ABSTRACT

Background

The excessive use of piperacillin/tazobactam (P/T) has promoted the emergence of P/T-resistant Enterobacterales. We reported that in Escherichia coli, P/T contributes to the development of extended-spectrum resistance to β-lactam/β-lactamase inhibitor (BL/BLI) (ESRI) in isolates that are P/T susceptible but have low-level resistance to BL/BLI. Currently, the detection of P/T resistance relying on conventional methods is time-consuming. To overcome this issue, we developed a cost-effective test based on MALDI-MS technology, called MALDIpiptaz, which aims to detect P/T resistance and ESRI developers in E. coli.

Methods

We used automated Clover MS Data Analysis software to analyse the protein profile spectra obtained by MALDI-MS from a collection of 248 E. coli isolates (91 P/T-resistant, 81 ESRI developers and 76 P/T-susceptible). This software allowed to preprocess all the spectra to build different peak matrices that were analysed by machine learning algorithms.

Results

We demonstrated that MALDIpiptaz can efficiently and rapidly (15 min) discriminate between P/T-resistant, ESRI developer and P/T-susceptible isolates and allowed the correct classification between ESRI developers from their isogenic resistance to P/T.

Conclusion

The combination of excellent performance and cost-effectiveness are all desirable attributes, allowing the MALDIpiptaz test to be a useful tool for the rapid determination of P/T resistance in clinically relevant E. coli isolates.

中文翻译：

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通过 MALDIpiptaz 测试对 ESRI 显影剂和哌拉西林/他唑巴坦耐药大肠杆菌的超灵敏和快速鉴定

摘要

背景

哌拉西林/他唑巴坦（P/T）的过度使用促进了P/T耐药肠杆菌的出现。我们报道，在大肠杆菌中，P/T 有助于在对 P/T 敏感但具有低水平耐药性的分离株中产生对 β-内酰胺/β-内酰胺酶抑制剂 (BL/BLI) (ESRI) 的超广谱耐药性到 BL/BLI。目前，依靠传统方法检测P/T阻力非常耗时。为了克服这个问题，我们开发了一种基于 MALDI-MS 技术的成本效益测试，称为 MALDIpiptaz，旨在检测大肠杆菌中的 P/T 抗性和 ESRI 开发者。

方法

我们使用自动 Clover MS 数据分析软件来分析通过 MALDI-MS 从收集的 248 个大肠杆菌分离物（91 个 P/T 抗性、81 个 ESRI 开发人员和 76 个 P/T 敏感）中获得的蛋白质谱图谱。该软件允许对所有光谱进行预处理，以构建不同的峰矩阵，并通过机器学习算法进行分析。

结果

我们证明了 MALDIpiptaz 可以有效且快速（15 分钟）区分 P/T 抗性、ESRI 显影剂和 P/T 易感分离株，并允许在 ESRI 显影剂之间根据其对 P/T 的同基因抗性进行正确分类。

结论

优异的性能和成本效益的结合都是理想的属性，这使得 MALDIpiptaz 测试成为快速确定临床相关大肠杆菌分离株中 P/T 耐药性的有用工具。