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J Antimicrob Chemother. 2014 Aug;69(8):2132-6. doi: 10.1093/jac/dku094. Epub 2014 Apr 9.

Detection of carbapenemase activity directly from blood culture vials using MALDI-TOF MS: a quick answer for the right decision.

Author information

1
Laboratório Alerta, Disciplina de Infectologia, Departamento de Medicina, Universidade Federal de São Paulo-UNIFESP, São Paulo, SP, Brazil cicacarvalhaes@gmail.com.
2
Laboratório Alerta, Disciplina de Infectologia, Departamento de Medicina, Universidade Federal de São Paulo-UNIFESP, São Paulo, SP, Brazil.
3
Laboratório Central, Hospital São Paulo, São Paulo, SP, Brazil.
4
Departamento de Biofísica, Universidade Federal de São Paulo-UNIFESP, São Paulo, SP, Brazil.
5
Departamento de Biofísica, Universidade Federal de São Paulo-UNIFESP, São Paulo, SP, Brazil Bruker Daltonics, Atibaia, SP, Brazil.

Abstract

OBJECTIVES:

Recently, matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) was successfully applied for the detection of carbapenemase activity directly from Gram-negative colonies. Based on this principle, we evaluated the performance of MALDI-TOF MS for rapid detection of carbapenemase activity directly from positive blood culture vials.

METHODS:

A total of 100 blood culture vials were randomly selected. MALDI-TOF MS carbapenemase assay results were confirmed by the detection of carbapenemase-encoding genes.

RESULTS:

A total of 110 bacterial isolates were recovered. The MALDI-TOF MS carbapenemase assay identified 21 of 29 (72.4%) of the carbapenemase-producing isolates directly from the blood culture vials, especially those encoding KPC-2 (100%) and SPM-1 (100%), after a 4 h incubation period. Although the majority of OXA-23-producing Acinetobacter baumannii isolates were not identified on day 1, all isolates were identified as carbapenemase producers directly from the colony on the next day.

CONCLUSIONS:

The MALDI-TOF MS carbapenemase assay is a feasible and rapid test to identify carbapenemase activity directly from blood culture vials. It may contribute to faster readjustment of empirical antimicrobial therapy and implementation of infection control measures.

KEYWORDS:

KPC; OXA-type; metallo-β-lactamases; oxacillinases; serine-β-lactamases

PMID:
24722840
DOI:
10.1093/jac/dku094
[Indexed for MEDLINE]

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