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2021, Cilt 51, Sayı 3, Sayfa(lar) 288-294
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Comparison of MALDI-TOF MS Method Using Samples From Blood Culture Bottles and Germ Tube Test in Rapid Detection and Identification of Candidemia
Kerem Yılmaz1, Nurten Altanlar2
1Soma Devlet Hastanesi, Tıbbi Mikrobiyoloji Laboratuvarı, Manisa, Türkiye
2Ankara Üniversitesi, Eczacılık Fakültesi, Farmasötik Mikrobiyoloji Anabilim Dalı, Ankara, Türkiye
Keywords: Candida spp, Candidemia, germ tube, matrix-assisted laser desorption Ionization mass spectrometry

Objective: Candidemia is an infection with a high mortality and increasing incidence day by day. Candida albicans is the most common microorganism responsible for clinical picture of candidemia but other species are also important. Therefore, in order to establish early diagnosis in fungal infections and decrease the mortality rate, methods which provide reliable results in a short time are needed. The objective of this study is to evaluate and compare several automated/manual methods in identification of the causative agent r in a much shorter time.

Method: In the study, average time to become positive in blood culture system for 50 Candida strains which were isolated from positive blood culture samples sent to Sakarya University Training and Research Hospital Medical Microbiology Laboratory between March 2018 and March 2019 was determined according to the species. All samples were were subjected to germ tube test and identification with MALDI-TOF MS directly from blood culture bottles, and after obtaining pure culture, germ tube test and MALDI-TOF MS method were used for identification. The data obtained were comparatively evaluated.

Results: In the study, average time intervals elapsed to become positive in blood culture system in terms of species were determined to be 36.1 h for C. albicans, 39.4 h for Candida parapsilosis, 17.7 h for Candida tropicalis and 50.5 h for Candida glabrata. In the processes performed after germ tube test from direct blood culture bottle and obtaining pure culture, compatibility was found in 49 (98%)strains. Identification results according to MALDI TOF MS method from direct blood culture. In the identification processes performed after MALDI-TOF method from direct blood culture bottle and obtaining pure culture, compatibility was found in 37 (74%) strains.

Conclusion: Time to get positive in blood culture may be a clue for prediction of species before final species identification among patients with candidemia. Direct GTT enables the detection of albicans/non-albicans Candida species the day before the culture with high accuracy. Thirty-seven Candida species were identified to be 100% compatible with standard methods, and this method was shown to provide at least 48 hours advantage over the MALDI-TOF MS method, that requires pure culture yield.


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