title: MALDI-ToF short incubation identification from blood cultures is associated with reduced length of hospitalization and a decrease in bacteremia associated mortality.
abstract: The purpose of this study was to assess the impact of MALDI-ToF identification and rapid short incubation MALDI-Tof identification protocol on patient care compared to conventional identification. By using a retrospective review we assessed the impact of a rapid Bruker MALDI-Tof identification protocol. Overall there was a 16.76-hour reduction in time to identification of the pathogen after the introduction of MALDI-TOF identification in 2013 (P<0.0001) and a further 15-hour reduction (P<9.37 E-05) after implementation of the short incubation MALDI-TOF identification protocol in 2014. Patients received appropriate therapy 20.25 hours earlier (P<0.002) in 2014 compared to the conventional identification group in 2012. Overall length in the patients needing optimization of antibiotic treatment was reduced by 6.87 days (P<0.042). In 2014 outcomes between the patients needing a change in their antibiotic compared to the patients where the empirical therapy was considered to be optimal were similar with respective difference in length of stay being reduced from 4.72 days (P<0.031) to 1.77 days (P<0.71) and an associated reduction in the absolute mortality risk of 3.79%. The all-cause mortality rate was twice as high in the group pre-implementation of the short incubation MALDI-TOF identification with an associated survival benefit in this patient population when 26 patients were treated. Rapid short incubation MALDI-ToF identification of bacterial pathogens in blood cultures is associated with a reduction in length of stay and mortality risk.
authors.affiliation: Division of Microbiology, Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada. johan.delport@LHSC.on.ca.|Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. johan.delport@LHSC.on.ca.|Department of Microbiology and Immunology, Schulich School of Medicine and Dentistry, Western University, LHSC Room B10-109, 800 Commissioners Road East, London, Ontario, N6A 5W9, Canada. johan.delport@LHSC.on.ca.|Clinical Skills Building, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. johan.delport@LHSC.on.ca.
authors.forename: J A
authors.initials: JA
authors.lastname: Delport
authors.affiliation: Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.|Clinical Skills Building, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Strikwerda
authors.affiliation: Division of Microbiology, Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Armstrong
authors.affiliation: Division of Microbiology, Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Schaus
authors.affiliation: Division of Microbiology, Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada.|Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.|Clinical Skills Building, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: M
authors.initials: M
authors.lastname: John
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis* / Q000401:mortality*; D001431:Bacteriological Techniques / Q000379:methods*; D000071997:Blood Culture; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods*; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult