Instant screening and verification of carbapenemase activity in in positive blood culture, using matrix-assisted laser desorption ionization–time of flight mass spectrometry Free

Abstract

Rapid identification of isolates in positive blood cultures are of great importance to secure correct treatment of septicaemic patients. As antimicrobial resistance is increasing, rapid detection of resistance is crucial. Carbapenem resistance in associated with -encoded class B metallo-beta-lactamase is emerging. In our study we spiked blood culture bottles with 26 strains with various -status and ertapenem MICs. By using main spectra specific for -positive and -negative strains, isolates could be screened for resistance. To verify strains that were positive in the screening, a carbapenemase assay was performed where the specific peaks of intact and hydrolysed ertapenem were analysed with matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS). We show here that it is possible to correctly identify and to screen for enzymic carbapenem resistance directly from the pellet of positive blood cultures. The carbapenemase assay to verify the presence of the enzyme was successfully performed on the pellet from the direct identification despite the presence of blood components. The result of the procedure was achieved in 3 h. Also the Bruker mass spectrometric β-lactamase assay (MSBL assay) prototype software was proven not only to be based on an algorithm that correlated with the manual inspection of the spectra, but also to improve the interpretation by showing the variation in the dataset.

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2014-08-01
2024-03-28
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