Rapid susceptibility testing of multi-drug resistant Escherichia coli and Klebsiella by glucose metabolization monitoring
| Autor: | Michael Neumaier, Beniam Ghebremedhin, Maximilian Kittel, Alexander Grundt, Parviz Ahmad-Nejad, Peter Findeisen, Thomas Miethke |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Imipenem Klebsiella medicine.drug_class 030106 microbiology Clinical Biochemistry Antibiotics Ceftazidime Clinical Chemistry Tests Microbial Sensitivity Tests Microbiology Agar plate 03 medical and health sciences 0302 clinical medicine Drug Resistance Multiple Bacterial Escherichia coli medicine Humans 030212 general & internal medicine biology Biochemistry (medical) General Medicine biology.organism_classification Anti-Bacterial Agents Ciprofloxacin Glucose Spectrometry Mass Matrix-Assisted Laser Desorption-Ionization Bacteria medicine.drug Piperacillin |
| Zdroj: | Clinical Chemistry and Laboratory Medicine (CCLM). 57:1271-1279 |
| ISSN: | 1437-4331 1434-6621 |
| DOI: | 10.1515/cclm-2018-1178 |
| Popis: | Background The increasing number of multi-drug resistant (MDR) bacteria provides enormous challenges for choosing an appropriate antibiotic therapy in the early phase of sepsis. While bacterial identification has been greatly accelerated by the introduction of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), the antibiotic susceptibility testing (AST) remains time-consuming. Here, we present a rapid susceptibility testing method for testing Gram-negative bacteria, exemplarily validated for Escherichia coli and Klebsiella spp. Methods Gram-negative isolates (E. coli and Klebsiella spp.) were either taken as single colonies from agar plates (n=136) or directly extracted and identified from positive blood cultures (n=42) using MALDI-TOF MS. Bacteria were incubated in glucose-supplemented Luria broths (LBs) each containing one antibiotic (ceftazidime, piperacillin, imipenem and ciprofloxacin), routinely used to classify Gram-negative bacteria in Germany. To determine susceptibility the dynamics of glucose utilization in bacterial suspensions were quantitatively measured in the presence or absence of antibiotics designated liquid-AST (L-AST). Results The L-AST can be run on clinical-chemistry analyzers and integrated into laboratory routines. It yields critical resistance information within 90–150 min downstream of a MS-based identification. The results showed a high concordance with routine susceptibility testing, with less than 1% very major errors (VME) and 3.51% major errors (ME) for 178 assessed isolates. Analysis of turnaround time (TAT) for 42 clinical samples indicated that L-AST results could be obtained 34 h earlier than the routine results. Conclusions As exemplified for E. coli and Klebsiella spp., L-AST provides substantial acceleration of susceptibility testing following MALDI-TOF MS identification. The assay is a simple and low-cost method that can be integrated into clinical laboratory to allow for 24/7 AST. This approach could improve antibiotic therapy. |
| Databáze: | OpenAIRE |
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