Abstract

BackgroundCarbapenemase-producing Enterobacteriaceae (CPE), particularly carbapenemase-producing Klebsiella pneumoniae isolates, are important causative agents of nosocomial infections associated with significant mortality rates mostly in critical wards. The rapid detection and typing of these strains is critical either for surveillance purposes and to prevent outbreaks and optimize antibiotic therapy. In this study, the MALDI-TOF MS method was used to detect rapidly these isolates from blood cultures (BCs) and to obtain proteomic profiles enable to discriminate between carbapenemase-producing and non-carbapenemase-producing strains.ResultsFifty-five K. pneumoniae strains were tested. Identification and carbapenemase-production detection assay using Ertapenem were performed both from bacterial pellets extracted directly from BCs flasks and from subcultures of these strains. For all isolates, a complete antimicrobial susceptibility testing and a genotypic characterization were performed.We found 100% agreement between the carbapenemase-producing profile generated by MALDI TOF MS and that obtained using conventional methods. The assay detected and discriminated different carbapenemase-producing K. pneumoniae isolates within 30 min to 3 h after incubation with Ertapenem.ConclusionsMALDI-TOF MS is a promising, rapid and economical method for the detection of carbapenemase-producing K. pneumoniae strains that could be successfully introduced into the routine diagnostic workflow of clinical microbiology laboratories.

Highlights

  • Carbapenemase-producing Enterobacteriaceae (CPE), carbapenemase-producing Klebsiella pneumoniae isolates, are important causative agents of nosocomial infections associated with significant mortality rates mostly in critical wards

  • In recent years, there was a worldwide spread of carbapenemase-producing Enterobacteriaceae (CPE), mainly carbapenemase-producing Klebsiella pneumoniae isolates, that has become an increasing health care problem all over the world [1,2,3]

  • A rapid detection of carbapenemases is essential in order to prevent spreading, detect outbreak and for an effective antibiotic therapy to improve the outcome of these patients

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Summary

Introduction

Carbapenemase-producing Enterobacteriaceae (CPE), carbapenemase-producing Klebsiella pneumoniae isolates, are important causative agents of nosocomial infections associated with significant mortality rates mostly in critical wards. The rapid detection and typing of these strains is critical either for surveillance purposes and to prevent outbreaks and optimize antibiotic therapy. The MALDI-TOF MS method was used to detect rapidly these isolates from blood cultures (BCs) and to obtain proteomic profiles enable to discriminate between carbapenemase-producing and non-carbapenemase-producing strains. There was a worldwide spread of carbapenemase-producing Enterobacteriaceae (CPE), mainly carbapenemase-producing Klebsiella pneumoniae isolates, that has become an increasing health care problem all over the world [1,2,3]. CPE are important etiological agents of hospital-acquired infections (HAI), which cause significant mortality among patients in intensive care units (UCI) [4]. Hydrolyzed and non-hydrolyzed substances which differ in their molecular weights could be monitoring [15, 17]

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