Diagnostic value of pediatric blood culture bottle allied to MALDI-TOF mass spectrometry in the etiological assessment of infectious keratitis
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Yes
Purpose
To evaluate the use of pediatric blood culture bottle (PBCB) combined with Matrix-assisted laser desorption ionization time of flight (MALDI-TOF) mass spectrometry (MS) for identifying the etiological agent of infectious keratitis
Methods
Prospective study of patients clinically diagnosed with infectious keratitis between 2019 and 2023 in a tertiary referral center. Inclusion criteria was corneal infiltrate equal or greater than 2x2 mm2 in size, centrally located, or unresponsive to previous treatment. Corneal scrapes were inoculated in both PBCB (BACTEC Plus Aerobic/F, BD Diagnostics) and on conventional culture media (thioglycolate broth, brain heart infusion broth with antibiotics, blood agar, chocolate agar and Sabouraud dextrose agar). Pathogens isolated from positive samples were identified by MALDI-TOF MS. Agreement between the culture methods results was calculated as Cohen’s kappa with 95% confidence intervals
Results
150 patients were included. 43% (65/150) were positive by the conventional method and 41% (62/150) were positive by PBCB. The most common isolated agent was Pseudomonas aeruginosa in both methods (20% and 23%, respectively). Culture results were similar between conventional method and PBCB in 116 (77%) cases, with a Cohen’s kappa of 0.69 (95% CI: 0.57-0.80). The overall growth rate for the two methods combined was 49% (74/150)
Conclusion
PBCB allied to MALDI-TOF mass spectrometry is an alternative diagnostic tool in infectious keratitis. PBCB has several advantages, such as the possibility of storage at room temperature, microorganism growth with small volume samples, ease of inoculation and low risk of contamination during transport
Conflict of interest
No
1
Last name
KATO
Initials of first name(s)
JM
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
2
Last name
Oliveira
Initials of first name(s)
LMS
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
3
Last name
Tanaka
Initials of first name(s)
T
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
4
Last name
Santana
Initials of first name(s)
L
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
5
Last name
di Gioia
Initials of first name(s)
TS
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
6
Last name
Araujo
Initials of first name(s)
EMPA
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
7
Last name
Yamamoto
Initials of first name(s)
JH
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
8
Last name
Santo
Initials of first name(s)
RM
Department
Hospital das Clinicas HC-FMUSP, Faculdade de Medicina, Universidade de Sao Paulo
City
Sao Paulo
Country
Brazil
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