Comparison of rapid BACpro® II, Sepsityper® kit and in-house preparation methods for direct identification of bacteria from blood cultures by MALDI-TOF MS with and without Sepsityper® module analysis

There are several approaches available for purifying microorganisms prior to matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) analysis. In the present study, rapid BACpro (R) II (Nittobo Medical Co., Ltd., Tokyo, Japan), a new application, has been compared with Sepsityper (R) kit (Bruker Daltonics, Billerica, USA) and an in-house method. Samples were also tested with two modules, standard and Sepsityper (R), identified in the Bruker MALDI-TOF MS. The bottles having monomicrobial growth were included in the study according to Gram staining results. In total, two hundred blood culture bottles were included but there was no growth in one of the subcultures so 199 blood culture bottles were studied prospectively. With the standard MALDI-TOF MS analysis, rapid BACpro (R) II could successfully identify microorganisms in 174/199 (87.4%) of the bottles where Sepsityper (R) kit and in-house method were successful in 136/199 (68.3%) and 114/199 (57.3%), respectively. When the MALDI-TOF MS data were analysed by Sepsityper (R) module, the identification rates were increased to 94.4%, 82.1% and 69.8% (p < 0.001), respectively. In the Sepsityper (R) module, 72/73 (98.6%) of Gram-negative and 97/106 (91.5%) of Gram-positive microorganisms were detected by rapid BACpro (R) II method. The present study shows that rapid BACpro (R) II is a reliable preparation procedure and has higher rates of identification compared with Sepsityper (R) kit and in-house method. The use of the Sepsityper (R) module in blood cultures increases the chance of identification for all three methods studied.