The use of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry for rapid bacterial identification in patients with smear-positive bacterial meningitis

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
B BishopA Neuberger

Abstract

To assess the potential of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) in rapid identification of bacteria from smear-positive cerebrospinal fluid (CSF) in a cohort of patients with meningitis. Single-centre observational study, including adults and children with community-acquired or postneurosurgical bacterial meningitis. Meningitis was defined using established criteria. Samples of CSF that had a positive CSF Gram stain were directly examined by MALDI-TOF-MS. Identification was considered accurate when identical to the CSF culture or PCR results (species and genus level). Laboratory workers performing the MALDI-TOF-MS and interpreting its results were blinded to the direct smear results, except for the fact that it was positive. MALDI-TOF-MS results were not conveyed to clinicians. MALDI-TOF-MS was tested on 44 CSF samples; ten samples were obtained from patients with community-acquired meningitis, and 34 samples were from patients with postneurosurgical meningitis. The assay identified bacteria correctly in 17/21 of the samples with Gram-negative rods observed on the direct smear, all obtained from patients who had undergone neurosurgery, (sensitivity 81%, 95% CI 64.2%-97.7%)....Continue Reading

References

Nov 9, 2002·The Journal of Infectious Diseases·W Michael ScheldHans-Walter Pfister
Oct 21, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Allan R TunkelRichard J Whitley
May 1, 2010·Scandinavian Journal of Infectious Diseases·Gitte Nyvang HartmeyerJens Jørgen E Christensen
May 7, 2014·Clinica Chimica Acta; International Journal of Clinical Chemistry·Shunsuke SegawaFumio Nomura
Apr 12, 2016·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·D van de BeekUNKNOWN ESCMID Study Group for Infections of the Brain (ESGIB)
Feb 17, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Allan R TunkelJoseph R Zunt

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