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Rapid Classification of Clostridioides difficile Strains Using MALDI-TOF MS Peak-Based Assay in Comparison with

Adriana Calderaro1, Mirko Buttrini1, Monica Martinelli2

  • 1Department of Medicine and Surgery, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy.

Microorganisms
|April 3, 2021
PubMed

Insights

Matrix-Assisted Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) offers a rapid alternative for typing Clostridioides difficile strains. This method shows high accuracy and cost-effectiveness for epidemiological tracking of C. difficile infections (CDI).

Area of Science:

  • Clinical Microbiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Growing incidence, severity, and mortality of Clostridioides difficile infections (CDI) necessitate improved typing methods for epidemiological surveillance.
  • Current methods like polymerase chain reaction (PCR)-ribotyping are effective but can be time-consuming and costly for rapid outbreak detection.

Purpose of the Study:

  • To evaluate the efficacy of a typing Matrix-Assisted Desorption/Ionization-Time of Flight Mass Spectrometry (T-MALDI) method for rapid classification of C. difficile strains.
  • To compare the performance of T-MALDI against established PCR-ribotyping for epidemiological tracking of C. difficile.

Main Methods:

  • Ninety-five C. difficile strains were initially typed using PCR-ribotyping, identifying 10 distinct ribotypes (PR1-PR10).
  • Two classifying algorithm models (CAM) for T-MALDI were tested: one encompassing all 10 ribotypes and a second focusing on the five most prevalent ribotypes (PR1-PR5).
  • Performance metrics including recognition capability, cross-validation, and agreement with PCR-ribotyping were assessed.

Main Results:

  • PCR-ribotyping identified 10 ribotypes, with 93.7% of isolates belonging to the five most common types (PR1-PR5).
  • The second CAM for T-MALDI, focusing on PR1-PR5, demonstrated superior performance with 100% recognition capability, 96.6% cross-validation, and 98.4% agreement with PCR-ribotyping.
  • T-MALDI proved highly reproducible, time-efficient, and cost-effective compared to PCR-ribotyping.

Conclusions:

  • T-MALDI serves as a viable and efficient alternative to PCR-ribotyping for the rapid classification of C. difficile strains.
  • The T-MALDI method is a valuable tool for epidemiological investigations, enabling swift detection of C. difficile clusters during outbreaks.
  • Its speed, reproducibility, and cost-effectiveness make T-MALDI suitable for routine surveillance and outbreak response.
Keywords:
Clostridioides difficileMALDI-TOF MSPCR-ribotyping

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