Accuracy of two Sepsityper MALDI-TOF MS methods for bacterial identification in bloodstream infections in dogs, foals, and calves using Bayesian latent class model.
Abstract: Accurate diagnosis of bloodstream infections is crucial for survival and antimicrobial de-escalation in veterinary medicine. Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry enables faster identification of bacteria in BSIs. This study aimed to compare diagnostic accuracy of two Sepsityper methods (Rapid Sepsityper and Sepsityper Extraction) with conventional culture method for bacterial identification in clinical samples. Mean time-to-positivity and frequency of bacteria in BSIs were also determined. This diagnostic test study used bloodstream infection samples from 385 critically ill animals (121 dogs, 119 foals, and 145 calves) admitted to the Faculty of Veterinary Medicine, Ghent (October 2021-February 2024). Accuracy was compared using Bayesian latent class model with priors for sensitivity (99.9%) and specificity (96.0%) based on literature, and a prevalence of 26.0%. Conventional culture method identified 173 bacteria with (19.1%,33/173), spp. (12.1%,21/173) and spp. (8.1%,14/173) being most common. Sensitivity of Rapid Sepsityper, Sepsityper Extraction, and conventional culture method was 62.1%, 86.1%, and 97.4%, respectively. Specificity was 94.3%, 90.4% and 92.3%, and accuracy was 85.8%, 89.3%, and 93.6%, respectively. Mean time-to-positivity and ±standard deviation for blood cultures flagging positive was 21h25min ±17.8h. Rapid Sepsityper identified bacteria in approximately 30min, while Sepsityper Extraction method required around 50min, and conventional culture method needed 12-48h. Altogether, Sepsityper Extraction shows promise given the sensitivity and results were delivered more rapidly than conventional culture. Enhancing diagnostic workflow, resulting in a better prognosis, reduced hospital stays, and lower healthcare costs due to more rational use of (critically important) antimicrobials.
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Overview
This study compared two rapid bacterial identification methods (Rapid Sepsityper and Sepsityper Extraction) using MALDI-TOF MS to the conventional culture method for detecting bloodstream infections in dogs, foals, and calves, evaluating their accuracy and speed of diagnosis.
Background and Purpose
Bloodstream infections (BSIs) in animals require fast and accurate identification of the causative bacteria to improve survival chances and guide appropriate antimicrobial therapy.
Traditional culture methods, though accurate, are time-consuming (12-48 hours to yield results).
Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) is a technology that enables rapid bacterial identification.
The Sepsityper kit, used with MALDI-TOF MS, offers methods to directly identify bacteria from positive blood cultures faster than conventional culture.
This study aimed to compare the diagnostic performance of two different Sepsityper methods—Rapid Sepsityper and Sepsityper Extraction—against the conventional culture method using a Bayesian latent class model to assess accuracy without assuming any method as a perfect gold standard.
Study Design and Data Collection
Samples were collected from 385 critically ill animals admitted between October 2021 and February 2024 at the Faculty of Veterinary Medicine, Ghent, including:
121 dogs
119 foals
145 calves
Bloodstream infection samples were tested using the two Sepsityper MALDI-TOF MS methods and the conventional culture method.
Time-to-positivity (the time for blood cultures to flag positive) and bacterial species distribution were also recorded.
Data Analysis: Bayesian Latent Class Modeling
This method allows estimating diagnostic test parameters (sensitivity, specificity, accuracy) without assuming one test as perfect gold standard.
Priors for the model were based on literature values:
Sensitivity prior: 99.9%
Specificity prior: 96.0%
Prevalence prior: 26.0%
Results: Bacterial Identification and Frequencies
The conventional culture method identified 173 bacteria from the samples.
Most common bacteria found:
One species at 19.1% of isolates
Second species at 12.1%
Third species at 8.1%
(Note: Bacterial species names were omitted in the abstract.)
Diagnostic Performance
Sensitivity (ability to correctly detect infected samples):
Rapid Sepsityper: 62.1%
Sepsityper Extraction: 86.1%
Conventional Culture: 97.4%
Specificity (ability to correctly identify uninfected samples):
Rapid Sepsityper: 94.3%
Sepsityper Extraction: 90.4%
Conventional Culture: 92.3%
Overall Accuracy:
Rapid Sepsityper: 85.8%
Sepsityper Extraction: 89.3%
Conventional Culture: 93.6%
Time to Results
Mean time-to-positivity for blood culture bottles: approximately 21 hours 25 minutes, with a large standard deviation (±17.8 hours), indicating variability.
Rapid Sepsityper delivered bacterial identification in about 30 minutes after positive culture detection.
Sepsityper Extraction required around 50 minutes for identification.
Conventional culture method took 12 to 48 hours for bacterial identification after culture.
Interpretation and Implications
The Sepsityper Extraction method showed improved sensitivity compared to Rapid Sepsityper and delivered results significantly faster than the conventional culture method, balancing accuracy and speed.
Rapid Sepsityper, while faster, had notably lower sensitivity, which may limit its use as a standalone diagnostic method.
The faster turnaround time of Sepsityper methods can lead to earlier antimicrobial therapy adjustments — important for de-escalation of broad-spectrum antibiotics to more targeted treatments.
Earlier diagnosis can improve clinical outcomes, reduce hospital stays, and lower healthcare costs.
The use of more rational antimicrobial use may help in combating antimicrobial resistance, especially in veterinary settings where critically important antimicrobials are used.
Conclusions
The Sepsityper Extraction method combined with MALDI-TOF MS represents a promising diagnostic tool for rapid identification of bacteria in bloodstream infections in veterinary patients.
Further optimization and clinical implementation could enhance diagnostic workflows and promote better prognoses in animals with BSIs.
Cite This Article
APA
Castelain D, Bokma J, Pas ML, Verbanck S, Paepe D, Pardon B, Boyen F.
(2025).
Accuracy of two Sepsityper MALDI-TOF MS methods for bacterial identification in bloodstream infections in dogs, foals, and calves using Bayesian latent class model.
Vet Q, 45(1), 2538873.
https://doi.org/10.1080/01652176.2025.2538873
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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