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

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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.

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References

  • Ballhausen B, Kriegeskorte A, Schleimer N, Peters G, Becker K (2014) The mecA homolog mecC confers resistance against β-lactams in Staphylococcus aureus irrespective of the genetic strain background. Antimicrob Agents Chemother 58:3791–3798

    Article  Google Scholar 

  • Chatterjee SS, Chen L, Joo HS, Cheung GYC, Kreiswirth BN, Otto M (2011) Distribution and regulation of the mobile genetic element-encoded phenol-soluble modulin PSM-mec in methicillin-resistant Staphylococcus aureus. PLoS One 6:e28781

    Article  CAS  Google Scholar 

  • de Kraker MEA, Davey PG, Grundmann H (2011) Mortality and hospital stay associated with resistant Staphylococcus aureus and Escherichia coli bacteremia: estimating the burden of antibiotic resistance in Europe. PLoS Med 8:e1001104

    Article  Google Scholar 

  • Du Z, Yang R, Guo Z, Song Y, Wang J (2002) Identification of Staphylococcus aureus and determination of its methicillin resistance by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Anal Chem 74:5487–5491

    Article  CAS  Google Scholar 

  • Edwards-Jones V, Claydon MA, Evason DJ, Walker J, Fox AJ, Gordon DB (2000) Rapid discrimination between methicillin-sensitive and methicillin-resistant Staphylococcus aureus by intact cell mass spectrometry. J Med Microbiol 49:295–300

    Article  CAS  Google Scholar 

  • European Committee on Antimicrobial Susceptibility Testing (EUCAST) (2017) EUCAST guidelines for detection of resistance mechanisms and specific resistances of clinical and/or epidemiological importance, Version 2.0. Available at http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Resistance_mechanisms/EUCAST_detection_of_resistance_mechanisms_170711.pdf

  • Fedorko DP, Stock F, Murray PR, Drake SK (2012) Identification of clinical isolates of anaerobic bacteria using matrix-assisted laser desorption ionization-time of flight mass spectrometry. Eur J Clin Microbiol Infect Dis 31:2257–2262

    Article  CAS  Google Scholar 

  • Gagnaire J, Dauwalder O, Boisset S, Khau D, Freydière AM, Ader F, Bes M, Lina G, Tristan A, Reverdy ME, Marchand A, Geissmann T, Benito Y, Durand G, Charrier JP, Etienne J, Welker M, Van Belkum A, Vandenesch F (2012) Detection of Staphylococcus aureus delta-toxin production by whole-cell MALDI-TOF mass spectrometry. PLoS One 7:e40660

    Article  CAS  Google Scholar 

  • García-Álvarez L, Holden MTG, Lindsay H, Webb CR, Brown DFJ, Curran MD, Walpole E, Brooks K, Pickard DJ, Teale C, Parkhill J, Bentley SD, Edwards GF, Girvan EK, Kearns AM, Pichon B, Hill RLR, Larsen AR, Skov RL, Peacock SJ, Maskell DJ, Holmes MA (2011) Meticillin-resistant Staphylococcus aureus with a novel mecA homologue in human and bovine populations in the UK and Denmark: a descriptive study. Lancet Infect Dis 11:595–603

    Article  Google Scholar 

  • Hanssen AM, Ericson Sollid JU (2006) SCCmec in staphylococci: genes on the move. FEMS Immunol Med Microbiol 46:8–20

    Article  CAS  Google Scholar 

  • Hrabák J, Chudacková E, Walková R (2013) Matrix-assisted laser desorption ionization-time of flight (MALDITOF) mass spectrometry for detection of antibiotic resistance mechanisms: from research to routine diagnosis. Clin Microbiol Rev 26:103–114

    Article  Google Scholar 

  • Jackson KA, Edwards-Jones V, Sutton CW, Fox AJ (2005) Optimisation of intact cell MALDI method for fingerprinting of methicillin-resistant Staphylococcus aureus. J Microbiol Methods 62:273–284

    Article  CAS  Google Scholar 

  • Jang KS, Park M, Lee JY, Kim JS (2017) Mass spectrometric identification of phenol-soluble modulins in the ATCC® 43300 standard strain of methicillin-resistant Staphylococcus aureus harboring two distinct phenotypes. Eur J Clin Microbiol Infect Dis 36:1151–1157

    Article  CAS  Google Scholar 

  • Josten M, Dischinger J, Szekat C, Reif M, Al-Sabti N, Sahl HG, Parcina M, Bekeredjian-Ding I, Bierbaum G (2014) Identification of agr-positive methicillin-resistant Staphylococcus aureus harbouring the class a mec complex by MALDI-TOF mass spectrometry. Int J Med Microbiol 304:1018–1023

    Article  CAS  Google Scholar 

  • Kretschmer D, Gleske AK, Rautenberg M, Wang R, Köberle M, Bohn E, Schöneberg T, Rabiet MJ, Boulay F, Klebanoff SJ, Van Kessel KA, Van Strijp JA, Otto M, Peschel A (2010) Human formyl peptide receptor 2 senses highly pathogenic Staphylococcus aureus. Cell Host Microbe 7:463–473

    Article  CAS  Google Scholar 

  • Lagacé-Wiens PRS, Adam HJ, Karlowsky JA, Nichol KA, Pang PF, Guenther J, Webb AA, Miller C, Alfa MJ (2012) Identification of blood culture isolates directly from positive blood cultures by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry and a commercial extraction system: analysis of performance, cost, and turnaround time. J Clin Microbiol 50:3324–3328

    Article  Google Scholar 

  • Lakhundi S, Zhang K (2018) Methicillin-resistant Staphylococcus aureus: molecular characterization, evolution, and epidemiology. Clin Microbiol Rev 12:e00020–e00018

    Google Scholar 

  • Liu J, Chen D, Peters BM, Li L, Li B, Xu Z, Shirliff ME (2016) Staphylococcal chromosomal cassettes mec (SCCmec): a mobile genetic element in methicillin-resistant Staphylococcus aureus. Microb Pathog 101:56–67

    Article  CAS  Google Scholar 

  • Majcherczyk PA, McKenna T, Moreillon P, Vaudaux P (2006) The discriminatory power of MALDI-TOF mass spectrometry to differentiate between isogenic teicoplanin-susceptible and teicoplanin-resistant strains of methicillin-resistant Staphylococcus aureus. FEMS Microbiol Lett 255:233–239

    Article  CAS  Google Scholar 

  • Marshall C, Kossmann T, Wesselingh S, Spelman D (2004) Methicillin-resistant Staphylococcus aureus and beyond: What's new in the world of the 'golden staph'? ANZ J Surg 74:465–469

    Article  Google Scholar 

  • Novick RP, Schlievert P, Ruzin A (2001) Pathogenicity and resistance islands of staphylococci. Microbes Infect 3:585–594

    Article  CAS  Google Scholar 

  • Otto M (2014) Phenol-soluble modulins. Int J Med Microbiol 304:164–169

    Article  CAS  Google Scholar 

  • Purrello SM, Garau J, Giamarellos E, Mazzei T, Pea F, Soriano A, Stefani S (2016) Methicillin-resistant Staphylococcus aureus infections: a review of the currently available treatment options. J Glob Antimicrob Resist 7:178–186

    Article  CAS  Google Scholar 

  • Rhoads DD, Wang H, Karichu J, Richter SS (2016) The presence of a single MALDI-TOF mass spectral peak predicts methicillin resistance in staphylococci. Diagn Microbiol Infect Dis 86:257–261

    Article  CAS  Google Scholar 

  • Rozgonyi F, Kocsis E, Kristóf K, Nagy K (2007) Is MRSA more virulent than MSSA? Clin Microbiol Infect 13:843–845

    Article  CAS  Google Scholar 

  • Schuster D, Josten M, Janssen K, Bodenstein I, Albert C, Schallenberg A, Gajdiss M, Sib E, Szekat C, Kehl K, Parčina M, Hischebeth GTR, Bierbaum G (2018) Detection of methicillin-resistant coagulase-negative staphylococci harboring the class A mec complex by MALDI-TOF mass spectrometry. Int J Med Microbiol 308:522–526

    Article  CAS  Google Scholar 

  • Shah HN, Rajakaruna L, Ball G, Misra R, Al-Shahib A, Fang M, Gharbia SE (2011) Tracing the transition of methicillin resistance in sub-populations of Staphylococcus aureus, using SELDI-TOF mass spectrometry and artificial neural network analysis. Syst Appl Microbiol 34:81–86

    Article  CAS  Google Scholar 

  • Shore AC, Deasy EC, Slickers P, Brennan G, O'Connell B, Monecke S, Ehricht R, Coleman DC (2011) Detection of staphylococcal cassette chromosome mec type XI carrying highly divergent mecA, mecI, mecR1, blaZ, and ccr genes in human clinical isolates of clonal complex 130 methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 55:3765–3773

    Article  CAS  Google Scholar 

  • Stevenson LG, Drake SK, Shea YR, Zelazny AM, Murray PR (2010) Evaluation of matrix-assisted laser desorption ionization - time of flight mass spectrometry for identification of clinically important yeast species. J Clin Microbiol 48:3482–3486

    Article  CAS  Google Scholar 

  • Sunagar R, Hegde NR, Archana GJ, Sinha AY, Nagamani K, Isloor S (2016) Prevalence and genotype distribution of methicillin-resistant Staphylococcus aureus (MRSA) in India. J Glob Antimicrob Resist 7:46–52

    Article  Google Scholar 

  • Walker J, Fox AJ, Edwards-Jones V, Gordon DB (2002) Intact cell mass spectrometry (ICMS) used to type methicillin-resistant Staphylococcus aureus: media effects and inter-laboratory reproducibility. J Microbiol Methods 48:117–126

    Article  CAS  Google Scholar 

  • Wang R, Braughton KR, Kretschmer D, Bach THL, Queck SY, Li M, Kennedy AD, Dorward DW, Klebanoff SJ, Peschel A, DeLeo FR, Otto M (2007) Identification of novel cytolytic peptides as key virulence determinants for community-associated MRSA. Nat Med 13:1510–1514

    Article  CAS  Google Scholar 

  • Watson PF, Petrie A (2010) Method agreement analysis: a review of correct methodology. Theriogenology 73:1167–1179

    Article  CAS  Google Scholar 

  • Wolters M, Rohde H, Maier T, Belmar-Campos C, Franke G, Scherpe S, Aepfelbacher M, Christner M (2011) MALDI-TOF MS fingerprinting allows for discrimination of major methicillin-resistant Staphylococcus aureus lineages. Int J Med Microbiol 301:64–68

    Article  CAS  Google Scholar 

  • Xie X, Bao Y, Ouyang N, Dai X, Pan K, Chen B, Deng Y, Wu X, Xu F, Li H, Huang S (2016) Molecular epidemiology and characteristic of virulence gene of community-acquired and hospital-acquired methicillin-resistant Staphylococcus aureus isolates in Sun Yat-sen Memorial hospital, Guangzhou, Southern China. BMC Infect Dis 16:339

    Article  Google Scholar 

Download references

Funding

This work was supported by the Medical Research Foundation of the Czech Republic (grant number NV19-05-00541).

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Authors and Affiliations

  1. Department of Microbiology, Faculty of Medicine and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic

    Veronika Paskova, Katerina Chudejova, Anna Sramkova, Lucie Kraftova, Costas C. Papagiannitsis & Jaroslav Hrabak

  2. Biomedical Center, Faculty of Medicine, Charles University, Pilsen, Czech Republic

    Veronika Paskova, Katerina Chudejova, Anna Sramkova, Lucie Kraftova, Vladislav Jakubu, Helena Zemlickova, Costas C. Papagiannitsis & Jaroslav Hrabak

  3. National Reference Laboratory for Antibiotics, National Institute of Public Health, Prague, Czech Republic

    Vladislav Jakubu & Helena Zemlickova

  4. Department of Clinical Microbiology, University Hospital and Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic

    Vladislav Jakubu, Helena Zemlickova & Katerina Neradova

  5. Department of Microbiology, University Hospital of Larissa, Larissa, Greece

    Efthimia A. Petinaki

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  1. Veronika Paskova
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  2. Katerina Chudejova
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Correspondence to Jaroslav Hrabak.

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Paskova, V., Chudejova, K., Sramkova, A. et al. Insufficient repeatability and reproducibility of MALDI-TOF MS-based identification of MRSA. Folia Microbiol 65, 895–900 (2020). https://doi.org/10.1007/s12223-020-00799-0

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