One System for All: Is Mass Spectrometry a Future Alternative for Conventional Antibiotic Susceptibility Testing?

Area of Science:

• Clinical Microbiology
• Diagnostic Technologies
• Mass Spectrometry Applications

Background:

• Clinical microbiology relies on pathogen identification and antibiotic susceptibility testing (AST) for effective treatment.
• Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is standard for microbial identification.
• Routine AST currently depends on conventional and molecular methods, with limited MS integration.

Purpose of the Study:

• To review and evaluate mass spectrometry-based approaches for antibiotic susceptibility testing (AST).
• To compare the advantages and disadvantages of MS-based AST with conventional and molecular techniques.
• To assess the current status and future potential of MS for routine AST.

Main Methods:

• Review of various mass spectrometry (MS) based AST methodologies.
• Analysis of approaches applied to different microbial taxa and resistance mechanisms.
• Evaluation of methods ranging from proof-of-principle to commercialized applications.

Main Results:

• Multiple MS-based AST approaches have been developed, with varying specificity and scope.
• Some MS-based AST methods are commercialized, while others remain in early research stages.
• Comparison highlights potential benefits and drawbacks relative to established AST techniques.

Conclusions:

• Mass spectrometry-based AST is an evolving field with significant potential.
• Widespread adoption of MS for routine AST is not immediate but is a likely future development.
• The rapid advancement mirrors the successful integration of MALDI-TOF MS for microbial identification.