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A Full MALDI-Based Approach to Detect Plasmid-Encoded KPC-Producing Klebsiella pneumoniae

Miriam Cordovana1, Markus Kostrzewa2, Jörg Glandorf2

  • 1Laboratory of Bacteriology, Operative Unit of Microbiology, University Hospital of Bologna Policlinico Sant'Orsola-Malpighi, Bologna, Italy.

Frontiers in Microbiology
|December 14, 2018
PubMed

Insights

Rapidly detect KPC-producing Klebsiella pneumoniae using MALDI-TOF MS. This method accurately identifies carbapenemase-producing Enterobacteriaceae (KPC) from colonies and blood cultures, aiding infection control.

Area of Science:

  • Clinical Microbiology
  • Infectious Diseases
  • Mass Spectrometry

Background:

  • Carbapenemase-producing Klebsiella pneumoniae (KPC) poses a global health threat.
  • Timely detection is crucial for effective antibiotic treatment and infection control.
  • Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) offers potential for rapid diagnostics.

Purpose of the Study:

  • To develop and validate a comprehensive MALDI-TOF MS-based approach for detecting KPC-producing K. pneumoniae.
  • To assess the performance of automated KPC-specific peak detection and carbapenemase activity confirmation.

Main Methods:

  • A MALDI-TOF MS method was developed to detect a KPC-specific peak (11,109 m/z) using an integrated algorithm.
  • Carbapenemase activity was confirmed using the STAR-Carba imipenem hydrolysis assay.
  • The approach was tested on 6209 K. pneumoniae isolates and 204 positive blood cultures, with isolates processed using the Sepsityper kit.

Main Results:

  • The automated MALDI-TOF MS approach achieved 100% specificity and 85.1% sensitivity for KPC detection from colonies.
  • Direct application to positive blood cultures yielded reliable and rapid results.
  • STAR-Carba assay demonstrated 100% sensitivity and specificity for carbapenemase confirmation.

Conclusions:

  • The developed MALDI-TOF MS approach provides a reliable and rapid method for detecting KPC-producing K. pneumoniae.
  • Automated peak detection integrates seamlessly into routine identification workflows.
  • This method facilitates prompt implementation of appropriate patient management and infection control strategies.
Keywords:
KPCKPC-related peakKlebsiella pneumoniaeMALDI-TOF MScarbapenemasemultidrug resistancepKpQIL plasmid

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