Supporting MALDI-TOF

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Positive Blood Culture? MALDI-TOF Data Ambiguous?

This is where QuickFISH can help: the ideal backup system for MALDI-TOF.

Although the MALDI-TOF system is becoming established as a system routinely used in the clinical diagnostic lab, there are nevertheless occasions where MALDI-TOF may not provide a clear species identification. On these occasions the MALDI-TOF data may need to be verified using a second method.
Situations that MALDI can find challenging include:

  • Gram positive bacteraemia
  • Fungaemia
  • Presence of charcoal in culture bottles
  • Polymicrobial Bacteraemia

 

Thankfully the QuickFISH system is often able to identify organisms in those situations where a MALDI-TOF system may encounter issues. Based on proven, patented PNA-FISH technology from AdvanDX, it is a robust, reliable and sensitive system that needs minimal sample preparation. As such it provides the ideal backup system to MALDI-TOF to ensure that the laboratory can always quickly and accurately report findings across the broadest possible spectrum of pathogens.

When MALDI-TOF data is ambiguous:

“In the present study, the overall identification rate [by MALDI-TOF] of Gram-positive grape-like clustered cocci still remained less than 70%”

Klien, S. et al Journal of Medical Microbiology, 61, 323–331 (2012)

“MALDI-TOF reliability for Staphylococcus aureus direct identification was low. Only two of 36 isolates (5.6%) were correctly identified at the species level”

Ferreira, L.et al. Clinical Microbiology and Infection, 17: 546–551 (2011)

“The results of the present study show that MALDI-TOF MS, at least with the protocol used, is not a reliable method for detecting fungaemia. In 18 fungaemia episodes, MALDI-TOF MS detected the microorganism in only one BC at the species level”

Ferreira L. et al, Clinical Microbiology and Infection, 17: 546–551 (2013)

“Whatever the extraction method used, the rate of direct species identification [by MALDI-TOF] was low for Gram-positive bacteria, especially for coagulase-negative Staphylococci

Meex, C. et al. Journal of Medical Microbiology 61, 1511-1516 (2012)

QuickFISH could provide a specific answer!

“PNA-FISH is easy to perform in the clinical laboratory and does not require significant capital equipment costs unlike microarrays or MALDI-TOF”

Harris, D. and Hata, D. Annals of Clinical Microbiology and Antimicrobials 12 (2013)

“PNA-FISH was shown to be superior to MALDI-TOF for detecting Stapylococcus aureus bacteraemia directly from blood culture bottles. It was also an acceptable methodology for standard diagnostic microbiology laboratory”

Kenicer et al. European Society of Clinical Microbiology and Infectious Diseases, 29 April 2013

“The QuickFISH technology appears robust and reliable, with the major advantage of providing results in half an hour. It can be expected that this technique will be used routinely for all blood cultures”

Caretto et al, Journal of Clinical Microbiology 51(1) p131-135 (2013)

“The method [QuickFISH] provides a presumptive identification of S. aureus and classifies most non-S. aureus staphylococci as CoNS. Clinical trial results demonstrated high sensitivity and specificity for detection of staphylococci in blood cultures and rapid and easy discrimination of S. aureus and CoNS.”

Deck et al, Journal of Clinical Microbiology 50(6) p1994-1998 (2012)
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About Sepsis Diagnostics

Sepsis is a potentially life-threatening condition caused by the presence of micro-organisms such as bacteria (bacteraemia) and fungi (fungaemia) in the bloodstream. Disease progression can be rapid so effective clinical intervention in these cases requires prompt diagnosis and identification of the responsible pathogen.

The QuickFISH system offers unprecedentedly fast (20 minute) species identification of pathogens directly from positive blood cultures, allowing the reporting of pathogen identification at the same time as the reporting of Gram stain results. Implementation of QuickFISH for sepsis diagnostics can deliver

  • Improved patient outcomes
  • Decreased financial outlay
  • Optimised antibiotic use
  • Decreased patient length of stay