= Discovery stage. (24.37%, 2023)
= Translation stage. (39.50%, 2023)
= Clinically available. (36.13%, 2023)
MSACL 2023 : Smith

MSACL 2023 Abstract

Self-Classified Topic Area(s): Microbiology > Lipidomics

Podium Presentation in Steinbeck 2 on Wednesday at 15:50 (Chair: Bo Burla / Xueheng Zhao)

Comparison of a Novel Lipid-based MALDI-TOF MS Technique to Two FDA-cleared Direct from Blood Culture Diagnostics

Richard D. Smith1, 2, Robert K. Ernst#1, and J. Kristie Johnson#2
1 Department of Microbial Pathogenesis, School of Dentistry, University of Maryland, Baltimore, MD 21201 USA 2 Department of Pathology, School of Medicine, University of Maryland, Baltimore, MD 21201 USA

Richard Smith (Presenter)
University of Maryland

Abstract

Background:
Managing Bloodstream Infections requires fast and accurate diagnostics. Current diagnostic methods for identification from positive blood culture require 24-hour subculture, potentially delaying time to appropriate therapy. In this study, we developed a direct-from-specimen, lipid-based MALDI-TOF MS platform, Fast Lipid Analysis Technique (FLAT), and compared it to several FDA-cleared, direct from blood culture diagnostic platforms.

Methods:
Positive blood cultures were collected (n=301) from September 2021 to August 2022 at the University of Maryland Medical Center. Platforms compared were FLAT, BioFire® BCID2, and Rapid Sepsityper®.

Results:
For monomicrobial cultures, lipid-based MS with FLAT identified 81.0% (85/105) of Gram-positives, 94.9% (149/157) of Gram-negatives, and 63.6% (7/11) of yeast. BioFire® BCID2 identified 85.7% (90/105) of Gram-positives, 89.8% (141/157) of Gram-negatives, and 90.9% (10/11) of yeast. Rapid Sepsityper® identified of 61.0% (64/105) of Gram-positives, 89.8% (141/157) of Gram-negatives, and 45.5% (5/11) of yeast. For polymicrobial cultures, FLAT had 71.4% (20/28) partial identifications and 28.6% (8/28) complete identifications. BioFire® BCID2 had 7.1% (2/28) partial identifications and 92.9% (26/28) complete. Sepsityper® 82.1% (23/28) and 10.7% (3/28) had partial and complete identifications, respectively, and 7.1% (2/28) without identifications, Time-to-results for BioFire®, Rapid Sepsityper®, were 60, 65, and 35 minutes, respectively. Hands-on time was 10, 5, and 25 minutes, respectively.

Conclusions:
Performance of these platforms can reduce time-to-results and may help effectively treat bloodstream infections faster. FLAT outperformed the current FDA-cleared, direct-from-blood culture MS method, Sepsityper®. Furthermore, FLAT had comparable result to the molecular assay BioFire® BCID2; however, cost is an important factor to be considered as lipid-based MALDI-TOF MS is much less expensive than molecular methods.


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