评估 MALDI 质谱在减少革兰氏阴性菌定向抗生素覆盖时间方面的影响。
Assessing impact of MALDI mass spectroscopy on reducing directed antibiotic coverage time for Gram-negative organisms.
机构信息
Hamilton Regional Laboratory Program, Hamilton, Ontario, Canada.
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
出版信息
PLoS One. 2020 Feb 26;15(2):e0228935. doi: 10.1371/journal.pone.0228935. eCollection 2020.
The objective of this study was to assess whether use of matrix assisted laser desorption ionization-time of flight (MALDI-TOF), through improvements in identification time, reduces time to directed antibiotic coverage. We therefore conducted a retrospective review of 377 blood cultures from hospitalized patients with gram negative bacteremia that underwent testing by MALDI-TOF compared to standard identification methods (VITEK 2) for blood cultures from January 2016 to December 2017. We found that MALDI significantly reduced time between blood culture collection to reach pathogen identification and was associated with a significantly reduced time to initiate more specific therapy, with a mean difference of 16.37 hours, 95% CI 10.05 to 22.69 (mean time 50.34 hours (+/- 21.21) vs VITEK: 66.71 hrs (+/- 27.12), p<0.001 as well as a reduced time to discontinue previous therapy (p = 0.004). In conclusion, in reducing time to identification of gram negative bacteremia, MALDI-TOF led to improvements in antibiotic coverage.
本研究旨在评估基质辅助激光解吸电离飞行时间（MALDI-TOF）是否通过缩短鉴定时间来减少针对性抗生素治疗的时间。我们因此对 2016 年 1 月至 2017 年 12 月间住院革兰氏阴性菌血症患者的 377 份血培养进行了回顾性研究，比较了 MALDI-TOF 与标准鉴定方法（VITEK 2）的检测结果。我们发现 MALDI 显著缩短了血培养采集到病原体鉴定的时间，与更特异的治疗起始时间显著缩短相关，平均差异为 16.37 小时，95%CI 为 10.05 至 22.69（平均时间 50.34 小时（+/-21.21）比 VITEK：66.71 小时（+/-27.12），p<0.001），以及更早停止之前的治疗（p=0.004）。总之，通过缩短革兰氏阴性菌血症的鉴定时间，MALDI-TOF 提高了抗生素的覆盖范围。
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