https://scholars.lib.ntu.edu.tw/handle/123456789/637167
標題: | Prediction of methicillin-resistant Staphylococcus aureus and carbapenem-resistant Klebsiella pneumoniae from flagged blood cultures by combining rapid Sepsityper MALDI-TOF mass spectrometry with machine learning | 作者: | Yu, Jiaxin Lin, Hsiu-Hsien Tseng, Kun-Hao Lin, Yu-Tzu Chen, Wei-Cheng Tien, Ni Cho, Chia-Fong Liang, Shinn-Jye Ho, Lu-Ching Hsieh, Yow-Wen Hsu, Kai Cheng Ho, Mao-Wang PO-REN HSUEH Cho, Der-Yang |
關鍵字: | Carbapenem-resistant Klebsiella pneumoniae; MALDI-TOF MS; Machine learning; Methicillin-resistant Staphylococcus aureus; Prediction platform; Specific MBT-Sepsityper module | 公開日期: | 4-十月-2023 | 卷: | 62 | 期: | 6 | 來源出版物: | International journal of antimicrobial agents | 摘要: | This study investigated combination of the Rapid Sepsityper Kit and a machine learning (ML)-based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) approach for rapid prediction of methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Klebsiella pneumoniae (CRKP) from positive blood culture bottles. The study involved 461 patients with monomicrobial bloodstream infections. Species identification was performed using the conventional MALDI-TOF MS Biotyper system and the Rapid Sepsityper protocol. The data underwent preprocessing steps, and ML models were trained using preprocessed MALDI-TOF data and corresponding labels. The interpretability of the model was enhanced using SHapely Additive exPlanations values to identify significant features. In total, 44 S. aureus isolates comprising 406 MALDI-TOF MS files and 126 K. pneumoniae isolates comprising 1249 MALDI-TOF MS files were evaluated. This study demonstrated the feasibility of predicting MRSA among S. aureus and CRKP among K. pneumoniae isolates using MALDI-TOF MS and Sepsityper. Accuracy, area under the receiver operating characteristic curve, and F1 score for MRSA/methicillin-susceptible S. aureus were 0.875, 0.898 and 0.904, respectively; for CRKP/carbapenem-susceptible K. pneumoniae, these values were 0.766, 0.828 and 0.795, respectively. In conclusion, the novel ML-based MALDI-TOF MS approach enables rapid identification of MRSA and CRKP from flagged blood cultures within 1 h. This enables earlier initiation of targeted antimicrobial therapy, reducing deaths due to sepsis. The favourable performance and reduced turnaround time of this method suggest its potential as a rapid detection strategy in clinical microbiology laboratories, ultimately improving patient outcomes. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/637167 | ISSN: | 09248579 | DOI: | 10.1016/j.ijantimicag.2023.106994 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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