Assuntos
Infecção Hospitalar , Infecções por Klebsiella , Meningite , Humanos , Klebsiella pneumoniae , Infecção Hospitalar/tratamento farmacológico , Ceftazidima/uso terapêutico , Compostos Azabicíclicos/uso terapêutico , Combinação de Medicamentos , Antibacterianos/uso terapêutico , beta-Lactamases/genética , Testes de Sensibilidade Microbiana , Infecções por Klebsiella/tratamento farmacológico , Proteínas de BactériasRESUMO
BACKGROUND: The implementation of MALDI-TOF MS for microorganism identification has changed the routine of the microbiology laboratories as we knew it. Most microorganisms can now be reliably identified within minutes using this inexpensive, user-friendly methodology. However, its application in the identification of mycobacteria isolates has been hampered by the structure of their cell wall. Improvements in the sample processing method and in the available database have proved key factors for the rapid and reliable identification of non-tuberculous mycobacteria isolates using MALDI-TOF MS. AIMS: The main objective is to provide information about the proceedings for the identification of non-tuberculous isolates using MALDI-TOF MS and to review different sample processing methods, available databases, and the interpretation of the results. SOURCES: Results from relevant studies on the use of the available MALDI-TOF MS instruments, the implementation of innovative sample processing methods, or the implementation of improved databases are discussed. CONTENT: Insight about the methodology required for reliable identification of non-tuberculous mycobacteria and its implementation in the microbiology laboratory routine is provided. IMPLICATIONS: Microbiology laboratories where MALDI-TOF MS is available can benefit from its capacity to identify most clinically interesting non-tuberculous mycobacteria in a rapid, reliable, and inexpensive manner.
Assuntos
Micobactérias não Tuberculosas/isolamento & purificação , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Técnicas Bacteriológicas , Humanos , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Fluxo de TrabalhoRESUMO
OBJECTIVE: Detection and differentiation of various types of carbapenemases is crucial to their control and dissemination. OXA-48 is the most common carbapenemase in Spain and in our environment. The aim of this study is the evaluation of a new immunochromatographic test OXA-48 Card letitest (Coris, BioConcept Belgium) to detect this carbapenemase from solid media. METHODS: During the last year 151 strains of carbapenemase producing bacteria have been isolated, of which 136 were OXA-48 (126 Klebsiella pneumoniae, 1 Klebsiella oxytoca, 5 Escherichia coli, 4 Enterobacter cloacae), and 15 producing other carbapenemases . These 15 strains with other 73 carrying other resistance mechanisms (54 extended-spectrum ß-lactamases producers and 19 with other mechanisms) were used as negative controls. RESULTS: One hundred and thirty six strains carrying OXA-48 were positive with the test OXA-48 Card letitest and the 88 species used as controls were negative, resulting in a sensitivity and specificity of 100%. CONCLUSIONS: The OXA-48 Card letitest is simple, quick, safe and cheap (approx. 6/test) and can be used in microbiology laboratories to confirm the production of OXA-48 carbapenemase in clinical isolates.
