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    Determination of Carbapenemase Producing of Klebsiella pneumoniae Isolated in Blood Cultures By Matrix Assisted Laser Desorption/Ionization-flight Time Mass Spectrometry
    (Bilimsel Tip Yayinevi, 2020) Dogan, Metin; Baba, Abdullah Yucel
    Introduction: Klebsiella pneumoniae can cause Healthcare Related Infections (HRIs), especially by carbapenemase producing microorganisms. Rapid methods are needed to determine carbapenem resistance. MALDI-TOF MS is a faster diagnostic method than conventional methods. It is expected that routine use and standardization of this diagnostic test in laboratories will contribute to the rapid determination of carbapenemase resistance. In this study, it was aimed to determine carbapenemase enzyme production by MALDI-TOF MS technique in K. pneumoniae strains. Materials and Methods: Carbapenem susceptible (n=40) and non-susceptible (n=96) K. pneumoniae strains isolated in the Medical Microbiology Laboratory between January 2016 to December 2017 were included into the study. Detecting of production of carbapenemase enzyme was investigated by MALDI-TOF MS technique by comparing with the polymerase chain reaction (PCR). Results: PCR analysis showed that 93 of the carbapenem resistant isolates had OXA-48 gene and three of them had NDM gene. In the MALDI-TOF MS analyzes of the 96 isolates with genotypic resistance, 88 were resistant and three were susceptible. Five isolates of carbapenem resistant with PCR could not be identified as resistant or sensitive by this method. Forty isolates susceptible to carbapenem were determined to be susceptible by MALDI-TOF MS. Sensitivity, specificity, positive predictive, negative predictive values were 96.7%, 100%, 100%, 93% respectively. Conclusion: It appears that MALDI-TOF MS determines carbapenemase production with high specificity and sensitivity. We think it will be beneficial to complete standardization studies and use them in routine practice.