1887

Abstract

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is increasingly used in clinical microbiological laboratories to identify bacteria and fungi at a species level and to subtype them. The gene encoding the unique carbapenemases found in is restricted to division II strains. The aim of this study was to evaluate whether MALDI-TOF MS is suitable for differentiating strains which harbour the gene from those that do not. A well-defined collection of 40 isolates with known imipenem MICs (0.062–>32 mg l) were selected for this study. Twelve strains with known status, including NCTC 9343 (division I) and TAL3636 (division II), were measured by means of microflex LT MALDI-TOF MS and well-defined differences in mass spectra between the -positive and -negative strains were found in the interval 4000–5500 Da. A further 28 strains were selected for the blind measurements: 9 -positive clinical isolates with different imipenem MICs ranging between 0.06 and >32 mg l (different expressions of the metallo-β-lactamase gene) were clearly separated from the 19 -negative isolates. The presence or absence of the selected peaks in all tested strains clearly differentiated the strains belonging to division I (-negative) or division II (-positive). These results suggest a realistic method for differentiating division II strains (harbouring the gene) and to determine them at a species level at the same time. Although not all -positive strains are resistant to carbapenems, they all have the possibility of becoming resistant to this group of antibiotics by acquisition of an appropriate IS element for full expression of the gene, leading to possible treatment failure.

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2011-11-01
2024-03-29
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