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Rapid colistin susceptibility determination by a novel fluorogenic method in Klebsiella pneumoniae strains
Meliha Negin1,2, Meltem Ayas3,4, Isin Akyar4
1Department of Medical Biotechnology, Institute of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Türkiye.
Introduction:
Klebsiella pneumoniae is a causative agent that can lead to fatal infections, especially in intensive care patients. Colistin treatment is employed as a last resort in K. pneumoniae infections caused by strains resistant to almost all antibiotics from different groups. However, in recent years, colistin resistance has also become widespread in K. pneumoniae strains. Therefore, before starting treatment with this relatively toxic drug, it is essential to know its susceptibility to colistin. A standard colistin susceptibility test typically takes 24-48 h. In this study, we investigated the accuracy of our novel fluorometric method, which enables the determination of colistin minimal inhibitory concentration (MIC) within 2 h for K. pneumoniae.
Methods:
For this purpose, we determined and compared the MIC values of 24 colistin-resistant and 18 colistin-susceptible K. pneumoniae strains using the standard broth microdilution method and the new fluorometric method.
Results:
In the comparison of MIC values determined by standard and fluorometric methods, it was observed that the MIC values of 22 strains were identical, there was a 1-dilution (1/2) difference in 14 strains, and a 2-dilution (1/4) difference in six strains.
Discussion:
We believe that the new fluorometric antibiotic susceptibility testing method will be a valuable tool in the rapid detection of colistin resistance in K. pneumoniae and thus for guiding appropriate treatment in critically ill patients.
Insights
A novel fluorometric method rapidly determines colistin resistance in Klebsiella pneumoniae within 2 hours. This aids timely treatment decisions for critical infections, unlike standard 24-48 hour tests.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Diagnostics
Background:
- Klebsiella pneumoniae causes severe infections, particularly in intensive care units.
- Colistin is a last-resort antibiotic for multidrug-resistant K. pneumoniae.
- Rising colistin resistance necessitates rapid susceptibility testing.
Purpose of the Study:
- To evaluate a novel fluorometric method for determining colistin minimal inhibitory concentration (MIC).
- To compare the accuracy and speed of the fluorometric method against standard susceptibility testing.
Main Methods:
- Determined MIC values for 42 K. pneumoniae strains (24 resistant, 18 susceptible).
- Compared results from a standard broth microdilution method with a new fluorometric assay.
- Assessed method accuracy based on MIC value agreement and differences.
Main Results:
- The fluorometric method yielded identical MIC values for 22 strains.
- A 1-dilution difference was observed in 14 strains, and a 2-dilution difference in six strains.
- The novel method provides results within 2 hours, significantly faster than standard methods.
Conclusions:
- The fluorometric method accurately detects colistin resistance in K. pneumoniae.
- This rapid test is a valuable tool for guiding colistin treatment in critically ill patients.
- Faster susceptibility results can improve patient outcomes and antibiotic stewardship.
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