The impact of blood culture identification by MALDI-TOF MS on the antimicrobial management of pediatric patients.

OBJECTIVE

To assess the impact of MALDI-TOF MS coupled with antimicrobial stewardship on clinical outcomes for pediatric inpatients with bloodstream infections.

METHODS

Outcomes of pediatric inpatients were compared before and after MALDI-TOF MS implementation. Outcomes measured included time until organism identification and susceptibility, duration of antibiotics, patient length of stay (LOS), mortality and hospital costs.

RESULTS

210 and 135 patient events were compared pre- and post-intervention. Average time to organism identification decreased from 41 to 11 hours (P = <0.0001). Time to i) susceptibilities decreased from 50.8 to 37.7 hours (P = <0.0001), ii) de-escalation of antibiotics decreased from 58 to 23 hours (P = <0.0001), iii) discontinuation of unnecessary antibiotics decreased from 49 to 20 hours (P = <0.0001). Infection-related LOS decreased from 10.5 to 8.37 days (P = 0.006). No significant differences were seen for other outcomes.

CONCLUSIONS

MALDI-TOF MS identification of bacteria from blood culture broth improves time to appropriate antibiotic treatment for pediatric inpatients.