A rapid diagnostic workflow for cefotaxime-resistant Escherichia coli and Klebsiella pneumoniae detection from blood cultures by MALDI-TOF mass spectrometry

Ivana Palucci, Giulia De Angelis, Tiziana D'Inzeo, Maurizio Sanguinetti, Brunella Posteraro, Teresa Spanu, Elena De Carolis, Silvia Paoletti, Domenico Rosario Nagel, Antonietta Vella, Enrica Mello Dottoressa

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Nowadays, the global spread of resistance to oxyimino-cephalosporins in Enterobacteriaceae implies the need for novel diagnostics that can rapidly target resistant organisms from these bacterial species. Methods: In this study, we developed and evaluated a Direct Mass Spectrometry assay for Beta-Lactamase (D-MSBL) that allows direct identification of (oxyimino)cephalosporin-resistant Escherichia coli or Klebsiella pneumoniae from positive blood cultures (BCs), by using the matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) technology. Results: The D-MSBL assay was performed on 93 E. coli or K. pneumoniae growing BC samples that were shortly co-incubated with cefotaxime (CTX) as the indicator cephalosporin. Susceptibility and resistance defining peaks from the samples’ mass spectra were analyzed by a novel algorithm for bacterial organism classification. The D-MSBL assay allowed discrimination between E. coli and K. pneumoniae that were resistant or susceptible to CTX with a sensitivity of 86.8% and a specificity of 98.2%. Conclusion: The proposed algorithm-based D-MSBL assay, if integrated in the routine laboratory diagnostic workflow, may be useful to enhance the establishment of appropriate antibiotic therapy and to control the threat of oxyimino-cephalosporin resistance in hospital.
Original languageEnglish
Pages (from-to)e0185935-N/A
JournalPLoS One
Volume12
DOIs
Publication statusPublished - 2017

Keywords

  • Agricultural and Biological Sciences (all)
  • Anti-Bacterial Agents
  • Biochemistry, Genetics and Molecular Biology (all)
  • Cefotaxime
  • Drug Resistance, Bacterial
  • Escherichia coli
  • Humans
  • Klebsiella pneumoniae
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

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