caa a22 4500 606157662 CHVBK 20210128100615.0 cr unu---uuuuu 210128e20150501xx s 000 0 eng 10.1007/s10096-015-2322-0 doi (NATIONALLICENCE)springer-10.1007/s10096-015-2322-0 A systematic review of matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry compared to routine microbiological methods for the time taken to identify microbial organisms from positive blood cultures [Elektronische Daten] [P. Dixon, P. Davies, W. Hollingworth, M. Stoddart, A. MacGowan] Bloodstream infections are a significant source of mortality and morbidity. Patient outcomes are improved by rapid identification of the causative pathogen and administration of appropriate antimicrobial therapy. Matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) mass spectrometry has recently emerged as an alternative to microbiological identification. It is important to establish whether the costs of MALDI-TOF are justified by more timely identification and appropriate therapy, reduced length of stay and reduced hospital costs. We undertook a systematic review of the literature comparing MALDI-TOF and routine methods for the identification of the aetiological agent in patients with known or suspected bloodstream infection. The primary outcome of the review was the ‘time to identify' organisms. Information on related measures such as ‘time to appropriate antimicrobial treatment' and downstream hospital cost was also collected where reported. Ten of 775 articles identified met the inclusion criteria. All included studies were observational. MALDI-TOF identification was at least 24h faster than routine methods in most circumstances. MADLI-TOF was associated with a reduction in downstream hospital costs and length of stay in studies reporting these outcomes. The observational studies reviewed provide evidence of potentially substantial time savings of MALDI-TOF in pathogen identification and instigation of appropriate therapy, which may also reduce hospital stay. Due to the small number of studies, all at relatively high risk of bias, this cannot be considered as definitive evidence of the impact of MALDI-TOF. More and better evidence, including impact on patient health and cost-effectiveness, is required. Springer-Verlag Berlin Heidelberg, 2015 Dixon P. School of Social and Community Medicine, University of Bristol, Bristol, UK aut Davies P. School of Social and Community Medicine, University of Bristol, Bristol, UK aut Hollingworth W. School of Social and Community Medicine, University of Bristol, Bristol, UK aut Stoddart M. North Bristol NHS Trust, Department of Medical Microbiology, Southmead Hospital, Bristol, UK aut MacGowan A. Bristol Centre for Antimicrobial Research and Evaluation, University of Bristol and North Bristol NHS Trust, Department of Medical Microbiology, Southmead Hospital, Bristol, UK aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/5(2015-05-01), 863-876 0934-9723 34:5<863 2015 34 10096 https://doi.org/10.1007/s10096-015-2322-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2322-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Dixon P. School of Social and Community Medicine, University of Bristol, Bristol, UK aut NATIONALLICENCE 700 1- Davies P. School of Social and Community Medicine, University of Bristol, Bristol, UK aut NATIONALLICENCE 700 1- Hollingworth W. School of Social and Community Medicine, University of Bristol, Bristol, UK aut NATIONALLICENCE 700 1- Stoddart M. North Bristol NHS Trust, Department of Medical Microbiology, Southmead Hospital, Bristol, UK aut NATIONALLICENCE 700 1- MacGowan A. Bristol Centre for Antimicrobial Research and Evaluation, University of Bristol and North Bristol NHS Trust, Department of Medical Microbiology, Southmead Hospital, Bristol, UK aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/5(2015-05-01), 863-876 0934-9723 34:5<863 2015 34 10096