{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T01:43:08Z","timestamp":1769046188741,"version":"3.49.0"},"reference-count":22,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T00:00:00Z","timestamp":1576540800000},"content-version":"unspecified","delay-in-days":350,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2019]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Homology surveillance of carbapenem-resistant<jats:italic>Klebsiella pneumoniae<\/jats:italic>(CRKP) is critical to monitor and prevent outbreaks of nosocomial infections. In the present study, a matrix-assisted laser desorption\/ionisation-time of flight (MALDI-TOF MS)-based method was evaluated as a rapid tool for typing CRKP in comparison with pulsed-field gel electrophoresis (PFGE) and multi locus sequence typing (MLST). Drug-resistant phenotypes and genotypes of 44 CRKP isolates were detected by microdilution broth method and polymerase chain reaction, and typed by PFGE, MLST and MALDI-TOF MS. Simpson's Index of Diversity was used to evaluate taxonomic diversity, Adjusted Rand Index (ARI) for congruence between the typing methods and Wallace coefficients (<jats:italic>W<\/jats:italic>) for the ability of either method to predict each other. Forty-four CRKP isolates of 15 sequence types (STs) produced either<jats:italic>NDM-1<\/jats:italic>(<jats:italic>n<\/jats:italic>= 16),<jats:italic>NDM-5<\/jats:italic>(<jats:italic>n<\/jats:italic>= 9) or<jats:italic>KPC-2<\/jats:italic>(<jats:italic>n<\/jats:italic>= 19) carbapenemases. PFGE differentiated these isolates into 16 distinct types, and two deoxyribonucleic acid profiles were assigned to ST337 and ST11, respectively. MALDI-TOF MS failed to clearly delineate between clusters on dendrograms based on principal components analysis and main spectrum profile. The chosen parameters resulted in a maximum ARI of 0.310 (95% CI 0.088\u20130.531) between MALDI-TOF MS typing and the PFGE reference, indicating a low ability of the former to correctly identify related isolates. Likewise, the maximum<jats:italic>W<\/jats:italic>coefficient of 0.367 (95% CI 0.203\u20130.532) showed that MALDI-TOF MS had a lower predictive power than PFGE. We conclude that MALDI-TOF MS lacks the discriminatory power necessary for clone assignment of CRKP isolates and consequently cannot be considered as a rapid and creditable method for this purpose.<\/jats:p>","DOI":"10.1017\/s0950268819002097","type":"journal-article","created":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T12:15:52Z","timestamp":1576584952000},"source":"Crossref","is-referenced-by-count":12,"title":["Overestimated discriminatory power of MALDI-TOF mass spectrometry for typing of carbapenem-resistant<i>Klebsiella 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