Rapid screening method for detection of toxigenic Klebsiella oxytoca in clinical samples by Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS)

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Rapid screening method for detection of toxigenic Klebsiella oxytoca in clinical samples by Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS)

 

Author: Chan, Siu Mang
Title: Rapid screening method for detection of toxigenic Klebsiella oxytoca in clinical samples by Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS)
Degree: M.Sc.
Year: 2014
Subject: Klebsiella.
Hong Kong Polytechnic University -- Dissertations
Department: Dept. of Health Technology and Informatics
Pages: x, 102 leaves : col. ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2680443
URI: http://theses.lib.polyu.edu.hk/handle/200/7347
Abstract: Antibiotic associated diarrhoea (AAD) is a common medical problem worldwide. A reliable and rapid diagnostic method in detecting the associated pathogen can enable the physician to use appropriate therapy for patient treatment against the infection. However, there has been little study performed on the second most important AAD related pathogen after Clostridium difficile, Klebsiella oxytoca which can cause antibiotic-associated hemorrhagic colitis. In this study, application of Matrix Assisted Laser Desorption Ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF MS) was used to investigate the feasibility of its use for K. oxytoca toxicity determination. Toxigenic and non-toxigenic K. oxytoca reference strains were used to build up the K. oxytoca reference library of toxicity in the MALDI-TOF MS system. Several differences in mass intensities between the toxigenic strains and the non-toxigenic strains were observed that may help deducing possible biomarkers specific to toxicity by MALDI-TOF MS. Beside, a rapid and easy screening method using MacConkey agar in combination of Simmons citrate and indole test was suggested in selecting presumptive K. oxytoca isolates from fecal specimen prior to identification and toxicity determination by MALDI-TOF MS which could effectively exclude 99.2% (2052/2068) of unwanted specimen with 62.5% (10/16) true positive rate. Moreover, the cost effectiveness of using MALDI-TOF MS over recently available conventional diagnostic methods was compared, showed that the successfulness in toxicity determination by MALDI-TOF as an "add-on" test for routine clinical laboratory in K. oxytoca toxicity determination could effectively relieve the workload with faster turn-around time and lower cost.

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