Abstract:
Aim: To standardize MALDI-TOF-MS based identification and antifungal susceptibility (AFST) for yeasts directly from automated blood cultures to reduce turnaround time. Materials & methods: Direct-ID after lysis-centrifugation (0.5% SDS) standardized in 40 and validated in 250 yeast positive samples. Direct-AFST was standardized with fluconazole (28 samples) and evaluated (70 samples) for seven antifungals. Results: Direct-ID had a high sensitivity (97.2%) and specificity (94.3%). Correct species-level identification showed 100% in C. tropicalis, C. krusei, C. parapsilosis. Direct-AFST had a 100% categorical agreement with culture-AFST for posaconazole, anidulafungin and >90% categorical agreement for amphotericin B, voriconazole and fluconazole. Conclusion: Direct-ID and subsequent direct-AFST is a rapid and robust method to reduce the turnaround time for the diagnosis of invasive candidiasis.
摘要:
目的:将基于MALDI-TOF-MS的鉴定和抗真菌敏感性(AFST)标准化,以直接从自动血液培养物中获得酵母,以减少周转时间。材料和方法:裂解-离心后的直接ID(0.5%SDS)在40个酵母阳性样品中标准化并在250个酵母阳性样品中验证。用氟康唑(28个样品)对直接-AFST进行了标准化,并对7种抗真菌药进行了评估(70个样品)。结果:Direct-ID具有较高的敏感性(97.2%)和特异性(94.3%)。正确的物种水平鉴定在热带梭菌中显示100%,C.Krusei,C.近平滑。直接-AFST与泊沙康唑的培养-AFST有100%的绝对一致性,Anidulafungin和两性霉素B>90%的分类一致性,伏立康唑和氟康唑.结论:直接ID和随后的直接AFST是一种快速,可靠的方法,可以减少诊断侵袭性念珠菌病的周转时间。