Accelerated Bacterial Identification with MALDI-TOF MS Leads to Fewer Diagnostic Tests and Cost Savings

Overview

Journal Antibiotics (Basel)

Specialty Pharmacology

Date 2025 Jan 8

PMID 39766553

Authors

Miriam Uzuriaga

Francisco Guillen-Grima

Marta Rua

Jose Leiva

Jose R Yuste

Affiliations

Soon will be listed here.

Abstract

Introduction: Rapid microbiology reporting can enhance both clinical and economic outcomes.

Material And Methods: This three-year, quasi-experimental study, single-group pretest-posttest study, conducted at a university medical center, aimed to evaluate the clinical and economic impact of rapid microbiological identification reporting using MALDI-TOF MS. A total of 363 consecutive hospitalized patients with bacterial infections were evaluated, comparing a historical control group (CG, n = 183) with an intervention group (IG, = 180). In the CG, microbiological information (bacterial identification and antibiotic susceptibility) was provided between 18:00 and 22:00 h, while in the IG, bacterial identification was reported between 12:00 and 14:00 h, and antibiotic susceptibility was reported between 18:00 and 22:00 h.

Results: The IG demonstrated a significant reduction in the number of patients undergoing Microbiology ( = 0.01), Biochemistry ( = 0.05), C-Reactive Protein ( = 0.02), Radiological Tests ( = 0.05), Computed Tomography Tests ( = 0.04), and Pathology ( = 0.01). However, no statistically significant reduction was observed in economic costs related to microbiological testing ( = 0.76) or antibiotic consumption ( = 0.59). The timely reporting of microbiological identification to clinicians resulted in fewer patients undergoing additional diagnostic tests, ultimately contributing to reduced healthcare resource utilization without adversely affecting clinical outcomes.

Citing Articles

Isolation and Characterization of Enterocin-Producing Strains from Algerian Traditional Food "Dried Figs Marinated in Olive Oil": Functional and Safety Evaluations.

Merzoug M, Bendida K, Aireche M, Zater Z, Brakna C, Hammadi A Foods. 2025; 14(5).

PMID: 40077468 PMC: 11899104. DOI: 10.3390/foods14050766.

References

Galar A, Leiva J, Espinosa M, Guillen-Grima F, Hernaez S, Yuste J . Clinical and economic evaluation of the impact of rapid microbiological diagnostic testing. J Infect. 2012; 65(4):302-9. DOI: 10.1016/j.jinf.2012.06.006. View

Roux-Dalvai F, Gotti C, Leclercq M, Helie M, Boissinot M, Arrey T . Fast and Accurate Bacterial Species Identification in Urine Specimens Using LC-MS/MS Mass Spectrometry and Machine Learning. Mol Cell Proteomics. 2019; 18(12):2492-2505. PMC: 6885708. DOI: 10.1074/mcp.TIR119.001559. View

Kerremans J, Verboom P, Stijnen T, Hakkaart-van Roijen L, Goessens W, Verbrugh H . Rapid identification and antimicrobial susceptibility testing reduce antibiotic use and accelerate pathogen-directed antibiotic use. J Antimicrob Chemother. 2007; 61(2):428-35. DOI: 10.1093/jac/dkm497. View

Charlson M, Pompei P, Ales K, MacKenzie C . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40(5):373-83. DOI: 10.1016/0021-9681(87)90171-8. View

Niwa T, Yonetamari J, Hayama N, Fujibayashi A, Ito-Takeichi S, Suzuki K . Clinical impact of matrix-assisted laser desorption ionization-time of flight mass spectrometry combined with antimicrobial stewardship interventions in patients with bloodstream infections in a Japanese tertiary hospital. Int J Clin Pract. 2019; 73(5):e13332. DOI: 10.1111/ijcp.13332. View

Dixon P, Hollingworth W, Pike K, Reynolds R, Stoddart M, MacGowan A . Cost-effectiveness of rapid laboratory-based mass-spectrometry diagnosis of bloodstream infection: evidence from the RAPIDO randomised controlled trial. BMJ Open. 2021; 11(10):e044623. PMC: 8524273. DOI: 10.1136/bmjopen-2020-044623. View

Munoz Bellido J, Gonzalez Buitrago J . [MALDI-TOF mass spectrometry in clinical microbiology. Current situation and future perspectives]. Enferm Infecc Microbiol Clin. 2015; 33(6):369-71. DOI: 10.1016/j.eimc.2015.02.016. View

Tran A, Alby K, Kerr A, Jones M, Gilligan P . Cost Savings Realized by Implementation of Routine Microbiological Identification by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry. J Clin Microbiol. 2015; 53(8):2473-9. PMC: 4508454. DOI: 10.1128/JCM.00833-15. View

Tsuchida S, Umemura H, Nakayama T . Current Status of Matrix-Assisted Laser Desorption/Ionization-Time-of-Flight Mass Spectrometry (MALDI-TOF MS) in Clinical Diagnostic Microbiology. Molecules. 2020; 25(20). PMC: 7587594. DOI: 10.3390/molecules25204775. View

10.

Neuenschwander F, Gross B, Schubert S . Rapid Antibiotic Susceptibility Testing of Gram-Negative Bacteria Directly from Urine Samples of UTI Patients Using MALDI-TOF MS. Antibiotics (Basel). 2023; 12(6). PMC: 10295066. DOI: 10.3390/antibiotics12061042. View

11.

Sanchez D, Torres I, Padron C, Gimenez E, Colomina J, Carretero D . Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and lateral flow immunochromatography for rapid identification of β-lactamase-gene-harboring Enterobacterales in urine specimens: Performance and cost-benefit analyses. Diagn Microbiol Infect Dis. 2023; 108(2):116127. DOI: 10.1016/j.diagmicrobio.2023.116127. View

12.

Clerc O, ProdHom G, Vogne C, Bizzini A, Calandra T, Greub G . Impact of matrix-assisted laser desorption ionization time-of-flight mass spectrometry on the clinical management of patients with Gram-negative bacteremia: a prospective observational study. Clin Infect Dis. 2012; 56(8):1101-7. DOI: 10.1093/cid/cis1204. View

13.

Bruins M, Oord H, Bloembergen P, Wolfhagen M, Casparie A, Degener J . Lack of effect of shorter turnaround time of microbiological procedures on clinical outcomes: a randomised controlled trial among hospitalised patients in the Netherlands. Eur J Clin Microbiol Infect Dis. 2005; 24(5):305-13. DOI: 10.1007/s10096-005-1309-7. View

14.

Huang A, Newton D, Kunapuli A, Gandhi T, Washer L, Isip J . Impact of rapid organism identification via matrix-assisted laser desorption/ionization time-of-flight combined with antimicrobial stewardship team intervention in adult patients with bacteremia and candidemia. Clin Infect Dis. 2013; 57(9):1237-45. DOI: 10.1093/cid/cit498. View

15.

Religioni U, Pakulska T . Clinical and economic benefits of hospital drug management rationalization. J Med Econ. 2022; 25(1):826-828. DOI: 10.1080/13696998.2022.2088008. View

16.

Rodrigues R, Passadouro R, Gomes O, Castro R . Risk Factors, Length of Stay and In-Hospital Mortality of Methicillin-Resistant Staphylococcus aureus Infections: A Case-Control Study. Acta Med Port. 2020; 33(3):174-182. DOI: 10.20344/amp.10952. View

17.

. Global burden of bacterial antimicrobial resistance 1990-2021: a systematic analysis with forecasts to 2050. Lancet. 2024; 404(10459):1199-1226. PMC: 11718157. DOI: 10.1016/S0140-6736(24)01867-1. View

18.

Fenselau C, Demirev P . Characterization of intact microorganisms by MALDI mass spectrometry. Mass Spectrom Rev. 2002; 20(4):157-71. DOI: 10.1002/mas.10004. View

19.

Tang K, Millar B, Moore J . Antimicrobial Resistance (AMR). Br J Biomed Sci. 2023; 80:11387. PMC: 10336207. DOI: 10.3389/bjbs.2023.11387. View

20.

Doern G, Vautour R, Gaudet M, Levy B . Clinical impact of rapid in vitro susceptibility testing and bacterial identification. J Clin Microbiol. 1994; 32(7):1757-62. PMC: 263786. DOI: 10.1128/jcm.32.7.1757-1762.1994. View