisted Laser
Desorption/Ionization Time of Flight, Mass Spectrometry (MALDI-TOF MS) after a
short incubation in solid medium (3 to 5h).

Methods: We have examined a total
of 1101 positive blood culture bottles from 782 patients.

Results: We obtained a correct
identification in 1037 (94.18%); 190 (98.44%) were Staphylococcus aureus, and 386 (98.44%) Enterobacteriaceae. Both are the most
frequent etiological agents of sepsis. A total of 1004 bottles were monomicrobial
(96.81%) and 33 (3.18%), polimicrobial. In the latter we identified at least one
species. Two hundred eighty (27.00%) organism isolated were considered skin
contaminant. Carbapenemase tests were performed with Blue-Carba test in 140
patinas from Gram negative bacilli, we have detected earlier 27 of 29 positive
(93.10%).

Conclusions: Mass spectrometry by MALDI-TOF MS is very useful
to quickly identify the microbial agent and Blue-Carba contribute to adapt the
antibiotic therapy to obtain a correct clinical management of the patient with
bacteremia.

Anahtar Kelimeler

MALDI-TOF MS, rapid identification, blood culture, carbapenemase, short incubation

Teşekkür

We are grateful to Tamara Posse and Luis Aquino for their technical assistance.

Kaynakça

• 1. Kang CI, Kim SH, Park WB, Lee KD, Kim HB, Kim EC, et al. Bloodstream infections caused by antibiotic-resistant gram-negative bacilli: risk factors for mortality and impact of inappropriate initial antimicrobial therapy on outcome. Antimicrob Agents Chemother 2005;49:760-6.
• 2. Cattani ME, Posse T, Hermes R, Kaufman S. [Rapid identification of microorganisms by mass spectrometry in a blood culture system. Comparison of two procedures]. Rev Argent Microbiol 2015;47:190-5. [Article in Spanish]
• 3. Prod'hom G, Bizzini A, Durussel C, Bille J, Greub G. Matrix-assisted laser desorption ionization-time of flight mass spectrometry for direct bacterial identification from positive blood culture pellets. J Clin Microbiol 2010;48:1481-3.
• 4. Curtoni A, Cipriani R, Marra Barbui AM, Cavallo R, Costa C. Rapid identification of microorganisms from positive blood culture by MALDI-TOF MS after short-term incubation on solid medium. Curr Microbiol 2017;74:97-102.
• 5. Prod'hom G, Bizzini A, Durussel C, Bille J, Greub G. Matrix-assisted laser desorption ionization-time of flight mass spectrometry for direct bacterial identification from positive blood culture pellets. J Clin Microbiol 2010;48:1481-3.
• 6. Stevenson L, Drake S, Murray P. Rapid identification of bacteria in positive blood culture broths by matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol 2010;48:444-7.
• 7. Cogut S, Errecalde L, Cattani M, Kaufman S. Desempeño del ensayo colorimétrico Blue Carba Test en la detección de bacterias portadoras de carbapenemasas. ALAM-CAM, 2016, Poster JU-1062, Rosario, Santa Fe, Argentina.
• 8. Clark A, Kaleta E, Arora A, Wolk D. Matrix-assisted laser desorption ionization time of flight mass spectrometry: a fundamental shift in the routine practice of clinical microbiology. Clin Microbiol Rev 2013;26:547-603.
• 9. De Bel A, Wybo I, Vandoorslaer K, Rosseel P, Lauwers S, Piérard D. Acceptance criteria for identification results of Gram-negative rods by mass spectrometry. J Med Microbiol 2011;60:684-6.
• 10. Vlek A, Boten M, Boel C. Direct matrix-assisted laser desorptionionization time-of-flight mass spectrometry improves appropriateness of antibiotic treatment of bacteremia. PloS One 2012;7:e32589.
• 11. Centers for Disease Control and Prevention/National Healthcare Safety Network (CDC/NHSN) (2014) CDC/NHSN surveillance definitions for specific types of infections. Available online at: http:// www.cdc.gov/nhsn/pdfs/pscmanual/17 pscnosinfdef_current.pdf. Accessed 19 June 2014
• 12. Pasteran F, Veliz O, Lucero C, Rapoport M, Ceriana P, Corso A. Blue-Carba Test (BCT) for Rapid Detection of Carbapenemases in Gram-negative Species: Performance against a Panel of Challenging Carbapenemases. 54th ICAAC, Abstract 963; 2014.
• 13. Pasteran F, Veliz O, Ceriana P, Lucero C, Rapoport M, Albornoz E, et al.; ReLAVRA Network Group. Evaluation of the Blue-Carba test for rapid detection of carbapenemases in gram-negative bacilli. J Clin Microbiol 2015;53:1996-8.
• 14. Pasteran F, Mendez T, Guerriero L, Rapoport M, Corso A. Sensitive screening tests for suspected class A car bapenemase production in species of Enterobacteriaceae. J Clin Microbiol 2009;47:1631-9.
• 15. Pasteran F, Veliz O, Lucero C, Guerriero L, Ceriana P, Cogut S, et al. Evaluación de un equipo comercial de discos combinados de meropenem (DCM-brit) para la detección de KPC, MBL y OXA basado en innovadoras combinaciones de inhibidores. XIII Congreso Argentino de Microbiologia, Ciudad de Buenos Aires, 23 al 26 de septiembre 2013.
• 16. Köck R, Wüllenweber J, Horn D, Lanckohr C, Becker K, Idelevich E. Implementation of short incubation MALDITOF MS identification from positive blood cultures in routine diagnostics and effects on empiric antimicrobial therapy. Antimicrob Resist Infect Control 2017;6:12.
• 17. Köck R, Kipp F, Ellger B. [Blood culture diagnostic-challenge or routine standard of care?]. Anasthesiol Intensivmed Notfallmed Schmerzther 2015;50:124-31. [Article in German]
• 18. Loonen AJ, Jansz AR, Stalpers J, Wolffs PF, van den Brule AJ. An evaluation of three processing methods and the effect of reduced culture times for faster direct identification of pathogens from BacT/ALERT blood cultures by MALDI-TOF MS. Eur J Clin Microbiol Infect Dis 2012;31:1575-83.
• 19. Ballestero-Téllez M, Recacha E, de Cueto M, Pascual Á. Identification and antimicrobial susceptibility testing of positive blood culture isolates from briefly incubated solid medium cultures. Enferm Infecc Microbiol Clin 2017;35:582-5.
• 20. Bazzi AM, Rabaan AA, El Edaily Z, John S, Fawarah MM, Al-Tawfiq JA. Comparison among four proposed direct blood culture microbial identification methods using MALDI-TOF MS. J Infect Public Health 2017;10:308-15.
• 21. Bhatti MM, Boonlayangoor S, Beavis KG, Tesic V. Rapid identification of positive blood cultures by matrix-assisted laser desorption ionization-time of flight mass spectrometry using prewarmed agar plates. J Clin Microbiol 2014;52:4334-8.
• 22. Köck J, Thomas L, Olma T, Chen S, Iredell J. Identification of bacteria in blood culture broths using matrix-assisted laser desorption-ionization Sepsityper and time of flight mass spectrometry. PloS One 2011;6:e23885.
• 23. Idelevich EA, Schüle I, Grünastel B, Wüllenweber J, Peters G, Becker K. Rapid identification of microorganisms from positive blood cultures by MALDITOF mass spectrometry subsequent to very short-term incubation on solid medium. Clin Microbiol Infect 2014;20:1001-6.
• 24. La Scola B, Raoult D. Direct identification of bacteria in positive blood culture bottles by matrix-assisted laser desorption ionisation time-of-flight mass spectrometry. PloS One 2009;4:e8041.
• 25. Verroken A, Defourny L, Lechgar L, Magnette A, Delmée M, Glupczynski Y. Reducing time to identification of positive blood cultures with MALDI-TOF MS analysis after a 5-h subculture. Eur J Clin Microbiol Infect Dis 2015;34:405-13.
• 26. Hong SK, Chang BK, Song SH, Kim EC. Use of MALDI-TOF MS technique for rapid identification of bacteria from positive blood cultures. Indian J Med Microbiol 2014;32:419-22.
• 27. Kohlmann R, Hoffmann A, Geis G, Gatermann S. MALDI-TOF mass spectrometry following short incubation on a solidmedium is a valuable tool for rapid pathogen identification from positive blood cultures. Int J Med Microbiol 2015;305:469-79.