title: Cost Savings Realized by Implementation of Routine Microbiological Identification by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry.
abstract: Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) is an emerging technology for rapid identification of bacterial and fungal isolates. In comparison to conventional methods, this technology is much less labor intensive and can provide accurate and reliable results in minutes from a single isolated colony. We compared the cost of performing the bioMérieux Vitek MALDI-TOF MS with conventional microbiological methods to determine the amount saved by the laboratory by converting to the new technology. Identification costs for 21,930 isolates collected between April 1, 2013, and March 31, 2014, were directly compared for MALDI-TOF MS and conventional methodologies. These isolates were composed of commonly isolated organisms, including commonly encountered aerobic and facultative bacteria and yeast but excluding anaerobes and filamentous fungi. Mycobacterium tuberculosis complex and rapidly growing mycobacteria were also evaluated for a 5-month period during the study. Reagent costs and a total cost analysis that included technologist time in addition to reagent expenses and maintenance service agreement costs were analyzed as part of this study. The use of MALDI-TOF MS equated to a net savings of $69,108.61, or 87.8%, in reagent costs annually compared to traditional methods. When total costs are calculated to include technologist time and maintenance costs, traditional identification would have cost $142,532.69, versus $68,886.51 with the MALDI-TOF MS method, resulting in a laboratory savings of $73,646.18, or 51.7%, annually by adopting the new technology. The initial cost of the instrument at our usage level would be offset in about 3 years. MALDI-TOF MS not only represents an innovative technology for the rapid and accurate identification of bacterial and fungal isolates, it also provides a significant cost savings for the laboratory.
authors.affiliation: Clinical Microbiology-Immunology Laboratories, University of North Carolina Health Care, Chapel Hill, North Carolina, USA atran@health.nyc.gov peter.gilligan@unchealth.unc.edu.
authors.forename: Anthony
authors.initials: A
authors.lastname: Tran
authors.affiliation: Clinical Microbiology-Immunology Laboratories, University of North Carolina Health Care, Chapel Hill, North Carolina, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Alby
authors.affiliation: Clinical Microbiology-Immunology Laboratories, University of North Carolina Health Care, Chapel Hill, North Carolina, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Kerr
authors.affiliation: Clinical Microbiology-Immunology Laboratories, University of North Carolina Health Care, Chapel Hill, North Carolina, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Jones
authors.affiliation: Clinical Microbiology-Immunology Laboratories, University of North Carolina Health Care, Chapel Hill, North Carolina, USA Departments of Pathology-Laboratory Medicine and Microbiology-Immunology, Chapel Hill, North Carolina, USA.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Gilligan
mesh_terms: D001424:Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology; D017046:Cost Savings; D006801:Humans; D008828:Microbiological Techniques / Q000191:economics* / Q000379:methods*; D009181:Mycoses / Q000175:diagnosis* / Q000382:microbiology; D012189:Retrospective Studies; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000191:economics* / Q000379:methods*; D013997:Time Factors