Literature DB >> 27658295

Correction: Clinical Impact of MALDI-TOF MS Identification and Rapid Susceptibility Testing on Adequate Antimicrobial Treatment in Sepsis with Positive Blood Cultures.

Alexia Verroken, Lydwine Defourny, Olivier le Polain de Waroux, Leïla Belkhir, Pierre-François Laterre, Michel Delmée, Youri Glupczynski.   

Abstract

[This corrects the article DOI: 10.1371/journal.pone.0156299.].

Entities:  

Year:  2016        PMID: 27658295      PMCID: PMC5033485          DOI: 10.1371/journal.pone.0160537

Source DB:  PubMed          Journal:  PLoS One        ISSN: 1932-6203            Impact factor:   3.240


There are numerical errors in the first and penultimate sentences of the second paragraph of the Results under the subheading “Rapid identification and susceptibility test performances.” The correct paragraph is: βLT performed on 164 BSI (P1 and P2 combined) yielded 24 positive, 139 negative and 1 uninterpretable test result due to an incoherent color change of the chromogenic test. All positive βLT results were found in non-natural AmpC EB isolates displaying third generation cephalosporin resistance by complete AST results and subsequently confirmed as ESBL producers. In 7 cases, βLT yielded false-negative results since complete AST and molecular testing identified 6 AmpC producing Escherichia coli and 1 VIM metallo-beta-lactamase-producing P. aeruginosa, all resistant to third generation cephalosporin. Globally, sensitivity and specificity of βLT were respectively 77.4% and 100%. No erroneous or uninterpretable results were observed with PBP2a testing. Performed on 25 S. aureus BSI in P1 and P2, PBP2a was able to detect all 3 MRSA strains (sensitivity and specificity of 100%). Ultimately, 8 BSI (6 in P1 and 2 in P2) were discarded from outcome analysis due to erroneous/uninterpretable rapid test results. Tables 1 and 2 appear incorrectly in the published article. Please see the correct Tables 1 and 2 and their captions here.
Table 1

Distribution of microorganisms and main resistances of all bloodstream infections across the three study periods.

3GC, third generation cephalosporin (cefotaxime, ceftriaxone, ceftazidime); AST, antimicrobial susceptibility testing; BSI, bloodstream infection; carbapenem (imipenem, meropenem); ID, identification; P0, pre-intervention period; P1, intervention period 1; P2, intervention period 2. Natural AmpC producers identified during the study periods: Citrobacter freundii, Enterobacter aerogenes, Enterobacter cloacae, Hafnia alvei, Serratia marcescens. Non-natural AmpC producers identified during the study periods: Citrobacter koseri, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris, Salmonella spp.

Microorganism ResistanceP0P1P2
n BSI (%)n BSI (%)n BSIn BSIn BSI (%)n BSIn BSI
final outcome analysisfinal outcome analysiswith failed IDwith failed partial ASTfinal outcome analysiswith failed IDwith failed partial AST
Gram-positive bacteria50 (37.3)40 (35.7)8044 (28.6)70
Staphylococci2522302420
  Staphylococcus aureus1411101400
   methicillin110-2--
  Coagulase negative Staphylococci1111201020
Enterococci121110910
Streptococci97201040
 Other Gram-positive bacteria4020100
Gram-negative bacteria77 (57.5)71 (63.4)16107 (69.5)22
 Enterobacteriaceae71630510312
  natural AmpC producers56001100
   3GC21--4--
   carbapenem00--0--
  non-natural AmpC producers6657059212
   3GC106-51802
   carbapenem00-0000
 Non fermenters6611410
  Pseudomonas aeruginosa3401310
   3GC00-100-
   carbapenem00-100-
  Other non fermenters3210100
 Other Gram-negative bacteria02-0000
Anaerobes6 (4.5)0 (0.0)602 (1.3)60
Yeast1 (0.7)1 (0.9)201 (0.6)30
TOTAL134 (100)112 (100)176154 (100)182
Table 2

Time to identification and time to partial/complete susceptibility results of all bloodstream infections during pre-intervention and intervention period 1 and 2.

Time to identification
PhaseMethodBSI (n)Mean time to ID (hours)
P0TOTAL13428.3
Subculture MALDI-TOF MS13428.3
Early MALDI-TOF MS--
Direct MALDI-TOF MS--
P1TOTAL11210.2
Subculture MALDI-TOF MS2315.9
Early MALDI-TOF MS6510.6
Direct MALDI-TOF MS243.6
P2TOTAL15410.8
Subculture MALDI-TOF MS3217.1
Early MALDI-TOF MS9610.7
Direct MALDI-TOF MS264.0
Time to complete susceptibility result
PhaseMethodBSI (n)Mean time to complete AST result (hours)
P0TOTAL13444.7
Phoenix from subculture5846.9
Phoenix from young subculture--
Direct Phoenix4828.3
Manual testing from subculture2868.3
Manuel testing from young subculture--
P1TOTAL11232.4
Phoenix from subculture2841.2
Phoenix from young subculture2332.2
Direct Phoenix4525.6
Manual testing from subculture749.1
Manuel testing from young subculture927.3
P2TOTAL15432.6
Phoenix from subculture3441.6
Phoenix from young subculture8129.9
Direct Phoenix2222.2
Manual testing from subculture852.2
Manuel testing from young subculture930.9
Time to partial susceptibility result
PhaseMethodBSI (n)Mean time to partial susceptibility testing result (hours)
P1TOTAL7211.8
Culture βLT2017.9
Young subculture βLT2911.2
Direct βLT123.7
Culture PBP2a315.3
Young subculture PBP2a612
Direct PBP2a22
P2TOTAL10911.7
Culture βLT2916.8
Young subculture βLT5111.1
Direct βLT153.6
Culture PBP2a420.2
Young subculture PBP2a98.8
Direct PBP2a16

Distribution of microorganisms and main resistances of all bloodstream infections across the three study periods.

3GC, third generation cephalosporin (cefotaxime, ceftriaxone, ceftazidime); AST, antimicrobial susceptibility testing; BSI, bloodstream infection; carbapenem (imipenem, meropenem); ID, identification; P0, pre-intervention period; P1, intervention period 1; P2, intervention period 2. Natural AmpC producers identified during the study periods: Citrobacter freundii, Enterobacter aerogenes, Enterobacter cloacae, Hafnia alvei, Serratia marcescens. Non-natural AmpC producers identified during the study periods: Citrobacter koseri, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris, Salmonella spp.
  1 in total

1.  Clinical Impact of MALDI-TOF MS Identification and Rapid Susceptibility Testing on Adequate Antimicrobial Treatment in Sepsis with Positive Blood Cultures.

Authors:  Alexia Verroken; Lydwine Defourny; Olivier le Polain de Waroux; Leïla Belkhir; Pierre-François Laterre; Michel Delmée; Youri Glupczynski
Journal:  PLoS One       Date:  2016-05-26       Impact factor: 3.240

  1 in total
  4 in total

1.  Direct β-Lactam Inactivation Method: a New Low-Cost Assay for Rapid Detection of Carbapenemase- or Extended-Spectrum-β-Lactamase-Producing Enterobacterales Directly from Positive Blood Culture Bottles.

Authors:  Gabriele Bianco; Matteo Boattini; Marco Iannaccone; Lucina Fossati; Rossana Cavallo; Cristina Costa
Journal:  J Clin Microbiol       Date:  2019-12-23       Impact factor: 5.948

2.  The implementation of rapid microbial identification via MALDI-ToF reduces mortality in gram-negative but not gram-positive bacteremia.

Authors:  Hila Zadka; Eli Raykhshtat; Boris Uralev; Nancy Bishouty; Ahuva Weiss-Meilik; Amos Adler
Journal:  Eur J Clin Microbiol Infect Dis       Date:  2019-07-30       Impact factor: 3.267

3.  EUCAST rapid antimicrobial susceptibility testing (RAST) in blood cultures: validation in 55 European laboratories.

Authors:  Anna Åkerlund; Emma Jonasson; Erika Matuschek; Lena Serrander; Martin Sundqvist; Gunnar Kahlmeter
Journal:  J Antimicrob Chemother       Date:  2020-11-01       Impact factor: 5.790

4.  Rapid versus standard antimicrobial susceptibility testing to guide treatment of bloodstream infection.

Authors:  Vanesa Anton-Vazquez; Paul Hine; Sanjeev Krishna; Marty Chaplin; Timothy Planche
Journal:  Cochrane Database Syst Rev       Date:  2021-05-04
  4 in total

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