Rapid detection of heterogeneous vancomycin-intermediate staphylococcus aureusbased on matrix-assisted laser desorption ionization time-of-flight: Using a machine learning approach and unbiased validation

Hsin Yao Wang, Chun Hsien Chen, Tzong Yi Lee, Jorng Tzong Horng, Tsui Ping Liu, Yi-Ju Tseng, Jang Jih Lu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

35 Scopus citations

Abstract

Heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) is an emerging superbug with implicit drug resistance to vancomycin. Detecting hVISA can guide the correct administration of antibiotics. However, hVISA cannot be detected in most clinical microbiology laboratories because the required diagnostic tools are either expensive, time consuming, or labor intensive. By contrast, matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) is a cost-effective and rapid tool that has potential for providing antibiotics resistance information. To analyze complex MALDI-TOF mass spectra, machine learning (ML) algorithms can be used to generate robust hVISA detection models. In this study, MALDI-TOF mass spectra were obtained from 35 hVISA/vancomycin-intermediate S. aureus (VISA) and 90 vancomycin-susceptible S. aureus isolates. The vancomycin susceptibility of the isolates was determined using an Etest and modified population analysis profile-area under the curve. ML algorithms, namely a decision tree, k-nearest neighbors, random forest, and a support vector machine (SVM), were trained and validated using nested cross-validation to provide unbiased validation results. The area under the curve of the models ranged from 0.67 to 0.79, and the SVM-derived model outperformed those of the other algorithms. The peaks at m/z 1132, 2895, 3176, and 6591 were noted as informative peaks for detecting hVISA/VISA. We demonstrated that hVISA/VISA could be detected by analyzing MALDI-TOF mass spectra using ML. Moreover, the results are particularly robust due to a strict validation method. The ML models in this study can provide rapid and accurate reports regarding hVISA/VISA and thus guide the correct administration of antibiotics in treatment of S. aureus infection.

Original languageEnglish
Article number2393
JournalFrontiers in Microbiology
Volume9
Issue numberOCT
DOIs
StatePublished - 11 10 2018

Bibliographical note

Publisher Copyright:
© 2007 - 2018 Frontiers Media S.A. All Rights Reserved.

Keywords

  • Heterogeneous vancomycin-intermediate staphylococcus aureus
  • Machine learning
  • Matrix-assisted laser desorption ionization (MALDI) mass spectrometry
  • Rapid detection
  • Vancomycin intermediate S. Aureus (VISA)

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