title: Clinical utility of rapid pathogen identification using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry in ventilated patients with pneumonia: A pilot study.
abstract: OBJECTIVE
  We evaluated the clinical utility of rapid identification of microorganisms in bronchoalveolar lavage (BAL) fluid using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) in terms of the clinical outcomes of ventilated patients with pneumonia.
  
  
  METHODS
  Patients for whom microorganisms were identified via MALDI-TOF MS (from March 2013 to February 2014; post-intervention group) were compared with patients for whom microorganisms were identified using conventional methods (from March 2012 to February 2013; pre-intervention group). All pneumonia types (community-acquired, hospital-acquired, healthcare-associated and ventilator-associated pneumonia) were included in the analysis.
  
  
  RESULTS
  In total, 77 patients (50 men, mean age 67.2 ± 12.5 years) were included (40 patients in the pre-intervention group and 37 in the post-intervention group). The time from BAL fluid collection to microorganism identification and the availability of antimicrobial susceptibility results was shorter in the post- compared with the pre-intervention group (51.9 ± 11.3 vs 67.3 ± 17.4 h, P < 0.001). Also, the time from BAL fluid collection to adjustment of antibiotic therapy was shorter in the post-intervention group (56.5 ± 10.9 vs 73.2 ± 18.5 h, P < 0.001). Microorganism identification via MALDI-TOF MS was independently associated with a shorter intensive care unit (ICU) stay after BAL fluid was drawn (hazard ratio = 2.324, P = 0.007).
  
  
  CONCLUSIONS
  Rapid identification of microorganisms in BAL fluid via MALDI-TOF MS was associated with adjustment of antibiotic therapy and a shorter ICU stay after BAL fluid was collected from ventilated patients with pneumonia.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Jeong Ha
authors.initials: JH
authors.lastname: Mok
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Jung Seop
authors.initials: JS
authors.lastname: Eom
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Jo
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Mi Hyun
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Kwangha
authors.initials: K
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Ki Uk
authors.initials: KU
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Hye-Kyung
authors.initials: HK
authors.lastname: Park
authors.affiliation: Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Jongyoun
authors.initials: J
authors.lastname: Yi
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Min Ki
authors.initials: MK
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010865:Pilot Projects; D011014:Pneumonia / Q000188:drug therapy / Q000382:microbiology*; D012121:Respiration, Artificial / Q000009:adverse effects; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: bronchoalveolar lavage; identification; matrix-assisted laser desorption mass spectrometry; pneumonia; ventilator