Abstract
Introduction: Diagnosis of NTM disease relies on a combination of repeat isolates and compatible symptoms. In the UK, NTM speciation is performed by reference laboratories (RL), lengthening time to clinical decision. MALDI-TOF is a rapid alternative speciation method. To determine its value, we compared the turnaround time (TAT) of NTM speciation between RL and MALDI-TOF.
Method: Observational study of all NTM isolated at our hospital (January 2011-April 2014). TAT was determined through workflow analysis for RL and MALDI-TOF. Data was collected from the electronic record.
Results: 182 NTM isolates were identified (87% pulmonary). Median TAT by the RL was 16 days, while that for MALDI-TOF was 3 days. 21 patients received anti-NTM therapy. Although no relationship was observed between confirmation of NTM identity by the RL and starting treatment (figure 1), in two thirds of cases (dashed circle) a significant correlation (r2=0.79) was apparent. The remaining subjects with extended times to treatment all had clinical reasons for not starting therapy promptly.
Conclusion: This study demonstrates that local MALDI-TOF will reduce TAT of NTM speciation, in part by removing administrative delay, which contributes to RL TAT. This will be of clinical value to patients who require treatment, exemplified by patients who received anti-NTM therapy in this study.
- Copyright ©ERS 2015
