# Comparative Assessment of the IR Biotyper and Pulsed-Field Gel Electrophoresis (PFGE) for Epidemiological Surveillance of Klebsiella pneumoniae in an Oncology Hospital

## TL;DR

This study compares two methods for tracking Klebsiella pneumoniae in a hospital, finding that the IR Biotyper is fast and effective but needs further validation.

## Contribution

The IR Biotyper's ability to distinguish isolates within a dominant PFGE clone is newly demonstrated for hospital epidemiology.

## Key findings

- The IR Biotyper showed high discriminatory power, identifying 70 FT-IR types.
- PFGE classified isolates into 59 types, with moderate concordance (adjusted Wallace coefficient: 0.515) with the IR Biotyper.
- The IR Biotyper successfully differentiated isolates within PFGE type B, a long-standing clone.

## Abstract

Background/Objectives: Klebsiella pneumoniae is one of the major causes of severe infections in cancer patients. The rapid and accurate typing of isolates is essential for tracking transmission routes and implementing infection control measures. The IR Biotyper, an automated system based on Fourier transform infrared (FT-IR) spectroscopy, enables fast cluster analysis with reduced cost and turnaround time. The aim of this paper was to compare typing results obtained by the IR Biotyper and pulsed-field gel electrophoresis (PFGE) for the epidemiological surveillance of K. pneumoniae in an oncology hospital. Methods: A total of 137 isolates collected between 2020 and 2023 from both colonization and infection were retrospectively analyzed using PFGE and the IR Biotyper. The discriminatory power of both methods and their concordance were assessed. Results: Both methods demonstrated high discriminatory power. PFGE classified the strains into 59 distinct types (96 including subtypes), while the IR Biotyper differentiated 70 FT-IR types. Concordance between the methods was moderate (adjusted Wallace coefficient: 0.515). PFGE type B was the most prevalent, comprising 43 isolates and subdivided into 16 subtypes. The most frequent FT-IR types were 16 (17 isolates), 10 (8 isolates), and 14 (5 isolates), all corresponding to PFGE type B with different subtypes. The IR Biotyper successfully distinguished isolates within the long-standing PFGE type B clone. Conclusions: The IR Biotyper demonstrated good discriminatory capacity and was able to differentiate isolates within a dominant PFGE clone, supporting its potential as a rapid tool for monitoring clonal spread in oncology settings. However, the moderate concordance with PFGE highlights that further studies are needed to optimize performance and confirm its role as a complementary method for routine hospital epidemiological surveillance.