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Application of Molecular Methods for Carbapenemase Detection
Anastasia Bilozor1,2, Arta Balode3, Giorgi Chakhunashvili4
1Department of Microbiology, Central Laboratory, East-Tallinn Central Hospital, Tallinn, Estonia.
This study compared carbapenemase detection methods for Klebsiella pneumoniae in Europe. Whole genome sequencing and MALDI-TOF showed high sensitivity, identifying NDM and OXA-48 as common carbapenemases, crucial for antimicrobial resistance surveillance.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Diagnostics
Background:
- Carbapenem non-susceptible Klebsiella pneumoniae poses a significant global health threat.
- Accurate and sensitive detection of carbapenemases is crucial for effective treatment and infection control.
Purpose of the Study:
- To evaluate and compare the performance of various carbapenemase detection methods.
- To assess the prevalence of different carbapenemases in K. pneumoniae isolates from Northern and Eastern Europe.
Main Methods:
- Screening of 5,001 K. pneumoniae isolates using disk diffusion, Vitek 2, or Phoenix systems.
- Confirmation of carbapenemase production using Luminex assay, whole genome sequencing, MALDI-TOF, and immunochromatography.
- Minimal inhibitory concentration determination for Meropenem.
Main Results:
- 171 (3.42%) carbapenemase screening-positive isolates were identified.
- Whole genome sequencing and MALDI-TOF assay demonstrated the highest sensitivity (>96.3%).
- NDM (54 isolates) and OXA-48 (26 isolates) were the most prevalent carbapenemases detected.
Conclusions:
- Multiple carbapenemase types are circulating in the studied European regions.
- A combination of detection methods ensures high sensitivity (>95%) for accurate carbapenemase identification.
- Continued surveillance and method optimization are recommended for precise antimicrobial resistance detection.
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