Poor Sensitivity of the MALDI Biotyper<sup>®</sup> MBT Subtyping Module for Detection of <i>Klebsiella pneumoniae</i> Carbapenemase (KPC) in <i>Klebsiella</i> Species

oleh: Luz Cuello, Judith Alvarez Otero, Kerryl E. Greenwood-Quaintance, Liang Chen, Blake Hanson, Jinnethe Reyes, Lauren Komarow, Lizhao Ge, Zane D. Lancaster, Garrett G. Gordy, Audrey N. Schuetz, Robin Patel

Format: Article
Diterbitkan: MDPI AG 2023-09-01

Deskripsi

Rapid detection of <i>Klebsiella pneumoniae</i> carbapenemase (KPC) in the <i>Klebsiella</i> species is desirable. The MALDI Biotyper<sup>®</sup> MBT Subtyping Module (Bruker Daltonics) uses an algorithm that detects a peak at ~11,109 m/z corresponding to a protein encoded by the <i>p019</i> gene to detect KPC simultaneously with organism identification by a matrix-assisted laser desorption ionization–time-of-flight mass spectrometry (MALDI-ToF MS). Here, the subtyping module was evaluated using 795 clinical <i>Klebsiella</i> isolates, with whole genome sequences used to assess for <i>bla</i><sub>KPC</sub> and <i>p019</i>. For the isolates identified as KPC positive by sequencing, the overall sensitivity of the MALDI-ToF MS subtyping module was 239/574 (42%) with 100% specificity. For the isolates harboring <i>p019</i>, the subtyping module showed a sensitivity of 97% (239/246) and a specificity of 100%. The subtyping module had poor sensitivity for the detection of <i>bla</i><sub>KPC</sub>-positive <i>Klebsiella</i> isolates, albeit exhibiting excellent specificity. The poor sensitivity was a result of <i>p019</i> being present in only 43% of the <i>bla</i><sub>KPC</sub>-positive <i>Klebsiella</i> isolates.