4 years ago

Total Laboratory Automation and MALDI-TOF Improve Turnaround Times in the Clinical Microbiology Laboratory: a Retrospective Analysis.

Sanchita Das, Richard B Thomson, Talent Theparee
Technological advances have changed the practice of clinical microbiology. We implemented Bruker MALDI-TOF and BD Kiestra Total Laboratory Automation (TLA) three and four years ago, respectively. To assess the impact of these new technologies, we compared turnaround times (TAT) for positive and negative urine cultures before and after implementation. Comparison I: TATs for 61,157 urine cultures were extracted for two periods corresponding to pre-TLA and post-TLA, both using MALDI-TOF for organism identification. Comparison II: time to organism identification (ID) and antimicrobial susceptibility (AST) reports were calculated for 5,402 positive culture reports representing four different periods: 1) manual plating and conventional biochemical identification (CONV), 2) manual plating and MALDI-TOF identification (MALDI), 3) MALDI-TOF identification and early phase implementation of TLA (TLA1), and 4) MALDI-TOF identification and late phase implementation of TLA (TLA2). Comparison I Results: Median pre- and post-TLA TATs to organism IDs, (18.5 to 16.9 h) AST results (41.8 to 40.8 h), and preliminary results for negative cultures (17.7 to 13.6 h), including interquartile ranges for all comparisons, were significantly decreased post-TLA (p<0.001). Comparison II Results: MALDI significantly improved TAT to organism ID compared to CONV (21.3 to 18 h). TLA further improved overall TAT to ID (18 to 16.5 h) and AST (42.3 to 40.7 h) results compared to MALDI, p<.001). In summary, TLA significantly improved TAT to organism ID, AST report, and preliminary negative results. MALDI-TOF significantly improved TAT for organism ID. Use of MALDI-TOF and TLA individually and together result in significant decreases in microbiology report TATs.

Publisher URL: http://doi.org/10.1128/JCM.01242-17

DOI: 10.1128/JCM.01242-17

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