{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T07:23:44Z","timestamp":1769153024384,"version":"3.49.0"},"reference-count":25,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Spontaneous bacterial peritonitis (SBP) is a severe infection that requires fast and accurate antibiotic therapy to improve the patient outcome. Direct bacterial identification using MALDI-TOF mass spectrometry from ascitic fluid inoculated in blood culture bottles (BCBs) could therefore improve patients\u2019 management. We evaluated the impact of the implementation of this method for the treatment of patients. Our identification protocol was performed on 136 positive BCBs collected from 61 patients between December 2018 and December 2020. The therapeutic impact of our protocol was evaluated using a before (2015\u20132016) and after (2019\u20132020) case\u2013control study in two populations of 41 patients diagnosed with SBP and treated with antibiotics. The decrease in time to first identification and the optimization of antibiotic therapy following communication of the identification result were evaluated. Our protocol allowed us to identify 78% of bacteria in ascitic fluids. The transmission of the direct identification allowed the introduction or adaption of the antibiotic therapy early in 37% of SBP, with a mean decrease in time to first antibiotic change of 17 h. Our direct identification protocol for positive inoculated ascitic fluids is fast, reliable and inexpensive. Its routine integration into a microbiology laboratory allows the early introduction of appropriate antibiotic therapy and improves the management of patients with SBP.<\/jats:p>","DOI":"10.3390\/microorganisms10061188","type":"journal-article","created":{"date-parts":[[2022,6,12]],"date-time":"2022-06-12T22:37:20Z","timestamp":1655073440000},"page":"1188","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Spontaneous Bacterial Peritonitis: The Incremental Value of a Fast and Direct Bacterial Identification from Ascitic Fluids Inoculated in Blood Culture Bottles by MALDI-TOF MS for a Better Management of Patients"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0064-5525","authenticated-orcid":false,"given":"Romain","family":"Lotte","sequence":"first","affiliation":[{"name":"Laboratory of Bacteriology, Centre Hospitalier Universitaire de Nice, 06200 Nice, France"},{"name":"Universit\u00e9 C\u00f4te d\u2019Azur, Centre Hospitalier Universitaire de Nice, 06000 Nice, France"},{"name":"Universit\u00e9 C\u00f4te d\u2019Azur, Inserm, C3M, 06200 Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Audrey","family":"Courduri\u00e9","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Centre Hospitalier Universitaire de Nice, 06200 Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Gaudart","sequence":"additional","affiliation":[{"name":"Laboratory of Bacteriology, Centre Hospitalier Universitaire de Nice, 06200 Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Audrey","family":"Emery","sequence":"additional","affiliation":[{"name":"Laboratory of Bacteriology, Centre Hospitalier Universitaire de Nice, 06200 Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"Chevalier","sequence":"additional","affiliation":[{"name":"Laboratory of Bacteriology, Centre Hospitalier Universitaire de Nice, 06200 Nice, France"},{"name":"Universit\u00e9 C\u00f4te d\u2019Azur, Centre Hospitalier Universitaire de Nice, 06000 Nice, France"},{"name":"Universit\u00e9 C\u00f4te d\u2019Azur, Inserm, C3M, 06200 Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Tran","sequence":"additional","affiliation":[{"name":"Universit\u00e9 C\u00f4te d\u2019Azur, Centre Hospitalier Universitaire de Nice, 06000 Nice, France"},{"name":"Universit\u00e9 C\u00f4te d\u2019Azur, Inserm, C3M, 06200 Nice, France"},{"name":"Hepatology Department, Centre Hospitalier Universitaire de Nice, 06200 Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathilde","family":"Payen","sequence":"additional","affiliation":[{"name":"Laboratory of Bacteriology, Centre Hospitalier Universitaire de Nice, 06200 Nice, France"},{"name":"Universit\u00e9 C\u00f4te d\u2019Azur, Centre Hospitalier Universitaire de Nice, 06000 Nice, France"},{"name":"Universit\u00e9 C\u00f4te d\u2019Azur, Inserm, C3M, 06200 Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Ruimy","sequence":"additional","affiliation":[{"name":"Laboratory of Bacteriology, Centre Hospitalier Universitaire de Nice, 06200 Nice, France"},{"name":"Universit\u00e9 C\u00f4te d\u2019Azur, Centre Hospitalier Universitaire de Nice, 06000 Nice, France"},{"name":"Universit\u00e9 C\u00f4te d\u2019Azur, Inserm, C3M, 06200 Nice, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/S0168-8278(00)80201-9","article-title":"Diagnosis, Treatment and Prophylaxis of Spontaneous Bacterial Peritonitis: A Consensus Document","volume":"32","author":"Rimola","year":"2000","journal-title":"J. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/S0168-8278(05)80280-6","article-title":"A Prospective Study of Bacterial Infections in Patients with Cirrhosis","volume":"18","author":"Caly","year":"1993","journal-title":"J. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1053\/jhep.2002.30082","article-title":"Bacterial Infections in Cirrhosis: Epidemiological Changes with Invasive Procedures and Norfloxacin Prophylaxis: Bacterial Infections in Cirrhosis: Epidemiological Changes With Invasive Procedures and Norfloxacin Prophylaxis","volume":"35","author":"Navasa","year":"2002","journal-title":"Hepatology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1136\/gut.2004.038679","article-title":"Sepsis in Cirrhosis: Report on the 7th Meeting of the International Ascites Club","volume":"54","author":"Wong","year":"2005","journal-title":"Gut"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"European Association For The Study Of The Liver (2010). EASL Clinical Practice Guidelines on the Management of Ascites, Spontaneous Bacterial Peritonitis, and Hepatorenal Syndrome in Cirrhosis. J. Hepatol., 53, 397\u2013417.","DOI":"10.1016\/j.jhep.2010.05.004"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1159\/000444551","article-title":"Current Management of the Complications of Cirrhosis and Portal Hypertension: Variceal Hemorrhage, Ascites, and Spontaneous Bacterial Peritonitis","volume":"34","year":"2016","journal-title":"Dig. Dis."},{"key":"ref_7","unstructured":"Nousbaum, J.-B. (2022, May 12). Infection du Liquide D\u2019ascite\u2008: Diagnostic, Traitement et Pr\u00e9vention. Available online: https:\/\/www.fmcgastro.org\/wp-content\/uploads\/file\/\/pdf-2015\/099_106_Nousbaum.pdf."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e01278-18","DOI":"10.1128\/JCM.01278-18","article-title":"Direct Identification of 80 Percent of Bacteria from Blood Culture Bottles by Matrix-Assisted Laser Desorption Ionization\u2013Time of Flight Mass Spectrometry Using a 10-Minute Extraction Protocol","volume":"57","author":"Simon","year":"2019","journal-title":"J. Clin. Microbiol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"La Scola, B., and Raoult, D. (2009). Direct Identification of Bacteria in Positive Blood Culture Bottles by Matrix-Assisted Laser Desorption Ionisation Time-of-Flight Mass Spectrometry. PLoS ONE, 4.","DOI":"10.1371\/journal.pone.0008041"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1111\/j.1469-0691.2010.03257.x","article-title":"Microorganisms Direct Identification from Blood Culture by Matrix-Assisted Laser Desorption\/Ionization Time-of-Flight Mass Spectrometry","volume":"17","author":"Ferreira","year":"2011","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/j.jmoldx.2011.07.004","article-title":"Novel, Improved Sample Preparation for Rapid, Direct Identification from Positive Blood Cultures Using Matrix-Assisted Laser Desorption\/Ionization Time-of-Flight (MALDI-TOF) Mass Spectrometry","volume":"13","author":"Schubert","year":"2011","journal-title":"J. Mol. Diagn."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3717","DOI":"10.1128\/JCM.01679-13","article-title":"Rapid Identification of Microbes in Positive Blood Cultures by Use of the Vitek MS Matrix-Assisted Laser Desorption Ionization\u2013Time of Flight Mass Spectrometry System","volume":"51","author":"Foster","year":"2013","journal-title":"J. Clin. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1080\/14789450.2016.1231578","article-title":"Mass Spectrometry Applications in Microbiology beyond Microbe Identification: Progress and Potential","volume":"13","author":"Sanguinetti","year":"2016","journal-title":"Expert Rev. Proteom."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.mimet.2016.09.003","article-title":"Matrix Assisted Laser Desorption Time of Flight Mass Spectrometry (MALDI-TOF MS) in Clinical Microbiology","volume":"138","author":"Angeletti","year":"2017","journal-title":"J. Microbiol. Methods"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1099\/jmm.0.044750-0","article-title":"Direct Identification of Bacteria from BacT\/ALERT Anaerobic Positive Blood Cultures by MALDI-TOF MS: MALDI Sepsityper Kit versus an in-House Saponin Method for Bacterial Extraction","volume":"61","author":"Meex","year":"2012","journal-title":"J. Med. Microbiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1128\/JCM.01831-09","article-title":"Rapid Identification of Bacteria from Positive Blood Culture Bottles by Use of Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry Fingerprinting","volume":"48","author":"Christner","year":"2010","journal-title":"J. Clin. Microbiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1093\/cid\/cit498","article-title":"Impact of Rapid Organism Identification via Matrix-Assisted Laser Desorption\/Ionization Time-of-Flight Combined With Antimicrobial Stewardship Team Intervention in Adult Patients With Bacteremia and Candidemia","volume":"57","author":"Huang","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.jinf.2012.06.006","article-title":"Clinical and Economic Evaluation of the Impact of Rapid Microbiological Diagnostic Testing","volume":"65","author":"Galar","year":"2012","journal-title":"J. Infect."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.resmic.2016.09.005","article-title":"Use of MALDI-TOF Mass Spectrometry after Liquid Enrichment (BD BactecTM) for Rapid Diagnosis of Bone and Joint Infections","volume":"168","author":"Lallemand","year":"2017","journal-title":"Res. Microbiol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Noll, C., Nasruddin-Yekta, A., Sternisek, P., Weig, M., Gro\u00df, U., Schilling, A.F., Beil, F.T., and Bader, O. (2020). Rapid Direct Detection of Pathogens for Diagnosis of Joint Infections by MALDI-TOF MS after Liquid Enrichment in the BacT\/Alert Blood Culture System. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0243790"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1099\/jmm.0.035550-0","article-title":"Integration of Matrix-Assisted Laser Desorption\/Ionization Time-of-Flight Mass Spectrometry in Blood Culture Diagnostics: A Fast and Effective Approach","volume":"61","author":"Klein","year":"2012","journal-title":"J. Med. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1055\/s-2008-1040319","article-title":"Bacterial Infections, Sepsis, and Multiorgan Failure in Cirrhosis","volume":"28","author":"Tandon","year":"2008","journal-title":"Semin. Liver Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1002\/hep.31884","article-title":"Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome: 2021 Practice Guidance by the American Association for the Study of Liver Diseases","volume":"74","author":"Biggins","year":"2021","journal-title":"Hepatology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/S1499-3872(16)60127-3","article-title":"Patients with Culture Negative Pyogenic Liver Abscess Have the Same Outcomes Compared to Those with Klebsiella Pneumoniae Pyogenic Liver Abscess","volume":"15","author":"Shelat","year":"2016","journal-title":"Hepatobiliary Pancreat. Dis. Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1002\/hep.25532","article-title":"Prevalence and Risk Factors of Infections by Multiresistant Bacteria in Cirrhosis: A Prospective Study","volume":"55","author":"Acevedo","year":"2012","journal-title":"Hepatology"}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/10\/6\/1188\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:27:13Z","timestamp":1760138833000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/10\/6\/1188"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,9]]},"references-count":25,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["microorganisms10061188"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms10061188","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,9]]}}}