Impact of Matrix-Assisted Laser Desorption/Ionization Time-of-Flight for the Identification of Gram-Positive Bloodstream Pathogens without Antimicrobial Stewardship Intervention in Hospitalized Children

Lisa Herrera; Karissa Culbreath; Walter Dehority

doi:10.1055/s-0038-1648245

Journal of Pediatric Infectious Diseases, Table of Contents

J Pediatr Infect Dis 2019; 14(03): 144-148
DOI: 10.1055/s-0038-1648245

Rapid Communication

Georg Thieme Verlag KG Stuttgart · New York

Impact of Matrix-Assisted Laser Desorption/Ionization Time-of-Flight for the Identification of Gram-Positive Bloodstream Pathogens without Antimicrobial Stewardship Intervention in Hospitalized Children

Lisa Herrera

¹The University of New Mexico School of Medicine, Albuquerque, New Mexico, United States

,

Karissa Culbreath

²Tricore Reference Laboratories, Albuquerque, New Mexico, United States

,

Walter Dehority

³Division of Infectious Diseases, Department of Pediatrics, The University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States

› Author Affiliations

Abstract

We performed a 2-year retrospective cohort study of inpatient children with growth of gram-positive bacteria from blood cultures identified with and without the use of matrix-assisted laser-desorption/ionization time-of-flight (MALDI-TOF) in the absence of an antimicrobial stewardship program. Use of MALDI-TOF reduced the time to organism identification by 15.7 hours (p < 0.0001). However, no differences in length of stay, time to optimization of antimicrobial therapy, or time to discontinuation of antibiotics for growth of contaminants were documented, suggesting that such potential patient-oriented benefits of MALDI-TOF may only be evident in the presence of a concurrent antimicrobial stewardship program.

Keywords

MALDI-TOF - bacteremia - antimicrobial stewardship

Full Text

References

References
1 Clerc O, Prod'hom G, Vogne C, Bizzini A, Calandra T, Greub G. Impact of matrix-assisted laser desorption ionization time-of-flight mass spectrometry on the clinical management of patients with Gram-negative bacteremia: a prospective observational study. Clin Infect Dis 2013; 56 (08) 1101-1107
2 Huang AM, Newton D, Kunapuli A. , et al. Impact of rapid organism identification via matrix-assisted laser desorption/ionization time-of-flight combined with antimicrobial stewardship team intervention in adult patients with bacteremia and candidemia. Clin Infect Dis 2013; 57 (09) 1237-1245
3 Perez KK, Olsen RJ, Musick WL. , et al. Integrating rapid pathogen identification and antimicrobial stewardship significantly decreases hospital costs. Arch Pathol Lab Med 2013; 137 (09) 1247-1254
4 Timbrook TT, Morton JB, McConeghy KW, Caffrey AR, Mylonakis E, LaPlante KL. The effect of molecular rapid diagnostic testing on clinical outcomes in bloodstream infections: a systematic review and meta-analysis. Clin Infect Dis 2017; 64 (01) 15-23
5 Kreitmeyr K, von Both U, Pecar A, Borde JP, Mikolajczyk R, Huebner J. Pediatric antibiotic stewardship: successful interventions to reduce broad-spectrum antibiotic use on general pediatric wards. Infection 2017; 45 (04) 493-504
6 Standiford HC, Chan S, Tripoli M, Weekes E, Forrest GN. Antimicrobial stewardship at a large tertiary care academic medical center: cost analysis before, during, and after a 7-year program. Infect Control Hosp Epidemiol 2012; 33 (04) 338-345
7 The Joint Commission. Approved: New antimicrobial stewardship standard. Available at: www.jointcommission.org . Accessed April 17, 2017
8 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 (02) 377-381
9 Tran A, Alby K, Kerr A, Jones M, Gilligan PH. Cost savings realized by implementation of routine microbiological identification by matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol 2015; 53 (08) 2473-2479
10 Haimi-Cohen Y, Vellozzi EM, Rubin LG. Initial concentration of Staphylococcus epidermidis in simulated pediatric blood cultures correlates with time to positive results with the automated, continuously monitored BACTEC blood culture system. J Clin Microbiol 2002; 40 (03) 898-901