Comprehensive Evaluation of the MBT STAR-BL Module for Simultaneous Bacterial Identification and β-Lactamase-Mediated Resistance Detection in Gram-Negative Rods from Cultured Isolates and Positive Blood Cultures

Lee, Annie W T; Lam, Johnson K.S.; Lam, R.; Ng, Wan Hwa; Lee, Ella N L; Lee, Vicky T Y; Sze, Po P; Rajwani, Rahim; Fung, Kitty S. C.; To, Wing‐Kin; Lee, Rodney A.; Tsang, Dominic N.C.; Siu, G. G.

doi:10.3389/fmicb.2018.00334

Cited by 14 publications

(9 citation statements)

References 33 publications

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“…All these MALDI-TOF MS detections of drug modifications have lead, so far, to the development of the MBT STAR-BL software (Bruker Daltonics) and to one carbapenemase detection kit called MBT STAR-Carba Kit (Bruker Daltonics). Recent studies demonstrated the efficacy of this software with a concomitant identification and detection of ESBL or carbapenemase in around 1.5–5.2 hours, instead of 12–48 hours, with conventional routine protocols [85,86].…”

Section: Resultsmentioning

confidence: 99%

Review of the impact of MALDI-TOF MS in public health and hospital hygiene, 2018

et al. 2019

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IntroductionMALDI-TOF MS represents a new technological era for microbiology laboratories. Improved sample processing and expanded databases have facilitated rapid and direct identification of microorganisms from some clinical samples. Automated analysis of protein spectra from different microbial populations is emerging as a potential tool for epidemiological studies and is expected to impact public health.AimTo demonstrate how implementation of MALDI-TOF MS has changed the way microorganisms are identified, how its applications keep increasing and its impact on public health and hospital hygiene.MethodsA review of the available literature in PubMED, published between 2009 and 2018, was carried out.ResultsOf 9,709 articles retrieved, 108 were included in the review. They show that rapid identification of a growing number of microorganisms using MALDI-TOF MS has allowed for optimisation of patient management through prompt initiation of directed antimicrobial treatment. The diagnosis of Gram-negative bacteraemia directly from blood culture pellets has positively impacted antibiotic streamlining, length of hospital stay and costs per patient. The flexibility of MALDI-TOF MS has encouraged new forms of use, such as detecting antibiotic resistance mechanisms (e.g. carbapenemases), which provides valuable information in a reduced turnaround time. MALDI-TOF MS has also been successfully applied to bacterial typing.ConclusionsMALDI-TOF MS is a powerful method for protein analysis. The increase in speed of pathogen detection enables improvement of antimicrobial therapy, infection prevention and control measures leading to positive impact on public health. For antibiotic susceptibility testing and bacterial typing, it represents a rapid alternative to time-consuming conventional techniques.

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Section: Resultsmentioning

confidence: 99%

Review of the impact of MALDI-TOF MS in public health and hospital hygiene, 2018

et al. 2019

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“…Recently, Bruker Daltonik launched a software module, named MBT STAR-BL, for the automatic analysis of drug hydrolysis mass spectra that has been integrated into the MBT Compass software for species identification (278,279). The software is accompanied by detailed protocols for the manual preparation of reagents.…”

Section: Phenotypic Confirmation Methodsmentioning

confidence: 99%

The Global Ascendency of OXA-48-Type Carbapenemases

et al. 2019

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SUMMARY Surveillance studies have shown that OXA-48-like carbapenemases are the most common carbapenemases in Enterobacterales in certain regions of the world and are being introduced on a regular basis into regions of nonendemicity, where they are responsible for nosocomial outbreaks. OXA-48, OXA-181, OXA-232, OXA-204, OXA-162, and OXA-244, in that order, are the most common enzymes identified among the OXA-48-like carbapenemase group. OXA-48 is associated with different Tn1999 variants on IncL plasmids and is endemic in North Africa and the Middle East. OXA-162 and OXA-244 are derivatives of OXA-48 and are present in Europe. OXA-181 and OXA-232 are associated with ISEcp1, Tn2013 on ColE2, and IncX3 types of plasmids and are endemic in the Indian subcontinent (e.g., India, Bangladesh, Pakistan, and Sri Lanka) and certain sub-Saharan African countries. Overall, clonal dissemination plays a minor role in the spread of OXA-48-like carbapenemases, but certain high-risk clones (e.g., Klebsiella pneumoniae sequence type 147 [ST147], ST307, ST15, and ST14 and Escherichia coli ST38 and ST410) have been associated with the global dispersion of OXA-48, OXA-181, OXA-232, and OXA-204. Chromosomal integration of blaOXA-48 within Tn6237 occurred among E. coli ST38 isolates, especially in the United Kingdom. The detection of Enterobacterales with OXA-48-like enzymes using phenotypic methods has improved recently but remains challenging for clinical laboratories in regions of nonendemicity. Identification of the specific type of OXA-48-like enzyme requires sequencing of the corresponding genes. Bacteria (especially K. pneumoniae and E. coli) with blaOXA-48, blaOXA-181, and blaOXA-232 are emerging in different parts of the world and are most likely underreported due to problems with the laboratory detection of these enzymes. The medical community should be aware of the looming threat that is posed by bacteria with OXA-48-like carbapenemases.

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“…In particular, matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry (MS) has proved a rapid and reliable method for microbial identification, and a number of recent studies indicate that it could be directly applied to identify microbial pathogens recovered from positive BCs [9–13]. However, microbial identification by MALDI-TOF MS directly in positive BC is intrinsically difficult for polymicrobial BCs, since the peaks of multiple species merge into a single mass spectrum and the results obtained often yield the identification of the predominant microorganism only [14–20].…”

Section: Introductionmentioning

confidence: 99%

A new culture-based method for rapid identification of microorganisms in polymicrobial blood cultures by MALDI-TOF MS

et al. 2019

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BackgroundThe application of matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry (MS) to microbial identification has allowed the development of rapid methods for identification of microorganisms directly in positive, blood cultures (BCs). These methods can yield accurate results for monomicrobial BCs, but often fail to identify multiple microorganisms in polymicrobial BCs. The present study was aimed at establishing a rapid and simple method for identification of bacteria and yeast in polymicrobial BCs from patients with bloodstream infection.ResultsThe rapid method herein proposed is based on short-term culture in liquid media allowing selective growth of microorganisms recovered from polymicrobial BCs, followed by rapid identification by MALDI-TOF MS. To evaluate the accuracy of this method, 56 polymicrobial BCs were comparatively analyzed with the rapid and routine methods. The results showed concordant identification for both microbial species in 43/50 (86%) BCs containing two different microorganisms, and for two microbial species in six BCs containing more than two different species. Overall, 102/119 (85.7%) microorganisms were concordantly identified by the rapid and routine methods using a cut-off value of 1.700 for valid identification. The mean time to identification after BC positivity was about 4.2 h for streptococci/enterococci, 8.7 h for staphylococci, 11.1 h for Gram-negative bacteria, and 14.4 h for yeast, allowing a significant time saving compared to the routine method.ConclusionsThe proposed method allowed rapid and reliable microbial identification in polymicrobial BCs, and could provide clinicians with timely, useful information to streamline empirical antimicrobial therapy in critically ill patients.

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Comprehensive Evaluation of the MBT STAR-BL Module for Simultaneous Bacterial Identification and β-Lactamase-Mediated Resistance Detection in Gram-Negative Rods from Cultured Isolates and Positive Blood Cultures

Cited by 14 publications

References 33 publications

Review of the impact of MALDI-TOF MS in public health and hospital hygiene, 2018

Review of the impact of MALDI-TOF MS in public health and hospital hygiene, 2018

The Global Ascendency of OXA-48-Type Carbapenemases

A new culture-based method for rapid identification of microorganisms in polymicrobial blood cultures by MALDI-TOF MS

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