A comparison of a matrix-assisted laser desorption ionization-time of flight mass spectrometric (MALDI-TOF MS) meropenem hydrolysis assay with the Carba NP test showed that both methods exhibited low sensitivity (approximately 76%), mainly due to the false-negative results obtained with OXA-48-type producers. The addition of NH4HCO3 to the reaction buffer for the MALDI-TOF MS assay dramatically improved its sensitivity (98%). Automatic interpretation of the MALDI-TOF MS assay, using the MBT STAR-BL software, generally agreed with the results obtained after manual analysis. For the Carba NP test, spectrophotometric analysis found six additional carbapenemase producers.

Department of Microbiology Faculty of Medicine and University Hospital in Plzen Charles University Prague Plzen Czech Republic

Department of Microbiology Faculty of Medicine and University Hospital in Plzen Charles University Prague Plzen Czech Republic Biomedical Center Faculty of Medicine and University Hospital in Plzen Charles University Prague Plzen Czech Republic

Department of Microbiology Medical School University of Thessaly Biopolis Larissa Greece

National Medicines Institute Warsaw Poland

Robert Koch Institute Nosocomial Pathogens and Antibiotic Resistance Wernigerode Germany

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