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European Journal of Clinical Microbiology & Infectious Diseases

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16-05-2024 | Cefoxitin | Original Article

Proteomic assay for rapid characterisation of Staphylococcus aureus antimicrobial resistance mechanisms directly from blood cultures

Authors: Francis Deforet, Romain Carrière, Pierre L.’Aour Dufour, Roxane Prat, Chloé Desbiolles, Noémie Cottin, Alicia Reuzeau, Olivier Dauwalder, Céline Dupieux-Chabert, Anne Tristan, Tiphaine Cecchini, Jérôme Lemoine, François Vandenesch

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 7/2024

Abstract

Purpose

Staphylococcus aureus is one of the most common pathogens causing bloodstream infection. A rapid characterisation of resistance to methicillin and, occasionally, to aminoglycosides for particular indications, is therefore crucial to quickly adapt the treatment and improve the clinical outcomes of septic patients. Among analytical technologies, targeted liquid chromatography-tandem mass spectrometry (LC-MS/MS) has emerged as a promising tool to detect resistance mechanisms in clinical samples.

Methods

A rapid proteomic method was developed to detect and quantify the most clinically relevant antimicrobial resistance effectors in S. aureus in the context of sepsis: PBP2a, PBP2c, APH(3’)-III, ANT(4’)-I, and AAC(6’)-APH(2’’), directly from positive blood cultures and in less than 70 min including a 30-min cefoxitin-induction step. The method was tested on spiked blood culture bottles inoculated with 124 S.aureus, accounting for the known genomic diversity of SCCmec types and the genetic background of the strains.

Results

This method provided 99% agreement for PBP2a (n = 98/99 strains) detection. Agreement was 100% for PBP2c (n = 5/5), APH(3’)-III (n = 16/16), and ANT(4’)-I (n = 20/20), and 94% for AAC(6')-APH(2'') (n = 16/17). Across the entire strain collection, 100% negative agreement was reported for each of the 5 resistance proteins. Additionally, relative quantification of ANT(4’)-I expression allowed to discriminate kanamycin-susceptible and -resistant strains, in all strains harbouring the ant(4’)-Ia gene.

Conclusion

The LC-MS/MS method presented herein demonstrates its ability to provide a reliable determination of S. aureus resistance mechanisms, directly from positive blood cultures and in a short turnaround time, as required in clinical laboratories.

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Title: Proteomic assay for rapid characterisation of Staphylococcus aureus antimicrobial resistance mechanisms directly from blood cultures
Authors: Francis Deforet
Romain Carrière
Pierre L.’Aour Dufour
Roxane Prat
Chloé Desbiolles
Noémie Cottin
Alicia Reuzeau
Olivier Dauwalder
Céline Dupieux-Chabert
Anne Tristan
Tiphaine Cecchini
Jérôme Lemoine
François Vandenesch
Publication date: 16-05-2024
Publisher: Springer Berlin Heidelberg
Keywords: Cefoxitin
Aminoglycoside
Published in: European Journal of Clinical Microbiology & Infectious Diseases / Issue 7/2024
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI: https://doi.org/10.1007/s10096-024-04811-0

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