Rapid species identification of Candida directly from blood culture broths by Sepsityper-MALDI-TOF mass spectrometry: impact on antifungal therapy

Abstract

Rapid identification of Candida species facilitates pathogen-directed therapy with either fluconazole or an echinocandin.

Method: We applied Sepsityper matrix-assisted laser desorption ionisation time of flight mass spectrometry (MALDI-TOF-MS) technology on positive blood culture broths for rapid species identification.

Results: Of the 74 patients with candidaemia, 25 had the species identified on the day of the positive blood culture directly from the broth (rapid identification group) while the remaining 49 had the species identified from culture (conventional identification group). Three (13.6%) out of 22 treated patients in the rapid identification group received echinocandin compared to 20/45 (44.4%) in the conventional identification group. The appropriateness of therapy was 90.9% in the rapid identification group and 62.2% in the conventional identification group (p = 0.01). Cost savings were more than £10,000 in the first three days of treatment.

Conclusion: Sepsityper-MALDI-TOF-MS is a useful tool in supporting antifungal stewardship programmes.

Keywords: MALDI-TOF; Sepsityper; antifungal stewardship; rapid identification.