Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.
PLoS One. 2012;7(3):e32589. doi: 10.1371/journal.pone.0032589. Epub 2012 Mar 16.
Matrix assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) allows the identification of microorganisms directly from positive blood culture broths. Use of the MALDI-TOF MS for rapid identification of microorganisms from blood culture broths can reduce the turnaround time to identification and may lead to earlier appropriate treatment of bacteremia. During February and April 2010, direct MALDI-TOF MS was routinely performed on all positive blood cultures. During December 2009 and March 2010 no direct MALDI-TOF MS was used. Information on antibiotic therapy was collected from the hospital and intensive care units' information systems from all positive blood cultures during the study period. In total, 253 episodes of bacteremia were included of which 89 during the intervention period and 164 during the control period. Direct performance of MALDI-TOF MS on positive blood culture broths reduced the time till species identification by 28.8-h and was associated with an 11.3% increase in the proportion of patients receiving appropriate antibiotic treatment 24 hours after blood culture positivity (64.0% in the control period versus 75.3% in the intervention period (p0.01)). Routine implementation of this technique increased the proportion of patients on adequate antimicrobial treatment within 24 hours.
基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）可直接从阳性血培养肉汤中鉴定微生物。MALDI-TOF MS 可用于快速鉴定血培养肉汤中的微生物，从而缩短鉴定时间，可能更早地进行适当的败血症治疗。2010 年 2 月至 4 月，所有阳性血培养均常规进行直接 MALDI-TOF MS。2009 年 12 月至 2010 年 3 月，未进行直接 MALDI-TOF MS。研究期间，从医院和重症监护病房的信息系统收集所有阳性血培养的抗生素治疗信息。共纳入 253 例菌血症，干预组 89 例，对照组 164 例。直接对阳性血培养肉汤进行 MALDI-TOF MS 分析，可将种属鉴定时间缩短 28.8 小时，且 24 小时后接受适当抗生素治疗的患者比例增加 11.3%（对照组为 64.0%，干预组为 75.3%（p<0.01））。常规应用该技术可增加 24 小时内接受适当抗菌治疗的患者比例。
