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An Improved In-house MALDI-TOF MS Protocol for Direct Cost-Effective Identification of Pathogens from Blood Cultures

Overview of attention for article published in Frontiers in Microbiology, September 2017
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Title
An Improved In-house MALDI-TOF MS Protocol for Direct Cost-Effective Identification of Pathogens from Blood Cultures
Published in
Frontiers in Microbiology, September 2017
DOI 10.3389/fmicb.2017.01824
Pubmed ID
Authors

Menglan Zhou, Qiwen Yang, Timothy Kudinha, Liying Sun, Rui Zhang, Chang Liu, Shuying Yu, Meng Xiao, Fanrong Kong, Yupei Zhao, Ying-Chun Xu

Abstract

Background: Bloodstream infection is a major cause of morbidity and mortality in hospitalized patients worldwide. Delays in the identification of microorganisms often leads to a poor prognosis. The application of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) directly to blood culture (BC) broth can potentially identify bloodstream infections earlier, and facilitate timely management. Methods: We developed an "in-house" (IH) protocol for direct MALDI-TOF MS based identification of organisms in positive BCs. The IH protocol was initially evaluated and improved with spiked BC samples, and its performance was compared with the commercial Sepsityper™ kit using both traditional and modified cut-off values. We then studied in parallel the performance of the IH protocol and the colony MS identifications in positive clinical BC samples using only modified cut-off values. All discrepancies were investigated by "gold standard" of gene sequencing. Results: In 54 spiked BC samples, the IH method showed comparable results with Sepsityper™ after applying modified cut-off values. Specifically, accurate species and genus level identification was achieved in 88.7 and 3.9% of all the clinical monomicrobial BCs (284/301, 94.4%), respectively. The IH protocol exhibited superior performance for Gram negative bacteria than for Gram positive bacteria (92.8 vs. 82.4%). For anaerobes and yeasts, accurate species identification was achieved in 80.0 and 90.0% of the cases, respectively. For polymicrobial cultures (17/301, 5.6%), MALDI-TOF MS correctly identified a single species present in all the polymicrobial BCs under the Standard mode, while using the MIXED method, two species were correctly identified in 52.9% of the samples. Comparisons based on BC bottle type, showed that the BACTEC™ Lytic/10 Anaerobic/F culture vials performed the best. Conclusion: Our study provides a novel and effective sample preparation method for MALDI-TOF MS direct identification of pathogens from positive BC vials, with a lower cost ($1.5 vs. $ 7) albeit a slightly more laborious extracting process (an extra 15 min) compared with Sepsityper™ kit.

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Mendeley readers

Mendeley readers

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Geographical breakdown

Country Count As %
Unknown 59 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 11 19%
Student > Ph. D. Student 6 10%
Student > Master 5 8%
Student > Bachelor 4 7%
Student > Postgraduate 3 5%
Other 9 15%
Unknown 21 36%
Readers by discipline Count As %
Medicine and Dentistry 8 14%
Biochemistry, Genetics and Molecular Biology 7 12%
Immunology and Microbiology 6 10%
Agricultural and Biological Sciences 5 8%
Pharmacology, Toxicology and Pharmaceutical Science 2 3%
Other 7 12%
Unknown 24 41%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 October 2017.
All research outputs
#20,450,513
of 23,006,268 outputs
Outputs from Frontiers in Microbiology
#22,682
of 25,101 outputs
Outputs of similar age
#280,179
of 321,005 outputs
Outputs of similar age from Frontiers in Microbiology
#441
of 513 outputs
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So far Altmetric has tracked 25,101 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.3. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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