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ORIGINAL RESEARCH article

Front. Microbiol.
Sec. Antimicrobials, Resistance and Chemotherapy
Volume 15 - 2024 | doi: 10.3389/fmicb.2024.1501038
This article is part of the Research Topic Global Dissemination and Evolution of Epidemic Multidrug-Resistant Gram-Negative Bacterial Pathogens: Surveillance, Diagnosis and Treatment, Volume III View all 9 articles

Rapid detection of carbapenem resistance via MALDI-TOF MS via an innovative broth microgrowth assay

Provisionally accepted
Zhenghua Xie Zhenghua Xie 1Qun Wang Qun Wang 2Ziyuan Zhou Ziyuan Zhou 3*Weixing Wu Weixing Wu 2*Xiaoyu Zhang Xiaoyu Zhang 2Li Zhang Li Zhang 2*
  • 1 National Cancer Center, Cancer Hospital Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
  • 2 Department of Laboratory Medicine, National Cancer Center, Cancer Hospital Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
  • 3 Department of Pharmacy, National Cancer Center, Cancer Hospital Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China

The final, formatted version of the article will be published soon.

    Purpose: Carbapenem-resistant Enterobacterales (CRE) is a growing threat to human health worldwide. This study aimed to develop a novel method, the broth microgrowth method, for the rapid identification of CRE from culture isolates via matrix-assisted laser desorption ionization-time-offlight mass spectrometry (MALDI-TOF MS).Methods: A total of 56 Escherichia coli and 24 Klebsiella pneumoniae isolates were collected for this study. The minimum inhibitory concentrations (MICs) of imipenem and meropenem were measured for all the isolates via the broth microdilution method. Carbapenem resistance (R) and susceptibility (S) were interpreted according to the Clinical and Laboratory Standards Institute (CLSI) Performance Standards for Antimicrobial Susceptibility Testing, M100, 34th Edition. These isolates were incubated both with and without carbapenem antibiotics, imipenem and meropenem at 35°C for 1 and 2 h. Following incubation, the mixtures were centrifuged, and the supernatant was pipetted off.The remaining sediment was subsequently applied to the MALDI-TOF MS target plate and the residual broth was subsequently absorbed via sterile filter paper. Identification of the isolates was performed via the VITEK MS system. CRE were distinguished if the microorganisms could be successfully identified.After 1 h of incubation with imipenem or meropenem, the growth efficiencies of E. coli and K. pneumoniae were 83.93% and 66.67%, respectively. For Escherichia coli, the sensitivity and specificity of imipenem were 82.14% and 100%, respectively. Conversely, meropenem demonstrated a sensitivity of 89.29% and a specificity of 100%. When Klebsiella pneumoniae was examined, both imipenem and meropenem had sensitivity and specificity values of 83.33% and 100%, respectively.After the incubation time was extended to 2 h, both antibiotics achieved perfect sensitivity and specificity of 100%, coupled with a growth efficiency of 100% for both bacterial strains. Conclusion: Combining the broth microgrowth method with MALDI-TOF MS offers a rapid and accurate approach to identifying CRE, thus facilitating the swift selection of appropriate antibiotics.

    Keywords: Carbapenem-resistant Enterobacterales1, Antimicrobial susceptibility testing2, imipenem3, Meropenem4, MALDI-TOF MS5

    Received: 24 Sep 2024; Accepted: 16 Dec 2024.

    Copyright: © 2024 Xie, Wang, Zhou, Wu, Zhang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ziyuan Zhou, Department of Pharmacy, National Cancer Center, Cancer Hospital Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
    Weixing Wu, Department of Laboratory Medicine, National Cancer Center, Cancer Hospital Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
    Li Zhang, Department of Laboratory Medicine, National Cancer Center, Cancer Hospital Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.