During bloodstream infections, rapid adaptation of empirical treatment according to the microorganism identified is essential to decrease mortality. The aim of the present study was to assess the microbiological performances of a new rapid version of the Sepsityper® kit (Bruker Daltonics) allowing identification of bacteria and yeast by MALDI-TOF mass spectrometry directly from positive blood cultures in 10 min and of the specific MBT-Sepsityper module for spectra analysis, designed to increase identification performance. Identification rates were determined prospectively on 350 bacterial and 29 fungal positive blood cultures, and compared to conventional diagnostic method. Our rapid diagnosis strategy (Rapid Sepsityper® protocol: one spot with and one without formic acid extraction step) combined to MBT-Sepsityper module provided 65.4%, 78.9% and 62% reliable identification to the species level of monomicrobial positive blood cultures growing respectively Gram-positive, Gram-negative bacteria or yeast. Importantly, identification rates of Gram-positive bacteria were higher in anaerobic than in aerobic bottles (77.8% vs 22.2%; p = 0.004), if formic acid extraction step was performed (60.8% vs 39.2%; p = 1.8e−6) and if specific MBT-Sepsityper module was used (76.2% vs 61.9%, p = 0.041) while no significant differences were observed for Gram-negative bacteria. For yeasts identification, formic acid extraction step improved rapid identification rate by 37.9% while the specific MBT-Sepsityper module increased overall performances by 38%, providing up to 89.7% reliable identification if associated with the standard Sepsityper® protocol. These performances, associated with a reduce turnaround time, may help to implement a rapid identification strategy of bloodstream infections in the routine workflow of microbiology laboratories.

中文翻译：

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评估 Rapid Sepsityper® 协议和特定 MBT-Sepsityper 模块 (Bruker Daltonics) 用于通过 MALDI-TOF-MS 快速诊断菌血症和真菌血症

在血流感染期间，根据鉴定的微生物快速适应经验性治疗对于降低死亡率至关重要。本研究的目的是评估新的快速版 Sepsityper® 试剂盒（布鲁克道尔顿）的微生物学性能，允许通过 MALDI-TOF 质谱法直接从 10 分钟内阳性血培养物和特定用于光谱分析的 MBT-Sepsityper 模块，旨在提高识别性能。鉴定率是根据 350 种细菌和 29 种真菌阳性血培养物前瞻性确定的，并与传统诊断方法进行比较。我们的快速诊断策略（Rapid Sepsityper® 协议：一个点有甲酸提取步骤，一个没有甲酸提取步骤）与 MBT-Sepsityper 模块相结合提供了 65.4%，78。对分别生长的革兰氏阳性菌、革兰氏阴性菌或酵母菌的单一微生物阳性血培养物的物种水平进行了 9% 和 62% 的可靠鉴定。重要的是，如果进行甲酸提取步骤（60.8% 对 39.2%；p = 1.8e-6），则厌氧瓶中革兰氏阳性菌的识别率高于需氧瓶（77.8% 对 22.2%；p = 0.004）如果使用特定的 MBT-Sepsityper 模块（76.2% 对 61.9%，p = 0.041），而对于革兰氏阴性细菌则没有观察到显着差异。对于酵母菌鉴定，甲酸提取步骤将快速鉴定率提高了 37.9%，而特定的 MBT-Sepsityper 模块将整体性能提高了 38%，如果与标准 Sepsityper® 协议相关联，则可提供高达 89.7% 的可靠鉴定。这些表演，