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Abstract：
The ability of VITEK mass spectrometry (MS) in detection of bacterial resistance is currently under exploration and evaluation. In this study, we developed and validated a VITEK MS method to rapidly test carbapenemase-producing Klebsiella pneumoniae (CPKP). Solvents, antibiotic concentrations, crystal conditions and times, centrifugation speeds, and other factors were optimized to design a rapid sample pretreatment process for CPKP detection by VITEK MS. The related parameters of the mass spectrum were adjusted on the instrument to establish an CPKP detection mode. 133 clinically isolated strains of CPKP in the microbiology laboratory at the Shenzhen People\'s Hospital from 2004 to 2017 were selected for accuracy evaluation. The fresh suspected strains from the microbiology laboratory in 2020 were used to complete the clinical verification. Two antibiotics, meropenem (MEM) and imipenem (IPM), were used as substrates. These two substrates were incubated with suspected CPKP, and the results were obtained by VITEK MS detection. Using this method, different types of CPKP showed different detection results and all the CPKP strains producing KPC-2 and IMP-4 carbapenemase were detected by VITEK MS. Thus, VITEK MS can be used for rapid detection of CPKP, especially for some common types of CPKP. This method provides high accuracy and speed of detection. Combined with its cost advantages, it can be intensely valuable in clinical microbiology laboratories after the standard operating procedures are determined.
摘要：
目前正在探索和评估VITEK质谱（MS）检测细菌耐药性的能力。在这项研究中,我们开发并验证了VITEKMS方法,以快速检测产碳青霉烯酶的肺炎克雷伯菌(CPKP).溶剂,抗生素浓度，晶体条件和时间，离心速度，和其他因素进行了优化，设计了VITEKMS检测CPKP的快速样品预处理工艺。在仪器上调整质谱的相关参数以建立CPKP检测模式。选取深圳市人民医院微生物实验室2004-2017年临床分离的133株CPKP进行准确性评价。2020年微生物实验室的新鲜疑似菌株用于完成临床验证。两种抗生素,美罗培南（MEM）和亚胺培南（IPM），用作底物。将这两种底物与可疑的CPKP孵育，并通过VITEKMS检测获得结果。使用此方法，不同类型的CPKP检测结果不同，所有产KPC-2和IMP-4碳青霉烯酶的CPKP菌株均用VITEKMS检测。因此，VITEKMS可用于CPKP的快速检测，特别是对于一些常见类型的CPKP。该方法提供了高的检测精度和速度。结合其成本优势,在确定标准操作程序后，它在临床微生物学实验室中可能非常有价值。
