Microarray-Based Nucleic Acid Assay and MALDI-TOF MS Analysis for the Detection of Gram-Negative Bacteria in Direct Blood Cultures

Am J Clin Pathol. 2019 Jan 7;151(2):143-153. doi: 10.1093/ajcp/aqy118.

Abstract

Objectives: To compare a microarray-based identification and resistance determination system (blood culture gram-negative [BC-GN]; Nanosphere, Northbrook, IL) with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for direct blood cultures (BCs).

Methods: BC-GN and MALDI-TOF MS assay results from direct BCs were compared with conventional test results after pure culture.

Results: Among 124 BCs, 130 gram-negative rods (GNRs), including six cultures with mixed GNRs (117 bacteria were covered by the BC-GN panel), were detected. The BC-GN test presented 116/117 (99.1%) concordance for the identification of targeted GNRs. Among the six polymicrobial BCs, 10 targeted GNRs were correctly identified. Among the 100 BCs tested by MALDI-TOF MS, 88/106 (86.7%) GNRs were correctly identified, and 18 GNRs were not identified. Among the six polymicrobial samples, seven of 12 GNRs (58.3%) were correctly identified.

Conclusions: The BC-GN assay exhibited superior performance compared with MALDI-TOF MS for the identification of targeted GNRs in direct BCs, particularly in polymicrobial samples.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteremia / blood
  • Bacteremia / diagnosis
  • Bacteremia / microbiology*
  • Blood Culture
  • Drug Resistance, Bacterial
  • Gram-Negative Bacteria / drug effects
  • Gram-Negative Bacteria / isolation & purification*
  • Gram-Negative Bacterial Infections / blood
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / microbiology*
  • Humans
  • Microbial Sensitivity Tests
  • Nanospheres
  • Oligonucleotide Array Sequence Analysis / methods*
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / methods
  • Tertiary Care Centers