TY - JOUR
T1 - A rapid diagnostic workflow for cefotaxime-resistant Escherichia coli and Klebsiella pneumoniae detection from blood cultures by MALDI-TOF mass spectrometry
AU - De Carolis, Elena
AU - Paoletti, Silvia
AU - Nagel, Domenico Rosario
AU - Vella, Antonietta
AU - Mello Dottoressa, Enrica
AU - Palucci, Ivana
AU - De Angelis, Giulia
AU - D'Inzeo, Tiziana
AU - Sanguinetti, Maurizio
AU - Posteraro, Brunella
AU - Spanu, Teresa
PY - 2017
Y1 - 2017
N2 - 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 ionizationâtime 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 samplesâ 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.
AB - 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 ionizationâtime 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 samplesâ 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.
KW - Agricultural and Biological Sciences (all)
KW - Anti-Bacterial Agents
KW - Biochemistry, Genetics and Molecular Biology (all)
KW - Cefotaxime
KW - Drug Resistance, Bacterial
KW - Escherichia coli
KW - Humans
KW - Klebsiella pneumoniae
KW - Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
KW - Agricultural and Biological Sciences (all)
KW - Anti-Bacterial Agents
KW - Biochemistry, Genetics and Molecular Biology (all)
KW - Cefotaxime
KW - Drug Resistance, Bacterial
KW - Escherichia coli
KW - Humans
KW - Klebsiella pneumoniae
KW - Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
UR - http://hdl.handle.net/10807/111071
UR - http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0185935&type=printable
U2 - 10.1371/journal.pone.0185935
DO - 10.1371/journal.pone.0185935
M3 - Article
SN - 1932-6203
VL - 12
SP - e0185935-N/A
JO - PLoS One
JF - PLoS One
ER -