Matrix-assisted Laser Desorption/Ionization Time-of-flight Mass Spectrometry for Determination of Resistance to Antibiotics
Abstract
Antibiotic resistance is a growing problem of current medicine worldwide, having significant impact on human health and economy. Rapid determination of susceptibility to antimicrobials in bacteria including detection of resistance mechanisms are crucial not only for successful treatment of infectious diseases in individual patients, but also for prevention of nosocomial acquisition and further transmission of multidrug resistant bacteria.
For that reason, there is an urgent need to develop highly sensitive and automatized methods that can be implemented in microbiology diagnostic laboratories. The current research demonstates that MALDI-TOF MS is becoming a very promising tool for detection of antibiotic resistance.
Several techniques have been developed up to know, some of them, such as MALDI-TOF detection of carbapenemases, have been already introduced into routine diagnostics. Pioneering works using MALDI-TOF for qualitative or quantitative evaluation of susceptibility or resistance as well as several techniques for detection clinically relevant pathogens (e.g., methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci) or specific antibacterial activity (e.g., beta-lactamase, ribosomal RNA methyltransferase) have been published and highlight many pitfalls during the early method development.
Introduction of novel techniques using MALDI-TOF MS approaches as well as optimalization, validation and full automatization of these methods, increasing their reproducibility and decreasing the costs, are urgently needed. It is quite evident that MALDI-TOF MS technology will play an important role in routine diagnostics of antibacterial susceptibility as well as in epidemiological surveillance, overall, improving the quality of health care.