Insufficient repeatability and reproducibility of MALDI-TOF MS-based identification of MRSA

Folia Microbiol (Praha). 2020 Oct;65(5):895-900. doi: 10.1007/s12223-020-00799-0. Epub 2020 Jul 2.

Abstract

Rapid identification of methicillin-resistant Staphylococcus aureus (MRSA) is essential for proper initial antibiotic therapy and timely set up of hygienic measures. Recently, detection of MRSA using MALDI-TOF mass spectrometer mediated by the peptide-phenol-soluble modulin (PSM-mec)-linked to the class A mec gene complex present in SCCmec cassettes types II, III, and VIII of MRSA strains, has been commercially available. We present here a multicentre study on MALDI-TOF MS detection of MRSA evincing a poor repeatability and reproducibility of the assay. The sensitivity of the assay varies between 50 and 90% in strains carrying psmMEC and psmδ genes encoding for PSM-mec and δ-toxin (a member of the PSM peptide family), respectively. No false positive results were found. The very major error calculation was 30% and the major error achieved 0%. Interlaboratory repeatability varies between 0 and 100%. No significant difference was observed with the use of different cultivation media. Our data showed a poor sensitivity of the method excluding it from the use in routine laboratory testing.

Keywords: MALDI-TOF MS; MRSA; PSM.

Publication types

  • Multicenter Study

MeSH terms

  • Bacterial Toxins / genetics
  • Diagnostic Errors
  • Diagnostic Tests, Routine
  • Humans
  • Methicillin-Resistant Staphylococcus aureus / genetics
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Molecular Diagnostic Techniques*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization*
  • Staphylococcal Infections / diagnosis*
  • Staphylococcal Infections / microbiology

Substances

  • Bacterial Toxins
  • staphylococcal delta toxin