Prediction of Mycobacterium tuberculosis drug resistance by nucleotide MALDI-TOF-MS

Int J Infect Dis. 2022 Aug:121:47-54. doi: 10.1016/j.ijid.2022.04.061. Epub 2022 May 4.

Abstract

Objectives: To evaluate the performance of nucleotide matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) in predicting the drug resistance of Mycobacterium tuberculosis.

Methods: A total of 115 rifampin-resistant and 53 rifampin-susceptible tuberculosis (TB) clinical isolates were randomly selected from TB strains stored at -80℃ in the clinical laboratory of Shanghai Pulmonary Hospital. Nucleotide MALDI-TOF-MS was performed to predict the drug resistance using phenotypic susceptibility as the gold standard.

Results: The overall assay sensitivities and specificities of nucleotide MALDI-TOF-MS were 92.2% and 100.0% for rifampin, 90.9% and 98.6% for isoniazid, 71.4% and 81.2% for ethambutol, 85.1% and 93.1% for streptomycin, 94.0% and 100.0% for amikacin, 77.8% and 99.3% for kanamycin, 75.0% and 93.3% for ofloxacin, and 75.0% and 93.3% for moxifloxacin. The concordances between nucleotide MALDI-TOF-MS antimicrobial susceptibility testing (AST) and phenotypic AST were 94.6% (rifampin), 90.1% (isoniazid), 79.2% (ethambutol), 89.9% (streptomycin), 99.4% (amikacin), 97.0% (kanamycin), 88.1% (ofloxacin), and 88.0% (moxifloxacin).

Conclusion: Nucleotide MALDI-TOF-MS could be a promising tool for rapid detection of Mycobacterium tuberculosis drug sensitivity to rifampin, isoniazid, ethambutol, streptomycin, amikacin, kanamycin, ofloxacin, and moxifloxacin.

Keywords: Antimicrobial susceptibility testing; Drug resistance; Drug-resistant tuberculosis; Nucleotide MALDI-TOF-MS.

MeSH terms

  • Amikacin
  • Antitubercular Agents / pharmacology
  • China
  • Drug Resistance
  • Ethambutol
  • Humans
  • Isoniazid
  • Kanamycin
  • Microbial Sensitivity Tests
  • Moxifloxacin
  • Mycobacterium tuberculosis*
  • Nucleotides
  • Ofloxacin
  • Rifampin
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / methods
  • Streptomycin
  • Tuberculosis, Lymph Node*

Substances

  • Antitubercular Agents
  • Nucleotides
  • Kanamycin
  • Amikacin
  • Ethambutol
  • Ofloxacin
  • Moxifloxacin
  • Isoniazid
  • Rifampin
  • Streptomycin