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Ultrasensitive and rapid identification of ESRI developer- and piperacillin/tazobactam-resistant Escherichia coli by
Angel Rodríguez Villodres1,2, Lydia Gálvez Benítez1,2, Manuel J Arroyo3
1Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Virgen del Rocío University Hospital, Seville, Spain.
Background:
The excessive use of piperacillin/tazobactam (P/T) has promoted the emergence of P/T-resistant Enterobacterales. We reported that in Escherichia coli, P/T contributes to the development of extended-spectrum resistance to β-lactam/β-lactamase inhibitor (BL/BLI) (ESRI) in isolates that are P/T susceptible but have low-level resistance to BL/BLI. Currently, the detection of P/T resistance relying on conventional methods is time-consuming. To overcome this issue, we developed a cost-effective test based on MALDI-MS technology, called MALDIpiptaz, which aims to detect P/T resistance and ESRI developers in E. coli.
Methods:
We used automated Clover MS Data Analysis software to analyse the protein profile spectra obtained by MALDI-MS from a collection of 248 E. coli isolates (91 P/T-resistant, 81 ESRI developers and 76 P/T-susceptible). This software allowed to preprocess all the spectra to build different peak matrices that were analysed by machine learning algorithms.
Results:
We demonstrated that MALDIpiptaz can efficiently and rapidly (15 min) discriminate between P/T-resistant, ESRI developer and P/T-susceptible isolates and allowed the correct classification between ESRI developers from their isogenic resistance to P/T.
Conclusion:
The combination of excellent performance and cost-effectiveness are all desirable attributes, allowing the MALDIpiptaz test to be a useful tool for the rapid determination of P/T resistance in clinically relevant E. coli isolates.
Insights
A new MALDIpiptaz test rapidly detects piperacillin/tazobactam (P/T) resistance in E. coli. This cost-effective MALDI-MS method distinguishes P/T-resistant, susceptible, and extended-spectrum resistance to β-lactam/β-lactamase inhibitor (ESRI) developing isolates.
Area of Science:
- Microbiology
- Clinical Diagnostics
- Mass Spectrometry
Background:
- Piperacillin/tazobactam (P/T) resistance is increasing in Enterobacterales.
- Escherichia coli can develop extended-spectrum resistance to β-lactam/β-lactamase inhibitors (ESRI) even when initially susceptible to P/T.
- Conventional P/T resistance detection methods are time-consuming.
Purpose of the Study:
- To develop a rapid, cost-effective test for detecting P/T resistance in E. coli.
- To identify isolates developing ESRI using MALDI-MS technology.
- To differentiate P/T-resistant, ESRI-developing, and P/T-susceptible E. coli isolates.
Main Methods:
- Utilized MALDI-MS technology to analyze protein profiles of 248 E. coli isolates.
- Employed automated Clover MS Data Analysis software for spectral preprocessing and peak matrix generation.
- Applied machine learning algorithms to analyze the data for resistance detection.
Main Results:
- The developed MALDIpiptaz test accurately discriminated between P/T-resistant, ESRI-developing, and P/T-susceptible E. coli isolates.
- The test achieved rapid results within 15 minutes.
- Correct classification of ESRI developers distinct from their P/T resistance was demonstrated.
Conclusions:
- MALDIpiptaz is an efficient and rapid tool for determining P/T resistance in clinically relevant E. coli.
- The test's cost-effectiveness and performance make it valuable for clinical settings.
- This method aids in timely identification of resistance patterns for improved patient management.
