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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2021.tde-05072021-152919
Document
Author
Full name
Patrícia Silva Bianchi Costa
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2021
Supervisor
Committee
Bollela, Valdes Roberto (President)
Martinez, Roberto
Vilar, Fernando Crivelenti
Title in Portuguese
Análise de custos do MALDI-TOF (espectrometria de massas) em comparação com a tecnologia Vitek 2 Compact em hospital de referência terciária
Keywords in Portuguese
Incorporação de novas tecnologias
MALDI-TOF
VITEK 2 Compact
Abstract in Portuguese
As infecções são um grave problema de saúde pública, uma vez que são responsáveis por altos índices de internações e apresentam taxa de mortalidade significativa. Outro problema é quanto ao surgimento de cepas resistentes, que tem sido crescente. Assim, busca-se constantemente diminuir as taxa de mortalidade, internações e evitar o surgimento de cepas resistente. Dentre as formas de reduzir tais taxas está a redução do tempo para o diagnóstico microbiológico, possível por meio de interpretações automatizadas. Dentre as tecnologias utilizadas para identificação microbiológica está o sistema Matrix Associated Laser Desorption-Ionization - Time of Flight (MALDI-TOF), que tem sido incorporado em hospitais do mundo todo. Apesar de sua eficiência comprovada existem dúvidas a cerca da sua efetividade e custo benefício quando comparado a outras tecnologias. Este estudo analisou os custos envolvidos na identificação microbiológica e comparação entre os equipamentos VITEK 2 Compact e MALDI-TOF. Para isso foram realizados levantamento de dados dos arquivos eletrônicos do Laboratório de Microbiologia do HCFMRP-USP. O MALDI-TOF possibilita a redução dos custos com o diagnóstico microbiológico de forma significativa, além de reduzir o tempo para liberação do resultado e tomada de decisão por parte da equipe médica. A redução do valor por exame foi de 14% saindo de R$ 32,24 com o Vitek 2 Compact para R$ 27,69 com o MALDI-TOF. Levando-se em consideração a quantidade de diagnósticos realizados anualmente, o impacto na redução dos custos seria ainda mais promissor, pois baseado nos dados do ano de 2018 foram realizados cerca de 48.000 exames, onde 11.118 apresentaram resultados positivos prosseguindo com a identificação microbiológica, com uma redução anual de R$ 329.194,00. Concluímos que a implementação do MALDI-TOF na rotina do laboratório de microbiologia pressupõe a mesma eficiência diagnóstica que o VITEK2, porém, com redução do tempo e o custo para identificação microbiológica. Esta redução de custos é ainda maior se considerarmos o uso de antibióticos de largo espectro, que teria sua utilização reduzida a partir da identificação precoce de agentes infecciosos relacionados à assistência a saúde.
Title in English
Cost analysis of MALDI-TOF (mass spectrometry) compared to Vitek 2 Compact technology in a tertiary referral hospital
Keywords in English
Incorporation of new technologies
MALDI-TOF
VITEK 2 Compact
Abstract in English
Infections are a serious public health problem, since they are responsible for high rates of hospitalizations and have a significant mortality rate. Another problem is the emergence of resistant strains, which has been growing. Thus, there is a constant attempt to decrease mortality rates, hospitalizations and avoid the emergence of resistant strains. Among the ways to reduce such rates is the reduction of time for microbiological diagnosis, made possible through automated interpretations. Among the technologies used for microbiological identification is the Matrix Associated Laser Desorption-Ionization - Time of Flight (MALDI-TOF) system, which has been incorporated into hospitals worldwide. Despite its proven efficiency, there are doubts about its effectiveness and cost benefit when compared to other technologies. This study analyzed the costs involved in microbiological identification and comparison between the VITEK 2 Compact and MALDI-TOF equipment. For this, data were collected from the electronic files of the Microbiology Laboratory of HCFMRP-USP. The MALDI-TOF makes it possible to significantly reduce the costs of microbiological diagnosis, in addition to reducing the time for the release of the result and decision making by the medical team. The reduction in the value per exam was 14%, from R$ 32.24 with the Vitek 2 Compact to R$ 27.69 with the MALDI-TOF. Taking into account the number of diagnoses performed annually, the impact on cost reduction would be even more promising, since based on data from the year 2018, about 48.000 tests were carried out, of which 11.118 presented positive results, proceeding with microbiological identification, with a annual reduction of R$ 329.194,00. We concluded that the implementation of MALDI-TOF in the routine of the microbiology laboratory presupposes the same diagnostic efficiency as VITEK2, however, with reduced time and cost for microbiological identification. This cost reduction is even greater if we consider the use of broad-spectrum antibiotics that would have their use reduced due to the early identification of infectious agents related to health care.
 
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Publishing Date
2021-07-08
 
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