Rapid identification & detection of antibiotic resistance profiles in blood culture bacterial isolates
We propose here to kick-start a multi-site study analyzing the prevalence, causative pathogens and their antibiotic resistance patterns, outcomes, and cofactors of BSI among febrile patients consecutively presenting to hospitals in Kenya. This study is highly innovative in an African setting because it proposes to use MALDI TOF MS to rapidly identify and test antimicrobial resistance patterns in bacterial pathogens causing BSI in the study population.
Study hospital setting
The first phase of the laboratory work for this study has taken already place at the Aga Khan University Hospital (AKUH), Nairobi, Kenya. AKUH is a flag bearer for a regional group of 5 hospitals located in three East African countries, namely in Mombasa, Kisumu, Kampala and Dar es Salaam.
Ali Kassim visits SwissTPH/Mabritec AG for 2 months in October to December 2014. During that time he analyses the 500 archived samples from Nairobi under the supervision of Valentin Pflüger and Claudia Daubenberger. Upon his return to Nairobi, the fellow had acquired in depths hands on experience of using the MALDI TOF MS system. Data collected at Basel was compared to the corresponding data available at Nairobi for site by site comparison of performance. Valentin Pflüger visited Nairobi in May 2015 to discuss with decision makers at the AKUH and the fellow the next steps of technology transfer.
• Identification of genus/ species and drug resistance pattern of a random selection of 500 archived samples from BSI of patients admitted to the Aga Khan University Hospital, Nairobi. In this first phase, we concentrated on Escherichia coli and Klebsiella pneumonia archived stocks since these bacteria dominate the BSIs.
• Identification of genus/species and drug resistance pattern of about twenty bacterial BSI isolates in patients admitted to the Aga Khan Hospital, Nairobi
directly from blood culture.
• Incorporation of uniquely identified mass spectrometry profiles into the in house database at Mabritec AG.
• Particular isolates that are not reliably identified using our MALDI TOF MS database was lined up for later whole genome sequencing.
• Transfer of technology from SwissTPH/Mabritec AG to the Aga Khan University Hospital to provide the foundation for later planned transfer of equipment and joint adaptation to the specific needs of East African settings.