title: Rapid Identification of Klebsiella pneumoniae by Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry and Detection of Meropenem Resistance by Flow Cytometric Assay.
abstract: BACKGROUND
  The aim of this study was to develop a rapid detection method of carbapenem-resistant Klebsiella pneumoniae (CRKP) strains both MALDI-TOF MS and flow cytometry (FCM).
  
  
  METHODS
  A total of 174 K. pneumoniae strains were included in this study. Molecular characterization of carbapenemase gene was performed by PCR. Bacterial identification was performed by MALDI-TOF-MS. Meropenem susceptibility was tested at the concentrations of breakpoints described by the Clinical and Laboratory Standards Institute (CLSI) guide by FCM.
  
  
  RESULTS
  Sixty-two CRKP were positive for at least one carbapenemase gene. A total of 174 K. pneumoniae isolates obtained from clinically relevant material were correctly identified by Bruker MALDI-TOF MS with log (score) >2.0. These results were 100% concordant with the Phoenix™Automated Microbiology System (BD, MD) and conventional identification results. Based on the analysis of the receiver operating characteristic (ROC) curves, the best validity and sensitivity data were obtained with a cut-off value of 18.88% by FCM. The concordance, sensitivity, and specificity for FCM by the selected cut-off values were 99.4%, 98.9%, and 100%, respectively.
  
  
  CONCLUSIONS
  We conclude that reliable results on bacterial identification and meropenem susceptibility test can be obtained within 2 hr combined by MALDI-TOF-MS and FCM.
authors.affiliation: Department of Microbiology, Gulhane Military Medical Academy, Etlik, 06010, Ankara, Turkey. abkilic@gata.edu.tr.|FMF Arthritis Vasculitis and Orphan Disease Research Center (FAVOR), Gulhane Military Medical Academy, Etlik, 06010, Ankara, Turkey. abkilic@gata.edu.tr.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Kilic
authors.affiliation: Department of Microbiology, Gulhane Military Medical Academy, Etlik, 06010, Ankara, Turkey.
authors.forename: Eyup
authors.initials: E
authors.lastname: Dogan
authors.affiliation: Department of Microbiology, Gulhane Military Medical Academy, Etlik, 06010, Ankara, Turkey.
authors.forename: Sinem
authors.initials: S
authors.lastname: Kaya
authors.affiliation: FMF Arthritis Vasculitis and Orphan Disease Research Center (FAVOR), Gulhane Military Medical Academy, Etlik, 06010, Ankara, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Oren
authors.affiliation: Department of Infectious Diseases, Gulhane Military Medical Academy, Etlik, 06010, Ankara, Turkey.
authors.forename: Duran
authors.initials: D
authors.lastname: Tok
authors.affiliation: Department of Microbiology, Gulhane Military Medical Academy, Etlik, 06010, Ankara, Turkey.
authors.forename: Nurittin
authors.initials: N
authors.lastname: Ardic
authors.affiliation: Department of Microbiology, Gulhane Military Medical Academy, Etlik, 06010, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Baysallar
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D006801:Humans; D007710:Klebsiella Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D007711:Klebsiella pneumoniae / Q000235:genetics / Q000302:isolation & purification*; D008297:Male; D000077731:Meropenem; D012372:ROC Curve; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods*; D013845:Thienamycins / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D000077731:Meropenem
keywords: 
  Klebsiella pneumonia
  ; MALDI-TOF MS; flow cytometric assay