ArticlePloS one2014
Gram-stain plus MALDI-TOF MS (Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry) for a rapid diagnosis of urinary tract infection.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed, 81 citations in OpenAlex.
- Tandem Bioluminescent Tests for Rapid Detection of Urinary Tract Infections and Antimicrobial Resistance Using a Portable Luminometer.Analytical chemistry · 2025Article
- Evaluation of Two Tests for the Rapid Detection of CTX-M Producers Directly in Urine Samples.Antibiotics (Basel, Switzerland) · 2023Article
- Mass spectrometry-based proteomics as an emerging tool in clinical laboratories.Clinical proteomics · 2023Review
- Review
- A Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry Direct-from-Urine-Specimen Diagnostic for Gram-Negative Pathogens.Microbiology spectrum · 2022Article
- MALDI-TOF MS for Rapid Analysis of Bacterial Pathogens Causing Urinary Tract Infections in the Riyadh Region.Diseases (Basel, Switzerland) · 2022Article
- Accuracy of molecular diagnostic techniques in patients with a confirmed urine culture: A systematic review and meta-analysis.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2022Article
- Applying Diagnostic Stewardship to Proactively Optimize the Management of Urinary Tract Infections.Antibiotics (Basel, Switzerland) · 2022Review
- Renal pelvis urine Gram stain as a traditional, but new marker in predicting postoperative fever and stone culture positivity in percutaneous nephrolithotomy: an observational, prospective, non-randomized cohort study.World journal of urology · 2021Observational
- Accuracy of matrix-assisted laser desorption ionization time-of-flight mass spectrometry for direct bacterial identification from culture-positive urine samples.Annals of translational medicine · 2021Article
- Rapid identification of uropathogens by combining Alfred 60 system with matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry technology.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Article
- Diagnostic Accuracy of MALDI-TOF Mass Spectrometry for the Direct Identification of Clinical Pathogens from Urine.Open medicine (Warsaw, Poland) · 2020Article
- Direct Identification of Pathogens in Urine by Use of a Specific Matrix-Assisted Laser Desorption Ionization-Time of Flight Spectrum Database.Journal of clinical microbiology · 2019Article
- Progress in Automated Urinalysis.Annals of laboratory medicine · 2019Review
- Rapid Identification and Antimicrobial Susceptibility Testing for Urinary Tract Pathogens by Direct Analysis of Urine Samples Using a MALDI-TOF MS-Based Combined Protocol.Frontiers in microbiology · 2019Article
- A Rapid and Low-Cost Pathogen Detection Platform by Using a Molecular Agglutination Assay.ACS central science · 2018Article
- Improved bacterial identification directly from urine samples with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.Journal of clinical laboratory analysis · 2018Article
- NaOH-HCl neutralized urine preparation for direct testing of uropathogens by Bruker MS.Journal of clinical laboratory analysis · 2018Article
- Detection of Foodborne Pathogens Using Proteomics and Metabolomics-Based Approaches.Frontiers in microbiology · 2018Article
- A multicentre study investigating parameters which influence direct bacterial identification from urine.PloS one · 2018Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Microbiological confirmation of a urinary tract infection (UTI) takes 24-48 h. In the meantime, patients are usually given empirical antibiotics, sometimes inappropriately. We assessed the feasibility of sequentially performing a Gram stain and MALDI-TOF MS mass spectrometry (MS) on urine samples to anticipate clinically useful information. In May-June 2012, we randomly selected 1000 urine samples from patients with suspected UTI. All were Gram stained and those yielding bacteria of a single morphotype were processed for MALDI-TOF MS. Our sequential algorithm was correlated with the standard semiquantitative urine culture result as follows: Match, the information provided was anticipative of culture result; Minor error, the information provided was partially anticipative of culture result; Major error, the information provided was incorrect, potentially leading to inappropriate changes in antimicrobial therapy. A positive culture was obtained in 242/1000 samples. The Gram stain revealed a single morphotype in 207 samples, which were subjected to MALDI-TOF MS. The diagnostic performance of the Gram stain was: sensitivity (Se) 81.3%, specificity (Sp) 93.2%, positive predictive value (PPV) 81.3%, negative predictive value (NPV) 93.2%, positive likelihood ratio (+LR) 11.91, negative likelihood ratio (-LR) 0.20 and accuracy 90.0% while that of MALDI-TOF MS was: Se 79.2%, Sp 73.5, +LR 2.99, -LR 0.28 and accuracy 78.3%. The use of both techniques provided information anticipative of the culture result in 82.7% of cases, information with minor errors in 13.4% and information with major errors in 3.9%. Results were available within 1 h. Our serial algorithm provided information that was consistent or showed minor errors for 96.1% of urine samples from patients with suspected UTI. The clinical impacts of this rapid UTI diagnosis strategy need to be assessed through indicators of adequacy of treatment such as a reduced time to appropriate empirical treatment or earlier withdrawal of unnecessary antibiotics.
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