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Kim, Yong, In, Park, and Lee: Application of Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry to Screen the Extended-Spectrum β-Lactamase-Producing ST131 Escherichia coli Strains
Original Article

Ann Clin Microbiol 2016;19(3):65-69.

Published online: 12 September 2016

DOI: https://doi.org/10.5145/ACM.2021.19.3.65

Application of Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry to Screen the Extended-Spectrum β-Lactamase-Producing ST131 Escherichia coli Strains

Young Ah Kim1, Dongeun Yong2, Yong Ha In3, Hyung Soon Park3, Kyungwon Lee2

1Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang

2Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Suwon, Korea

3R&D Center, ASTA Inc, Suwon, Korea

Correspondence: Dongeun Yong, Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. (Tel) 82-2-2228-2442, (Fax) 82-2-364-1583, (E-mail) deyong@yuhs.ac

Received 18 July 2016       Revised 29 August 2016       Accepted 30 August 2016

Copyright © 2016 The Korean Society of Clinical Microbiology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Sequence type 131 (ST131) O25b serogroup Escherichia coli, producing CTX-M type ex-tended-spectrum β-lactamase (ESBL), is a major clone involved in worldwide pandemic spread in both community- and healthcare-associated infections. Recently, matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) has become a routine tool for the identification of bacteria in many laboratories. This study aimed to assess the performance of MALDI-TOF MS for the screening of ESBL-producing E. coli ST131 in a rapid, inexpensive, and simple way.

Methods

A total 26 clinical E. coli, isolated from blood between 2013 and 2014, were used. The characteristics are ST131-O25b ESBL producers (n=6), ST131-O16 ESBL producers (n=4), non-ST131 ESBL producers (n=11), and non-ST131 non-ESBL producers (n=5). Specific biomarker peaks to distinguish the ST131 clonal group from others were investigated by MicroIDSys (ASTA, South Korea) and ASTA Tinker-bell 2.0 software.

Results

A peak at 9,713 m/z peak is useful to screen for ST131 E. coli, regardless of serogroup O25 or O16, showing a sensitivity of 100%, specificity of 56.2%, positive predictive value of 58.8%, and negative predictive value of 100% when using a relative intensity cutoff of 15%.

Conclusion

We can screen for ST131 E. coli using MicroIDSys (ASTA), MALDI-TOF MS in a rapid, inex-pensive, and simple way. However, other confirmatory tests are needed to confirm ST131 E. coli due to the low specificity of this method.

Keywords: Escherichia coli, Extended-spectrum-lactamase, Matrix-assisted laser desorption ionization time-of-flight mass spectrometry, Sequence type 131, Serogroup O16, Serogroup O25b

References

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Fig. 1.
Visual inspection of 9,713 m/z for ST131 E. coli with relative intensity 15% (cutoff). Test performance: sensitivity 100%, specificity 56.2%, positive-predictive value 58.8%, and negative-predictive vale 100%.
acm-19-65f1.tif
Table 1.
Characteristics of the 26 Escherichia coli isolates, included in this study
Group N ESBL (n) MLST
PST (n) ST (n)
Non-ST131-ESBL 11 CTX-M-1 (1), CTX-M-14 (3), CTX-M-15 (6), CTX-M-27 (1) PST2 (1), PST3 (1), PST8 (2), PST13 (1), PST39 (1), PST44 (1), PST53 (1), PST253 (1), PST478 (1), PST594 (1)  
Non-ST131-NonESBL 5 None    
ST131-O16-ESBL 4 CTX-M-14 (2), CTX-M-15 (1), CTX-M-27 (1) PST506 (4) ST131 (4)
ST131-O25-ESBL 6 CTX-M-14 (2), CTX-M-15 (4) PST43 (6) ST131 (6)
Total 26      

Abbreviations: n, number; ESBL, extended-spectrum β-lactamase; MLST, multilocus sequence typing; PST, Pasteur method; ST, Achtman method.

Table 2.
The peaks for the detection of ST131 Escherichia coli and their performances
m/z Cutoff (Relative intensity) Positive rate (%) Marker for:
Non-ST131 ST131-O16 ST131-O25
3,580 9 31.3 100.0 16.7 ST131-O16
3,935 6 43.8 100.0 33.3 ST131-O16
5,382 60 31.3 100.0 16.7 ST131-O16
6,256 36 31.3 100.0 16.7 ST131-O16
6,316 25 37.5 100.0 16.7 ST131-O16
6,506 6 37.5 100.0 33.3 ST131-O16
7,159 6 43.8 100.0 16.7 ST131-O16
8,350 5 37.5 50.0 100.0 ST131-O25
8,993 7 43.8 100.0 33.3 ST131-O16
9,536 17 37.5 100.0 50.0 ST131-O16
9,713 15 43.8 100.0 100.0 ST131-O16 & O25

Cutoff 0.15=relative intensity 15%.

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