title: [Studies of the cost effectiveness of MALDI-TOF and clinical impact].
abstract: In general, new technologies usually increase laboratory costs due to the need for an initial investment. However, as occurred with MALDI-TOF (matrix-assisted laser desorption ionization time-of-flight) mass spectrometry, this increase is subsequently offset by the discontinued use of traditional technologies and by the benefits to patients of the new information generated. In the clinical microbiology laboratory, the identification time is reduced with the use of MALDI-TOF (by at least 24 hours) and turnaround is improved, allowing faster production of the microbiological report. This beneficial effect has mainly been studied with blood cultures in patients with bacteraemia. In these patients, the length of hospital stay has been reduced by 1.6-6.6 days, depending on the type of patient and the appropriateness of treatment. This leads to better antimicrobial use and a reduction in total hospital cost of up to 43% per patient. Another factor that has been analysed is the decrease in mortality due to better management of antimicrobial therapy. Future multicentre studies should include other factors such as hospital organisation changes and clinical activity arising in response to the efforts of the clinical microbiology laboratory to rapidly obtain information of clinical value.
authors.affiliation: Servicio de Microbiología, Hospital Universitario Ramón y Cajal e Instituto de Investigación Sanitaria (IRYCIS), Madrid, España; Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, España.
authors.forename: Elia Gómez G
authors.initials: EG
authors.lastname: de la Pedrosa
authors.affiliation: Servicio de Microbiología, Hospital General de Valencia y Departamento de Microbiología, Facultad de Medicina, Valencia, España.
authors.forename: Concepción
authors.initials: C
authors.lastname: Gimeno
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Clínic IDIBAPS, Universidad de Barcelona, Barcelona, España.
authors.forename: Alex
authors.initials: A
authors.lastname: Soriano
authors.affiliation: Servicio de Microbiología, Hospital Universitario Ramón y Cajal e Instituto de Investigación Sanitaria (IRYCIS), Madrid, España; Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, España. Electronic address: rafael.canton@salud.madrid.org.
authors.forename: Rafael
authors.initials: R
authors.lastname: Cantón
mesh_terms: D016470:Bacteremia / Q000097:blood / Q000382:microbiology; D064790:Clinical Laboratory Services / Q000191:economics; D003362:Cost-Benefit Analysis; D004352:Drug Resistance, Microbial; D005544:Forecasting; D017721:Hospital Costs; D006801:Humans; D008826:Microbial Sensitivity Tests; D008828:Microbiological Techniques / Q000191:economics* / Q000379:methods; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000191:economics* / Q000379:methods; D057188:Workflow
keywords: Clinical impact; Cost-effectiveness; Coste económico; Coste-efectividad; Economic cost; Espectrometría de masas; Impacto clínico; MALDI-TOF; Mass spectrometry; Programas PROA; Stewardship program