Application of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) in the detection of drug resistance of Mycobacterium tuberculosis in re-treated patients

Jichan Shi; Guiqing He; Hongye Ning; Lianpeng Wu; Zhengxin Wu; Xinchun Ye; Chaochao Qiu; Xiangao Jiang

doi:10.1016/j.tube.2022.102209

Application of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) in the detection of drug resistance of Mycobacterium tuberculosis in re-treated patients

Tuberculosis (Edinb). 2022 Jul:135:102209. doi: 10.1016/j.tube.2022.102209. Epub 2022 Apr 30.

Authors

Jichan Shi¹, Guiqing He², Hongye Ning¹, Lianpeng Wu², Zhengxin Wu¹, Xinchun Ye¹, Chaochao Qiu¹, Xiangao Jiang³

Affiliations

¹ The Dingli Clinical College of Wenzhou Medical University, Department of Infectious Disease of Wenzhou Central Hospital, Wenzhou, Zhejiang, 325000, People's Republic of China.
² The Dingli Clinical Institute of Wenzhou Medical University, Department of Laboratory, Wenzhou Central Hospital, Wenzhou, Zhejiang, 325000, People's Republic of China.
³ The Dingli Clinical College of Wenzhou Medical University, Department of Infectious Disease of Wenzhou Central Hospital, Wenzhou, Zhejiang, 325000, People's Republic of China. Electronic address: jxgjxg11@163.com.

PMID: 35550524
DOI: 10.1016/j.tube.2022.102209

Abstract

Objective: To evaluate the value of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) in the detection of drug resistance of Mycobacterium tuberculosis in re-treated patients.

Methods: MALDI-TOF MS was used to detect the resistance of 202 cases of retreatment pulmonary tuberculosis infection strains to isoniazid (INH), rifampin (RFP), ethambutol (EMB), streptomycin (SM), ofloxacin (Ofx), moxifloxacin (Mfx), amikacin (Am), Kanamycin (Km) and capreomycin (Cm), and the results were compared with those of BACTEC 960 liquid culture detection to compare the coincidence rate of the two methods.

Results: MALDI-TOF MS detected 60 copies of Mtb gene mutation, and drug-resistant gene mutation strains accounted for 34.68% (60/173) of positive strains. Rifampicin-related rpoB gene mutations accounted for 86.67% (52/60), isoniazid-related katG + inhA gene mutations accounted for 80.00% (48/60) and inhA-15 gene mutations accounted for 8.33% (5/60), streptomycin-related rpsL gene mutations accounted for 28.33% (17/60), ethambutol-related embB gene mutations accounted for 45.00% (27/60), quinolone-related gyrA basic mutation accounted for 26.67% (16/60), ethyl/propylthiamine-related embB gene mutation accounted for 36.67% (22/60) and inhA-15 gene mutation accounted for 10.00% (6/60), aminoglycoside-related rrs gene mutation accounted for 26.67% (16/60), clofazimine Fazimine, bedaquiline related Rv0678 193 gene mutations accounted for 3.33% (2/60), pyrazinamide, p-aminosalicylate, linezolid were not seen mutated genes. Multi-gene mutant strains accounted for 63.33% (38/60) of drug-resistant strains.

Conclusion: MALDI-TOF MS assay has good agreement with BACTEC960 liquid culture drug sensitivity test, which can be a rapid and effective method to screen for drug resistance of Mycobacterium tuberculosis, and has some clinical application value in patients with relapse tuberculosis.

Keywords: Comparative study; Drug resistance; MALDI-TOF MS assay; Retreatment; Tuberculosis.

Publication types

Review

MeSH terms

Antitubercular Agents / pharmacology
Antitubercular Agents / therapeutic use
Drug Resistance
Ethambutol / pharmacology
Humans
Isoniazid / pharmacology
Lasers
Microbial Sensitivity Tests
Mutation
Mycobacterium tuberculosis* / genetics
Rifampin / pharmacology
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
Streptomycin / pharmacology
Tuberculosis, Lymph Node*
Tuberculosis, Multidrug-Resistant* / diagnosis
Tuberculosis, Multidrug-Resistant* / drug therapy
Tuberculosis, Multidrug-Resistant* / microbiology

Substances

Antitubercular Agents
Ethambutol
Isoniazid
Rifampin
Streptomycin