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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Clin+Microbiol
2017 ; 55
(5
): 1437-1445
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Effect of Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass
Spectrometry (MALDI-TOF MS) Alone versus MALDI-TOF MS Combined with Real-Time
Antimicrobial Stewardship Interventions on Time to Optimal Antimicrobial Therapy
in Patients with Positive Blood Cultures
#MMPMID28228491
Beganovic M
; Costello M
; Wieczorkiewicz SM
J Clin Microbiol
2017[May]; 55
(5
): 1437-1445
PMID28228491
show ga
Matrix-assisted laser desorption ionization-time of flight mass spectrometry
(MALDI-TOF MS) decreases the time to organism identification and improves
clinical and financial outcomes. The purpose of this study was to evaluate the
impact of MALDI-TOF MS alone versus MALDI-TOF MS combined with real-time,
pharmacist-driven, antimicrobial stewardship (AMS) intervention on patient
outcomes. This single-center, pre-post, quasiexperimental study evaluated
hospitalized patients with positive blood cultures identified via MALDI-TOF MS
combined with prospective AMS intervention compared to a control cohort with
MALDI-TOF MS identification without AMS intervention. AMS intervention included:
real-time MALDI-TOF MS pharmacist notification and prospective AMS provider
feedback. The primary outcome was the time to optimal therapy (TTOT). A total of
252 blood cultures, 126 in each group, were included in the final analysis.
MALDI-TOF MS plus AMS intervention significantly reduced the overall TTOT (75.17
versus 43.06 h; P < 0.001), the Gram-positive contaminant TTOT (48.21 versus
11.75 h; P < 0.001), the Gram-negative infection (GNI) TTOT (71.83 versus 35.98
h; P < 0.001), and the overall hospital length of stay (LOS; 15.03 versus 9.02
days; P = 0.021). The TTOT for Gram-positive infection (GPI) was improved (64.04
versus 41.61 h; P = 0.082). For GPI, the hospital LOS (14.64 versus 10.31 days; P
= 0.002) and length of antimicrobial therapy 24.30 versus 18.97 days; P = 0.018)
were reduced. For GNI, the time to microbiologic clearance (51.13 versus 34.51 h;
P < 0.001), the hospital LOS (15.40 versus 7.90 days; P = 0.027), and the
intensive care unit LOS (5.55 versus 1.19 days; P = 0.035) were reduced. To
achieve optimal outcomes, rapid identification with MALDI-TOF MS combined with
real-time AMS intervention is more impactful than MALDI-TOF MS alone.