Application of MALDI-TOF Protein Profiles for Rapid Detection of Streptococcus agalactiae Highly Virulent Strains: ST1

Expanding the capacity of Matrix-Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) beyond species identification to strain typing becomes a new challenge in clinical microbiology. This study demonstrated a specific identification of Streptococcus agalactiae sequence type 1 (ST1) by a manual decision tree and automatically ranking from the newly added MTPPs library, which has not been previously reported. The mass spectra of 25 STs (277 isolates) were generated. The presence and absence of specific peaks were combined to create a decision tree for manual identification. Three peaks at 3127, 5914, and 6252 in combination with m/z 3368 and 6281 were used for primary identification of ST1. However, to differentiate ST1 and ST314, five additional peaks were required. For the automatic system, the MTPP of all isolates was divided into three training–testing ratios of 40:60, 50:50, and 60:40. All categories revealed excellent accuracy rates of above 90% for ST1 identification. The 60:40 group showed the highest overall performance, in which sensitivity was observed at 83.9 to 96.8%, and specificity reached up to 100.0% for both the top two and the top three matches. In conclusion, we propose that the MTPP from MALDI-TOF is a potential model for speedy bacterial typing, crucial in epidemiology, prevention, and patient management.