Use of Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry To Identify Vancomycin-Resistant Enterococci and Investigate the Epidemiology of an Outbreak

摘要: The control of vancomycin-resistant enterococci (VRE) has become an increasing burden on health care resources since their discovery over 20 years ago. Current techniques employed for detection include time-consuming and laborious phenotypic methods or molecular requiring costly equipment consumables highly trained staff. An accurate, rapid diagnostic test the ability to greatly reduce spread this organism, which colonize patients long periods, potentially even lifelong. Matrix-assisted laser desorption ionization-time flight mass spectrometry (MALDI-TOF MS) is a technology with identify organisms in seconds shown promise identification other forms antimicrobial resistance organisms. Here we show that MALDI-TOF MS capable rapidly accurately identifying vanB-positive Enterococcus faecium VRE from susceptible isolates. Internal validation optimal model generated produced sensitivity 92.4% specificity 85.2%. Prospective results, following incorporation into routine laboratory work flow, demonstrated greater at 96.7% 98.1%, respectively. In addition, utilization determine relatedness isolates contributing outbreak also demonstrated.