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287 protocols using maldi biotyper

1

Automated Blood Culture Identification Techniques

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Each hospital was equipped with in-house microbiology laboratories containing automated blood culture systems: the BD BACTECTM™ FX system (Becton, Dickinson, and Co., NJ, USA) at Okayama University Hospital and Okayama City Hospital, and the BACT/ALERT® VIRTUO® R3.0 System (bioMérieux Japan Ltd., Tokyo, Japan) at Tsuyama Chuo Hospital. At Okayama University Hospital, bacterial strains were identified using API® CAMPY (bioMérieux Japan Ltd., Tokyo, Japan) during 2011–2014 and MALDI Biotyper (Bruker Daltonics GmbH & Co. KG, Bremen, Germany) during 2014–2021. At Tsuyama Chuo Hospital, strains were initially identified based on bacterial metabolic properties, followed by the VITEK MS system (bioMérieux Japan Ltd., Tokyo, Japan) (2011–2017) and MALDI Biotyper (Bruker Daltonics GmbH & Co. KG, Bremen, Germany) (2017–2021) were used. At Okayama City Hospital, the VITEK 2 system (bioMérieux Japan Ltd., Tokyo, Japan) was used during the entire study period.
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2

Comparative Analysis of S. pseudintermedius Isolates

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In total, 57 MSSP isolates were included, 32 S. pseudintermedius isolates from human infections obtained from 6 Dutch hospitals between 2014 and January 2019, and 25 S. pseudintermedius isolates from canine infections isolated at the Veterinary Microbiological Diagnostic Centre were selected to match the years of isolation of human isolates. All isolates were selected based on convenience sampling and epidemiologically unrelated. Species identification was confirmed by matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF MS) (Bruker MALDI Biotyper, Bruker Daltonics, Billerica, MA, USA).
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3

Antimicrobial Susceptibility Testing of M. abscessus

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The test organisms evaluated were M. abscessus ATCC 19977 and MMX 9450, an isolate collected from a patient sputum sample in Indiana, USA in 2017. NTM were grown on Middlebrook 7H11 selective agar (Hardy Diagnostics; 137898, 14213) for 3–5 days at 30°C. They were then subcultured onto Middlebrook 7H11 non-selective agar (Hardy Diagnostics; 498795, 501472) and incubated for approximately 5 days at 30°C prior to use in the MIC assay. All test organisms were identified by a Bruker MALDI Biotyper (Bruker Daltonics).
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4

Gonococcal Isolates Detection and Storage

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All swabs were transported in ≤12 h to the laboratory and inoculated on selective chocolate culture medium (International for Medical Equipment and Supplies, Doha, Qatar), followed by incubation in 5±1% CO2-enriched humid atmosphere at 36±1°C for 24 h, and if negative, for an additional 24 h. Suspected colonies were verified as N. gonorrhoeae using an oxidase test, Bruker Maldi Biotyper (Bruker Daltonik, Bremen, Germany), and Phadebact Monoclonal GC Test (MKL Diagnostic AB, Sollentuna, Sweden). Isolates were stored in a Microbank cryovial system that incorporates 25 treated beads and a proprietary cryopreservative (Pro-Lab Diagnostics, Cheshire, UK) at -80°С.
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5

Bacterial and Fungal Identification using MALDI-TOF MS and Vitek 2

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ID of isolates was confirmed by Bruker MALDI Biotyper (Bruker, Bremen, Germany) and Vitek 2 Compact system (bioMérieux SA, Marcy-l’Étoile, France) on colony growth from the PBC bottle as previously described [21 (link)–23 (link)]. Briefly, bacterial and fungal isolates grown on SBA at 37 °C for 24–48 h. Samples were spotted onto the target plate, overlaid with 1 μl matrix solution (Bruker α-cyano), and analysed by the Bruker MALDI Biotyper system. Fungal isolates were subjected to ethanol-formic acid extraction protocol according to the manufacturers’ instructions prior to being spotted on the plate. Spectra were analysed with MALDI MBT compass version 4.1.80 and Reference Library DB-7854 (version H, Bruker). Scores ≥2.0 were considered acceptable.
ID of bacterial isolates was also performed on Vitek 2 Compact system. Briefly, a bacterial suspension with turbidity of 0.5 McFarland using 0.45% sterile saline according to manufacturer’s instructions was prepared. The inoculum was subsequently tested with Vitek 2 GP67 and Vitek 2 GN69 and XN06 on the Vitek 2 Compact system.
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6

Comprehensive CRE Infection Analysis

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This was a prospective study that included consecutive inpatients of any age and sex, having an infection with any CRE in the period between January 2017 and June 2018. During this period, a total of 147 strains of CRE, referred to outside reference laboratories, were isolated from blood, urine, and tracheal aspirate. Using standard microbiology laboratory techniques, the clinical samples were analyzed. Only one isolate per patient was included. All the bacterial isolates were identified by matrix-assisted laser desorption ionization time of flight/mass spectrometry (Bruker MALDI Biotyper; Bruker Daltonics; Bremen, Germany).
Phenotypic extended-spectrum beta-lactamase (ESBL), ampicillin (AmpC), and carbapenemase tests Antibiotic susceptibility tests were conducted and the ESBLs from the isolates were analyzed by the BD Phoenix automated system (BD Diagnostics, Sparks, MD). Meropenem disks (10 μg) were used to screen the carbapenem resistance in all the isolates. If the diameter of the disk zones was found to be <28 mm, the production of carbapenemase was investigated [9] . ESBL, AmpC, and carbapenemase were tested using the phenotypical Mast D68C AmpC + ESBL Detection Set and the Mast D70C Carbapenemase Detection Set (Mast Diagnostics, UK). The Mastdisks ID inhibitor combination disks (Mast Diagnostics) method was performed according to the manufacturer's instructions.
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7

MALDI-TOF MS Analysis of ST131 E. coli

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The method of MALDI-TOF MS analysis followed that of our previous study17 (link). The strains were cultured at 37 °C for 16-24 h using 5% sheep blood agar. We performed ethanol-formic acid protein extraction from grown colonies for preparation of the MALDI-TOF MS analysis and used Bruker Bacterial Test Standard (Bruker Daltonik, Bremen, Germany) for calibration. MALDI-TOF MS analysis was performed using MALDI Biotyper (Bruker Daltonik). Spectra obtained by MALDI-TOF MS analysis were used for comparison of the spectrum of the ST131 with that of the non-ST131 using ClinProTools v2.2 (Bruker Daltonik), and peaks specific to ST131 were searched. We analysed spectra with Peak Statistic Calculation, which includes the Wilcoxon rank sum test. We analysed each isolate three times, and the peaks that were observed at least two of the three times in Peak Statistic Calculation were extracted as reproducible specific peaks of ST131. For the specific peaks judged to be significant by ClinProTools, peaks within the range of ±400 ppm were confirmed by FlexAnalysis v3.4 software (Bruker Daltonik) for each strain. The settings used for MALDI-TOF MS analysis were linear positive mode, 20-Hz laser frequency, 20-kV acceleration voltage, 18.5-kV IS2 voltage, 250-ns extraction delay, and 2000–20,000 m/z range.
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8

Moraxella Keratitis: Clinical and Microbiological Analysis

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Clinical and microbiological records of 27 culture-proven Moraxella keratitis cases reported at Ehime University Hospital from March 2006 to February 2022 were retrospectively analyzed in addition to the species and predisposing factors for Moraxella keratitis. The organisms were identified by Gram-stained smears and corneal scrape culture on sheep blood agar at 37 °C and 5% CO2. On a Bruker MALDI Biotyper (Bruker Daltonics, Billerica, MA), MALDI-TOF MS was performed to identify Moraxella species. The identification criteria were a score of ≥ 2.0 for species-level identification.
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9

Carbapenemase Detection in Isolates

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Both patient and environmental swabs were effaced on ChromAgar ESBL (MAST Group Ltd, Reinfeld, Germany). Species identification was performed using matrixassisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry (MALDI BioTyper, Bruker, Bremen, Germany). AMR was determined using the disc diffusion method, and results were interpreted using European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints (version 9.0). Carbapenemase screening was performed using the β-CARBA Test (Bio-Rad Laboratories Inc., Feldkirchen, Germany). Positive results were confirmed with Xpert Carba-R assay (Cepheid, Krefeld, Germany).
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10

Klebsiella pneumoniae Infection Analysis

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A 63-year-old diabetic man admitted to Chung Shan Medical University Hospital (CSMUH) suffered from K. pneumoniae infections (Fig. 1). An isolate was collected from each K. pneumoniae-positive specimen and stored at −80°C for subsequent analysis. Species identification was performed with the Bruker MALDI Biotyper, and antimicrobial susceptibility testing was performed with the Phoenix Automatic Microbiology System (BD Diagnostics, MD, USA) and CLSI breakpoints (M100-S27). The CSMUH Institute Review Board approved this study (IRB CS19108). All methods were performed following relevant guidelines and regulations.
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