P016

1:Laboratory of Microbiology and Virology, University Hospital “Maggiore della Carità”, Novara, Italy

Accurate and rapid diagnosis of disseminated mycobacteriosis is critical for the appropriate management of patients. The use of a fully automated method, like the BACTEC-MYCO/F-LYTIC-Becton Dickinson (BD) bottles system, represents a sensitive method for mycobacteremia detection. Unfortunately, Line Probe Assay (LPA) conventional assay for mycobacteria identification cannot be used for samples containing blood (a previous subculture on liquid/solid media is required. In this clinical case we prove the validity of the MBT Sepsityper Kit (Bruker) for the direct mycobacteria identification from positive blood cultures bottles (BCBs) using MALDI-TOF MS Biotyper-Bruker and LPA. A positive BCBs from a 48-year-old HIV-positive patient was sent to our laboratory to confirm the suspicion of disseminated mycobacterial infection. The Kinyoun stain confirmed the presence of acid-fast bacilli. The sample was then subcultured onto solid (Middlebrook 7H10-BD) and liquid (MGIT-BD) media. To evaluate the possibility of direct identification of mycobacteria from BCBs, in addition to the standard protocol, the validated Sepsityper® kit-Bruker and MALDI-TOF MS technology was used. The identification of M. avium was obtained in less than two hours. The bacterial biomass obtained with the Sepsityper method was also used for genotyping NTM-DR VER-1.0 LPA (Hain-Bruker). The identification of M. avium was confirmed and the genotypic susceptibility profile was rapidly assessed. The results were confirmed with the conventional protocol after 10 days. This clinical case showed that, using the Sepsityper® kit, it may be possible to accelerate the complete diagnosis of mycobacterial bloodstream infections. Same-day results could guarantee more adequate management of patients.