Application of MALDI-TOF-MS for rapid drug susceptibility test of polymyxin B in Carbapenem-resistant Enterobacteriaceae
Objective To establish a rapid drug susceptibility test method for Carbapenem-resistant Enterobacteriaceae(CRE)against polymyxin B for providing a foundation in the selection and precise adjustment of clinical antibiotics.Methods The clinical informa-tion of 108 CRE strains in Xi'an NO.1 Hospital from March 2023 to March 2024 was screened using WHONET 5.6 software.Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF-MS)was used for rapid drug susceptibility test of polymyxin B,with broth dilution method as the reference.Results The 108 CRE isolates were predominantly Klebsiella pneumoniae(48.14％),followed by Enterobacter aerogenes(13.89％)and Proteus mirabilis(13.89％).The majority of CRE strains were isolated from sputum samples(65.74％),followed by urine(18.52％)and blood(8.33％).The CRE strains were mainly from department of neurosurgery(48.15％),followed by department of intensive care medicine(18.52％)and department of respiratory medicine(14.81％).CRE isolates exhibited high resistance to most drugs.The rates of resistance to β-Lactams,quinolones,aminoglycosides,and β-lactam complex antibiotics exceeded 70％,80％,50％,and 75％,respectively.Compared with the broth dilution method,the MALDI-TOF-MS results presented 98.1％of category agreement(CA),1.85％of major error rate(ME),and no very major errors(VME),which all were within acceptable ranges.Conclusion The CRE strains isolated in this study exhibit extensive resistance to multiple antibiotics.The rapid drug susceptibility test method based on MALDI-TOF-MS is both accurate and reliable,which can be used to quickly detect the sensitivity of CRE to polymyxin B and timely facilitate adjustments of clinical treatment plans for extensively drug-resistant bacteria.
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