Discriminatory Power of Three Typing Techniques in Determining Relatedness of Nosocomial Klebsiella pneumoniae Isolates from a Tertiary Hospital in India

Abstract

ERIC-PCR was the most reproducible method for typing K. pneumoniae isolates and could not be substituted by MALDI-TOF for clonality analysis. A high degree of genetic diversity and the presence of MDR genes highlight the challenges in treating K. pneumoniae-associated infections.

Evaluation of ERIC-PCR and MALDI-TOF as typing tools for multidrug resistant Klebsiella pneumoniae clinical isolates from a tertiary care center in India

“…The large number of serotypes in this species could also explain this genetic diversity highlighted by the ERIC-PCR genotypic analysis. Similar to other studies, in our study the clustering pattern by MALDI-TOF was different compared to that seen with ERIC-PCR based techniques (14,15). This might be because of the fact that phenotype expressed is not always the true representative of genotype.…”

“…Similar to our study Rim et al found MALDI-TOF to have low/insufficient discriminatory power to determine the relatedness of MDR- Acinetobacter baumannii isolates (16). A recent study by Purighalla S et al, have the supporting results indicating ERIC being more reproducible and better tool than MALDI-TOF to determine the relatedness of nosocomial K. pneumoniae isolates (14) though with routine use of MALDI for microbial identification, it is also being used for outbreak investigations with no added cost for effective interventions (17,18). Although MALDI-TOF is a quick and easy technique and can speed up the infection control measures to prevent further outbreak (19), it does not fit in every situation for perfect discrimination (20).…”

Evaluation of ERIC-PCR and MALDI-TOF as typing tools for multidrug resistant Klebsiella pneumoniae clinical isolates from a tertiary care center in India

“…However, many of these are expensive, labor intensive and time-consuming. Methods such as palindromic repetitive element-based ERIC-PCR and proteomic signature based MALDI-TOF are quick, reliable, and cost-effective techniques for molecular typing of the Enterobacteriaceae family [ 14 , 23 , 24 ]. Several recent studies represent that ERIC-PCR represents discrimination power equivalent to PFGE [ 25 – 28 ].…”

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“…Further improvements have since been made to the database, mainly by including spectra from the most difficult bacterial cases, as was recently illustrated for Brucella [26]. Thus, although Ueda et al [27] demonstrated that MALDI typing could be used for clone-level identification of methicillin-resistant S. aureus with accuracy equivalent to PFGE, Purighalla et al [28], by highlighting differences in clustering for nosocomial Klebsiella pneumoniae isolates on the basis of genomic or proteomic signatures, revealed the need for further investigation to establish the widespread applicability of MALDI-TOF methods for clonality studies across a wider variety of bacteria implicated in nosocomial infections. A similar conclusion was drawn by Pinto et al [29] following typing of Streptococcus pneumoniae isolates.…”