Bal A M, McGill M
Department of Microbiology, University Hospital, Crosshouse, Kilmarnock KA2 0BE, UK,
Department of Microbiology, University Hospital Crosshouse, Kilmarnock, UK.
J R Coll Physicians Edinb. 2018 Jun;48(2):114-119. doi: 10.4997/JRCPE.2018.203.
Rapid identification of Candida species facilitates pathogen-directed therapy with either fluconazole or an echinocandin.
We applied Sepsityper matrix-assisted laser desorption ionisation time of flight mass spectrometry (MALDI-TOF-MS) technology on positive blood culture broths for rapid species identification.
Of the 74 patients with candidaemia, 25 had the species identified on the day of the positive blood culture directly from the broth (rapid identification group) while the remaining 49 had the species identified from culture (conventional identification group). Three (13.6%) out of 22 treated patients in the rapid identification group received echinocandin compared to 20/45 (44.4%) in the conventional identification group. The appropriateness of therapy was 90.9% in the rapid identification group and 62.2% in the conventional identification group (p = 0.01). Cost savings were more than £10,000 in the first three days of treatment.
Sepsityper-MALDI-TOF-MS is a useful tool in supporting antifungal stewardship programmes.
快速鉴定念珠菌属有助于使用氟康唑或棘白菌素进行病原体导向治疗。
我们将Sepsityper基质辅助激光解吸电离飞行时间质谱（MALDI-TOF-MS）技术应用于阳性血培养肉汤，以进行快速菌种鉴定。
在74例念珠菌血症患者中，25例在血培养阳性当天直接从肉汤中鉴定出菌种（快速鉴定组），其余49例从培养物中鉴定出菌种（传统鉴定组）。快速鉴定组22例接受治疗的患者中有3例（13.6%）接受了棘白菌素治疗，而传统鉴定组为20/45例（44.4%）。快速鉴定组治疗的适宜性为90.9%，传统鉴定组为62.2%（p = 0.01）。治疗的前三天节省成本超过10,000英镑。
Sepsityper-MALDI-TOF-MS是支持抗真菌管理计划的有用工具。
