Use of MALDI-TOF mass spectrometry after liquid enrichment (BD Bactec™) for rapid diagnosis of bone and joint infections.
Advantages of MALDI-TOF MS (MS) were evaluated for diagnosis of bone and joint infections after enrichment of synovial fluid (SF) or crushed osteoarticular samples (CSs). MS was performed after enrichment of SF or crushed osteoarticular samples CS (n = 108) in both aerobic and anaerobic vials. Extraction was performed on 113 vials (SF: n = 47; CS: n = 66), using the Sepsityper®kit prior identification by MS. The performances of MS, score and reproducibility results on bacterial colonies from blood agar and on pellets after enrichment in vials, were compared. MS analysis of the vial resulted in correct identification of bacteria at a species and genus level (80.5% and 92% of cases, respectively). The reproducibility was superior for aerobic Gram-positive bacteria (Staphylococci and Gram-positive bacilli: 100% colonies), as compared to aerobic Gram-negative bacilli (89.7%), anaerobes (83.3%) and Streptococcus/Enterococcus (58.8%). MS performance was significantly better for staphylococci than for streptococci on all identification parameters. For polymicrobial cultures, identification (score>1.5) of two species by MS was acceptable in 92.8% of cases. Use of MS on enrichment pellets of bone samples is an accurate, rapid and robust method for bacterial identification of clinical isolates from osteoarticular infections, except for streptococci, whose identification to species level remains difficult.
EA 1254 Microbiologie/INSERM NUMECAN, Université de Rennes 1, 2, avenue du Pr Léon Bernard, 35043 Rennes, France; Pole Biologie, Rennes University Hospital, 35043 Rennes, France.
Elise
E
Lallemand
Service des Maladies Infectieuses, Rennes University Hospital, 2 rue Henri Le Guilloux, 35043 Rennes, France; Centre de Référence en Infections Ostéo-Articulaires du Grand Ouest (CRIOGO), France.
Cédric
C
Arvieux
Centre de Référence en Infections Ostéo-Articulaires du Grand Ouest (CRIOGO), France; Service de Rhumatologie, Hôpital Sud, CHU, F-35000 Rennes, France; INSERM UMR U991/NUMECAN, F-35000 Rennes, France.
Guillaume
G
Coiffier
Centre de Référence en Infections Ostéo-Articulaires du Grand Ouest (CRIOGO), France; Service de Chirurgie orthopédique, Rennes University Hospital, 2 rue Henri Le Guilloux, 35043 Rennes, France.
Jean-Louis
JL
Polard
Centre de Référence en Infections Ostéo-Articulaires du Grand Ouest (CRIOGO), France; Service de Rhumatologie, Hôpital Sud, CHU, F-35000 Rennes, France; INSERM UMR U991/NUMECAN, F-35000 Rennes, France.
Jean-David
JD
Albert
Centre de Référence en Infections Ostéo-Articulaires du Grand Ouest (CRIOGO), France; Service de Rhumatologie, Hôpital Sud, CHU, F-35000 Rennes, France; INSERM UMR U991/NUMECAN, F-35000 Rennes, France; Université de Rennes 1, F-35000 Rennes, France.
Pascal
P
Guggenbuhl
EA 1254 Microbiologie/INSERM NUMECAN, Université de Rennes 1, 2, avenue du Pr Léon Bernard, 35043 Rennes, France; Pole Biologie, Rennes University Hospital, 35043 Rennes, France; Centre de Référence en Infections Ostéo-Articulaires du Grand Ouest (CRIOGO), France; Université de Rennes 1, F-35000 Rennes, France. Electronic address: anne.gougeon@univ-rennes1.fr.
Anne
A
Jolivet-Gougeon
D001424:Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology; D001431:Bacteriological Techniques; D001850:Bone Diseases, Infectious / Q000175:diagnosis* / Q000382:microbiology; D001842:Bone and Bones / Q000382:microbiology / Q000503:physiopathology; D060085:Coinfection / Q000175:diagnosis / Q000382:microbiology; D003470:Culture Media / Q000737:chemistry; D006088:Gram-Negative Aerobic Bacteria / Q000145:classification / Q000302:isolation & purification*; D006089:Gram-Negative Anaerobic Bacteria / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000382:microbiology; D006094:Gram-Positive Bacteria / Q000145:classification / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000382:microbiology; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis* / Q000382:microbiology; D007596:Joints / Q000382:microbiology / Q000503:physiopathology; D015203:Reproducibility of Results; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods*; D013210:Staphylococcus / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification; D013582:Synovial Fluid / Q000382:microbiology*
D003470:Culture Media
Beadmill processing; MALDI-TOF mass spectrometry; Osteoarticular infection; Polymicrobial samples; Sepsityper(®) kit; Time of detection