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
- Author:
Jeongha MOK
1
;
Eun Jung JO
;
Jung Seop EOM
;
Mi Hyun KIM
;
Ki Uk KIM
;
Hye Kyung PARK
;
Min Ki LEE
;
Kwangha LEE
Author Information
- Publication Type:Original Article
- From:The Korean Journal of Internal Medicine 2019;34(5):1058-1067
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: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: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: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.
CONCLUSIONS:Our study showed that MALDI-TOF MS accelerated microorganism identification in patients with MDR bacteremia, but did not inf luence 28-day mortality.
