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首页> 外文期刊>Journal of Clinical Microbiology >Prospective Evaluation of a Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry System in a Hospital Clinical Microbiology Laboratory for Identification of Bacteria and Yeasts: a Bench-by-Bench Study for Assessing the Impact on Time to Identification and Cost-Effectiveness
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Prospective Evaluation of a Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry System in a Hospital Clinical Microbiology Laboratory for Identification of Bacteria and Yeasts: a Bench-by-Bench Study for Assessing the Impact on Time to Identification and Cost-Effectiveness

机译：在医院临床微生物学实验室鉴定细菌和酵母的基质辅助激光解吸电离-飞行时间质谱系统的前瞻性评估：逐项研究，评估对鉴定时间和成本效益的影响

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Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) has been found to be an accurate, rapid, and inexpensive method for the identification of bacteria and yeasts. Previous evaluations have compared the accuracy, time to identification, and costs of the MALDI-TOF MS method against standard identification systems or commercial panels. In this prospective study, we compared a protocol incorporating MALDI-TOF MS (MALDI protocol) with the current standard identification protocols (standard protocol) to determine the performance in actual practice using a specimen-based, bench-by-bench approach. The potential impact on time to identification (TTI) and costs had MALDI-TOF MS been the first-line identification method was quantitated. The MALDI protocol includes supplementary tests, notably for Streptococcus pneumoniae and Shigella, and indications for repeat MALDI-TOF MS attempts, often not measured in previous studies. A total of 952 isolates (824 bacterial isolates and 128 yeast isolates) recovered from 2,214 specimens were assessed using the MALDI protocol. Compared with standard protocols, the MALDI protocol provided identifications 1.45 days earlier on average (P < 0.001). In our laboratory, we anticipate that the incorporation of the MALDI protocol can reduce reagent and labor costs of identification by $102,424 or 56.9% within 12 months. The model included the fixed annual costs of the MALDI-TOF MS, such as the cost of protein standards and instrument maintenance, and the annual prevalence of organisms encountered in our laboratory. This comprehensive cost analysis model can be generalized to other moderate- to high-volume laboratories.
机译：已发现基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）是鉴定细菌和酵母菌的准确，快速且廉价的方法。先前的评估已将MALDI-TOF MS方法与标准识别系统或商用面板的准确性，识别时间和成本进行了比较。在这项前瞻性研究中，我们将结合MALDI-TOF MS的协议（MALDI协议）与当前的标准识别协议（标准协议）进行了比较，以确定使用基于样本的逐个工作台方法在实际操作中的性能。量化MALDI-TOF MS作为一线鉴定方法对鉴定时间（TTI）和成本的潜在影响。 MALDI协议包括补充测试，尤其是针对肺炎链球菌和志贺氏菌的补充测试，以及重复MALDI-TOF MS尝试的适应症，通常在以前的研究中未进行测量。使用MALDI方案评估了从2,214个标本中回收的总共952个分离株（824个细菌分离株和128个酵母分离株）。与标准协议相比，MALDI协议提供了平均1.45天之前的识别（ P <0.001）。在我们的实验室中，我们预计MALDI方案的合并可以在12个月内将试剂和人工鉴定成本降低102,424美元或56.9％。该模型包括MALDI-TOF MS的固定年度费用，例如蛋白质标准品和仪器维护的费用，以及在我们实验室中遇到的生物的年度流行率。这种全面的成本分析模型可以推广到其他中型到大型实验室。

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