Application value of nucleic acid MALDI-TOF MS in mycobacterial species identification and drug resistance detection in Mycobacterium tuberculosis

ABSTRACT Tuberculosis (TB) and non-tuberculous mycobacteria (NTM) infections pose global health threats, requiring swift and accurate identification for effective treatment. This study aims to assess the ability of nucleic acid matrix-assisted laser desorption ionization time-of-flight mass spectrom...

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Main Authors: Xiaofang Liu, Honghong Niu, Donglin Guo, Huixia Gao, Lihong Wu, Jingyang Liu, Chunfeng Bai, Yuxi Li, Peilong Wang, Zhengfeng Zhou, Yuling Wang, Jianqin Liang, Wenping Gong
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Language:English
Published: American Society for Microbiology 2025-05-01
Series:Microbiology Spectrum
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Online Access:https://journals.asm.org/doi/10.1128/spectrum.01545-24
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author Xiaofang Liu
Honghong Niu
Donglin Guo
Huixia Gao
Lihong Wu
Jingyang Liu
Chunfeng Bai
Yuxi Li
Peilong Wang
Zhengfeng Zhou
Yuling Wang
Jianqin Liang
Wenping Gong
author_facet Xiaofang Liu
Honghong Niu
Donglin Guo
Huixia Gao
Lihong Wu
Jingyang Liu
Chunfeng Bai
Yuxi Li
Peilong Wang
Zhengfeng Zhou
Yuling Wang
Jianqin Liang
Wenping Gong
author_sort Xiaofang Liu
collection DOAJ
description ABSTRACT Tuberculosis (TB) and non-tuberculous mycobacteria (NTM) infections pose global health threats, requiring swift and accurate identification for effective treatment. This study aims to assess the ability of nucleic acid matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) to rapidly identify Mycobacterium tuberculosis (MTB), NTM, and the drug resistance of MTB. A comparative analysis of 133 clinical samples was performed using acid-fast bacilli (AFB) staining, Lowenstein–Jensen (LJ) culture, GeneXpert, real-time PCR, and nucleic acid MALDI-TOF MS. The study focused on the diagnostic performance of nucleic acid MALDI-TOF MS in detecting MTB and NTM, as well as its accuracy in identifying the drug resistance profiles of MTB. The positive detection rate of nucleic acid MALDI-TOF MS for mycobacterium was 84.96%, which was significantly higher than that of AFB staining (29.32%). For NTM, nucleic acid MALDI-TOF MS had 89.29% sensitivity and 97.14% specificity, with an area under the curve (AUC) of 0.932, which was superior to other methods. The nucleic acid MALDI-TOF MS identified 28 NTM species, while real-time PCR identified only 12. Drug resistance detection showed concordance rates of 80% to 95% compared with drug sensitivity tests of LJ culture. Nucleic acid MALDI-TOF identified mutations, like KatG315 AGC-ACC for low-level isoniazid resistance, rpoB 531 TCG-TTG for high-level rifampicin resistance, and the InhA-15 C-T mutations, were also found in six isoniazid resistance cases and prothionamide resistance cases. Nucleic acid MALDI-TOF MS is a valuable diagnostic tool for the rapid and precise identification of mycobacterial species and the drug resistance profiles of MTB. With high sensitivity and specificity, it can guide the early initiation of effective anti-tuberculosis treatment in clinical settings.IMPORTANCETuberculosis (TB) remains a critical global health challenge, exacerbated by the emergence of drug-resistant strains. Accurate, rapid diagnosis is imperative for effective treatment and control of TB. The ability to discern MTB from NTM is equally vital, as they demand distinct therapeutic approaches. This study underscores the significance of nucleic acid matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) technology in providing a swift and precise diagnostic tool. Its high sensitivity and specificity in identifying mycobacterial species and their resistance profiles are paramount for guiding targeted anti-tuberculosis therapy. By potentially reducing the time to diagnosis and enabling personalized treatment plans, this technology could revolutionize TB management, ultimately mitigating its impact on public health.
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spelling doaj-art-8929b0aca4634a4ebfd78aab5e5a666a2025-08-20T03:11:29ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972025-05-0113510.1128/spectrum.01545-24Application value of nucleic acid MALDI-TOF MS in mycobacterial species identification and drug resistance detection in Mycobacterium tuberculosisXiaofang Liu0Honghong Niu1Donglin Guo2Huixia Gao3Lihong Wu4Jingyang Liu5Chunfeng Bai6Yuxi Li7Peilong Wang8Zhengfeng Zhou9Yuling Wang10Jianqin Liang11Wenping Gong12Institute of Tuberculosis, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, ChinaInstitute of Tuberculosis, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, ChinaInstitute of Tuberculosis, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, ChinaHebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, Shijiazhuang, ChinaInstitute of Tuberculosis, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, ChinaInstitute of Tuberculosis, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, ChinaInstitute of Tuberculosis, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, ChinaInstitute of Tuberculosis, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, ChinaInstitute of Tuberculosis, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, ChinaInstitute of Tuberculosis, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, ChinaHebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, Shijiazhuang, ChinaInstitute of Tuberculosis, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, ChinaInstitute of Tuberculosis, Senior Department of Tuberculosis, The Eighth Medical Center of PLA General Hospital, Beijing, ChinaABSTRACT Tuberculosis (TB) and non-tuberculous mycobacteria (NTM) infections pose global health threats, requiring swift and accurate identification for effective treatment. This study aims to assess the ability of nucleic acid matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) to rapidly identify Mycobacterium tuberculosis (MTB), NTM, and the drug resistance of MTB. A comparative analysis of 133 clinical samples was performed using acid-fast bacilli (AFB) staining, Lowenstein–Jensen (LJ) culture, GeneXpert, real-time PCR, and nucleic acid MALDI-TOF MS. The study focused on the diagnostic performance of nucleic acid MALDI-TOF MS in detecting MTB and NTM, as well as its accuracy in identifying the drug resistance profiles of MTB. The positive detection rate of nucleic acid MALDI-TOF MS for mycobacterium was 84.96%, which was significantly higher than that of AFB staining (29.32%). For NTM, nucleic acid MALDI-TOF MS had 89.29% sensitivity and 97.14% specificity, with an area under the curve (AUC) of 0.932, which was superior to other methods. The nucleic acid MALDI-TOF MS identified 28 NTM species, while real-time PCR identified only 12. Drug resistance detection showed concordance rates of 80% to 95% compared with drug sensitivity tests of LJ culture. Nucleic acid MALDI-TOF identified mutations, like KatG315 AGC-ACC for low-level isoniazid resistance, rpoB 531 TCG-TTG for high-level rifampicin resistance, and the InhA-15 C-T mutations, were also found in six isoniazid resistance cases and prothionamide resistance cases. Nucleic acid MALDI-TOF MS is a valuable diagnostic tool for the rapid and precise identification of mycobacterial species and the drug resistance profiles of MTB. With high sensitivity and specificity, it can guide the early initiation of effective anti-tuberculosis treatment in clinical settings.IMPORTANCETuberculosis (TB) remains a critical global health challenge, exacerbated by the emergence of drug-resistant strains. Accurate, rapid diagnosis is imperative for effective treatment and control of TB. The ability to discern MTB from NTM is equally vital, as they demand distinct therapeutic approaches. This study underscores the significance of nucleic acid matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) technology in providing a swift and precise diagnostic tool. Its high sensitivity and specificity in identifying mycobacterial species and their resistance profiles are paramount for guiding targeted anti-tuberculosis therapy. By potentially reducing the time to diagnosis and enabling personalized treatment plans, this technology could revolutionize TB management, ultimately mitigating its impact on public health.https://journals.asm.org/doi/10.1128/spectrum.01545-24nucleic acidmass spectrometryMycobacterium tuberculosisnon-tuberculous mycobacteriaspecies identificationdrug susceptibility
spellingShingle Xiaofang Liu
Honghong Niu
Donglin Guo
Huixia Gao
Lihong Wu
Jingyang Liu
Chunfeng Bai
Yuxi Li
Peilong Wang
Zhengfeng Zhou
Yuling Wang
Jianqin Liang
Wenping Gong
Application value of nucleic acid MALDI-TOF MS in mycobacterial species identification and drug resistance detection in Mycobacterium tuberculosis
Microbiology Spectrum
nucleic acid
mass spectrometry
Mycobacterium tuberculosis
non-tuberculous mycobacteria
species identification
drug susceptibility
title Application value of nucleic acid MALDI-TOF MS in mycobacterial species identification and drug resistance detection in Mycobacterium tuberculosis
title_full Application value of nucleic acid MALDI-TOF MS in mycobacterial species identification and drug resistance detection in Mycobacterium tuberculosis
title_fullStr Application value of nucleic acid MALDI-TOF MS in mycobacterial species identification and drug resistance detection in Mycobacterium tuberculosis
title_full_unstemmed Application value of nucleic acid MALDI-TOF MS in mycobacterial species identification and drug resistance detection in Mycobacterium tuberculosis
title_short Application value of nucleic acid MALDI-TOF MS in mycobacterial species identification and drug resistance detection in Mycobacterium tuberculosis
title_sort application value of nucleic acid maldi tof ms in mycobacterial species identification and drug resistance detection in mycobacterium tuberculosis
topic nucleic acid
mass spectrometry
Mycobacterium tuberculosis
non-tuberculous mycobacteria
species identification
drug susceptibility
url https://journals.asm.org/doi/10.1128/spectrum.01545-24
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