Use of MALDI-TOF mass spectrometry after liquid enrichment (BD Bactec™) for rapid diagnosis of bone and joint infections

Elise Lallemand (1, 2) , Cédric Arvieux (3) , Guillaume Coiffier (4, 5, 1) , Jean-Louis Polard (5) , Jean-David Albert (4, 6, 1) , Pascal Guggenbuhl (6, 4, 1) , Anne Jolivet-Gougeon (5, 2, 1)

1 NuMeCan - Nutrition, Métabolismes et Cancer
2 Microbiologie : Risques Infectieux
3 Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes]
4 Foie, métabolismes et cancer
5 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
6 Service de rhumatologie [Rennes] = Rheumatology [Rennes]

Advantages of MALDI-TOF MS (MS) were evaluated for diagnosis of bone and joint infections after enrichment of synovial fluid (SF) or crushed osteoarticular samples (CSs). MS was performed after enrichment of SF or crushed osteoarticular samples CS (n = 108) in both aerobic and anaerobic vials. Extraction was performed on 113 vials (SF: n = 47; CS: n = 66), using the Sepsityper(®) kit prior identification by MS. The performances of MS, score and reproducibility results on bacterial colonies from blood agar and on pellets after enrichment in vials, were compared. MS analysis of the vial resulted in correct identification of bacteria at a species and genus level (80.5% and 92% of cases, respectively). The reproducibility was superior for aerobic Gram-positive bacteria (Staphylococci and Gram-positive bacilli: 100% colonies), as compared to aerobic Gram-negative bacilli (89.7%), anaerobes (83.3%) and Streptococcus/Enterococcus (58.8%). MS performance was significantly better for staphylococci than for streptococci on all identification parameters. For polymicrobial cultures, identification (score>1.5) of two species by MS was acceptable in 92.8% of cases. Use of MS on enrichment pellets of bone samples is an accurate, rapid and robust method for bacterial identification of clinical isolates from osteoarticular infections, except for streptococci, whose identification to species level remains difficult.

Mots clés: Beadmill processing; Sepsityper® kit; MALDI-TOF mass spectrometry; Osteoarticular infection; Polymicrobial samples; Time of detection

Domaines: Rhumatologie et système ostéo-articulaire; Maladies infectieuses; Ingénierie biomédicale

Elise Lallemand, Cédric Arvieux, Guillaume Coiffier, Jean-Louis Polard, Jean-David Albert, et al.. Use of MALDI-TOF mass spectrometry after liquid enrichment (BD Bactec™) for rapid diagnosis of bone and joint infections. Research in Microbiology, 2017, 168 (2), pp.122-129. ⟨10.1016/j.resmic.2016.09.005⟩. ⟨hal-01446879⟩