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Rapid identification of uropathogens by combining Alfred 60 system with matrix-assisted laser desorption/ionization–time-of-flight mass spectrometry technology

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Abstract

Rapid identification of uropathogens is needed to determine appropriate antimicrobial therapy. This study evaluated performance of the Alfred 60 system combined with matrix-assisted laser desorption/ionization–time-of-flight mass spectrometry (MALDI-TOF MS) technology for rapid identification of uropathogens. The Alfred 60 system was used to screen urine cultures, followed by identifying the microbial pathogen in positive cultures using MALDI-TOF MS. The Alfred 60 detected positive cultures by measuring the turbidity of urine samples, which were transferred automatically to vials containing liquid medium and incubated for 3.5 h at 35 °C in the Alfred 60 system. Vials that showed growth were removed and centrifuged. The pellet was subjected to MALDI-TOF MS identification. In parallel, positive urine samples were inoculated onto agar plates for identification by conventional culture. The time required to detect positive urine cultures with Alfred 60 and identify the uropathogens with MALDI-TOF MS ranged from 15 min to 3.5 h. Among 146 positive urine samples tested, conventional cultures showed three culture groups: group 1 included 101 samples with growth of a single type of microorganism; group 2 included 34 samples with 2 types of microorganisms; and group 3 included 11 samples with ≥ 3 types of microorganisms. Direct identification by MALDI-TOF MS was concordant with 95% of the samples in group 1, 100% of the principal microorganism in group 2, but could not identify microorganisms in group 3. This combination of methods provides rapid, reliable microbial identification for most positive urine cultures.

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Acknowledgments

The authors gratefully acknowledge Mr. Aviram Aziel, Biotron, Israel, for providing the vials for the tests.

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Authors and Affiliations

  1. Clinical Microbiology Laboratory, Hillel Yaffe Medical Center, Hadera, Israel

    Abed Athamna, Albira Zbriger, Stella Avadov & Sarit Freimann

  2. Laboratory Division, Hillel Yaffe Medical Center, Hadera, Israel

    Maanit Shapira

  3. Clinical Biochemistry Laboratory, Hillel Yaffe Medical Center, Hadera, Israel

    Yana Tal

Authors
  1. Abed Athamna
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  2. Albira Zbriger
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  3. Stella Avadov
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  4. Maanit Shapira
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  5. Yana Tal
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  6. Sarit Freimann
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Contributions

Abed Athamna, Sarit Freiman, and Maanit Shapira contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Albira Zbriger, Stella Avadov, and Yana Tal. The first draft of the manuscript was written by Abed Athamna and all authors commented on the subsequent versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Abed Athamna.

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The authors declare that they have no conflict of interest.

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All specimens were collected as part of the routine clinical management of patients, according to the national and local guidelines. Consequently, informed consent was not sought and approval from the institutional ethics committee was not required.

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Athamna, A., Zbriger, A., Avadov, S. et al. Rapid identification of uropathogens by combining Alfred 60 system with matrix-assisted laser desorption/ionization–time-of-flight mass spectrometry technology. Eur J Clin Microbiol Infect Dis 39, 1855–1863 (2020). https://doi.org/10.1007/s10096-020-03919-3

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