A prospective study of acinetobacter baumannii complex isolates and colistin susceptibility monitoring by mass spectrometry of microbial membrane glycolipids

Lisa M. Leung, Christi L. McElheny, Francesca M. Gardner, Courtney E. Chandler, Sarah L. Bowler, Roberta T. Mettus, Caressa N. Spychala, Erin L. Fowler, Belita N.A. Opene, Robert A. Myers, David R. Goodlett, Yohei Doi, Robert K. Ernst

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Acinetobacter baumannii is a prevalent nosocomial pathogen with a high incidence of multidrug resistance. Treatment of infections due to this organism with colistin, a last-resort antibiotic of the polymyxin class, can result in the emergence of colistin-resistant strains. Colistin resistance primarily occurs via modifications of the terminal phosphate moieties of lipopolysaccharide-derived lipid A, which reduces overall membrane electronegativity. These modifications are readily identified by mass spectrometry (MS). In this study, we prospectively collected Acinetobacter baumannii complex clinical isolates from a hospital system in Pennsylvania over a 3-year period. All isolates were evaluated for colistin resistance using standard MIC testing by both agar dilution and broth microdilution, as well as genospecies identification and lipid A profiling using MS analyses. Overall, an excellent correlation between colistin susceptibility and resistance, determined by MIC testing, and the presence of a lipid A modification, determined by MS, was observed with a sensitivity of 92.9% and a specificity of 94.0%. Additionally, glycolipid profiling was able to differentiate A. baumannii complex organisms based on their membrane lipids. With the growth of MS use in clinical laboratories, a reliable MS-based glycolipid phenotyping method that identifies colistin resistance in A. baumannii complex clinical isolates, as well as other Gram-negative organisms, represents an alternative or complementary approach to existing diagnostics.

Original languageEnglish
Article numbere01100-18
JournalJournal of clinical microbiology
Volume57
Issue number3
DOIs
Publication statusPublished - 01-03-2019

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Colistin
Acinetobacter baumannii
Glycolipids
Mass Spectrometry
Prospective Studies
Lipid A
Membranes
Polymyxins
Multiple Drug Resistance
Membrane Lipids
Agar
Lipopolysaccharides
Phosphates
Anti-Bacterial Agents
Incidence
Growth
Infection

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)

Cite this

Leung, Lisa M. ; McElheny, Christi L. ; Gardner, Francesca M. ; Chandler, Courtney E. ; Bowler, Sarah L. ; Mettus, Roberta T. ; Spychala, Caressa N. ; Fowler, Erin L. ; Opene, Belita N.A. ; Myers, Robert A. ; Goodlett, David R. ; Doi, Yohei ; Ernst, Robert K. / A prospective study of acinetobacter baumannii complex isolates and colistin susceptibility monitoring by mass spectrometry of microbial membrane glycolipids. In: Journal of clinical microbiology. 2019 ; Vol. 57, No. 3.
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abstract = "Acinetobacter baumannii is a prevalent nosocomial pathogen with a high incidence of multidrug resistance. Treatment of infections due to this organism with colistin, a last-resort antibiotic of the polymyxin class, can result in the emergence of colistin-resistant strains. Colistin resistance primarily occurs via modifications of the terminal phosphate moieties of lipopolysaccharide-derived lipid A, which reduces overall membrane electronegativity. These modifications are readily identified by mass spectrometry (MS). In this study, we prospectively collected Acinetobacter baumannii complex clinical isolates from a hospital system in Pennsylvania over a 3-year period. All isolates were evaluated for colistin resistance using standard MIC testing by both agar dilution and broth microdilution, as well as genospecies identification and lipid A profiling using MS analyses. Overall, an excellent correlation between colistin susceptibility and resistance, determined by MIC testing, and the presence of a lipid A modification, determined by MS, was observed with a sensitivity of 92.9{\%} and a specificity of 94.0{\%}. Additionally, glycolipid profiling was able to differentiate A. baumannii complex organisms based on their membrane lipids. With the growth of MS use in clinical laboratories, a reliable MS-based glycolipid phenotyping method that identifies colistin resistance in A. baumannii complex clinical isolates, as well as other Gram-negative organisms, represents an alternative or complementary approach to existing diagnostics.",
author = "Leung, {Lisa M.} and McElheny, {Christi L.} and Gardner, {Francesca M.} and Chandler, {Courtney E.} and Bowler, {Sarah L.} and Mettus, {Roberta T.} and Spychala, {Caressa N.} and Fowler, {Erin L.} and Opene, {Belita N.A.} and Myers, {Robert A.} and Goodlett, {David R.} and Yohei Doi and Ernst, {Robert K.}",
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Leung, LM, McElheny, CL, Gardner, FM, Chandler, CE, Bowler, SL, Mettus, RT, Spychala, CN, Fowler, EL, Opene, BNA, Myers, RA, Goodlett, DR, Doi, Y & Ernst, RK 2019, 'A prospective study of acinetobacter baumannii complex isolates and colistin susceptibility monitoring by mass spectrometry of microbial membrane glycolipids', Journal of clinical microbiology, vol. 57, no. 3, e01100-18. https://doi.org/10.1128/JCM.01100-18

A prospective study of acinetobacter baumannii complex isolates and colistin susceptibility monitoring by mass spectrometry of microbial membrane glycolipids. / Leung, Lisa M.; McElheny, Christi L.; Gardner, Francesca M.; Chandler, Courtney E.; Bowler, Sarah L.; Mettus, Roberta T.; Spychala, Caressa N.; Fowler, Erin L.; Opene, Belita N.A.; Myers, Robert A.; Goodlett, David R.; Doi, Yohei; Ernst, Robert K.

In: Journal of clinical microbiology, Vol. 57, No. 3, e01100-18, 01.03.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A prospective study of acinetobacter baumannii complex isolates and colistin susceptibility monitoring by mass spectrometry of microbial membrane glycolipids

AU - Leung, Lisa M.

AU - McElheny, Christi L.

AU - Gardner, Francesca M.

AU - Chandler, Courtney E.

AU - Bowler, Sarah L.

AU - Mettus, Roberta T.

AU - Spychala, Caressa N.

AU - Fowler, Erin L.

AU - Opene, Belita N.A.

AU - Myers, Robert A.

AU - Goodlett, David R.

AU - Doi, Yohei

AU - Ernst, Robert K.

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Acinetobacter baumannii is a prevalent nosocomial pathogen with a high incidence of multidrug resistance. Treatment of infections due to this organism with colistin, a last-resort antibiotic of the polymyxin class, can result in the emergence of colistin-resistant strains. Colistin resistance primarily occurs via modifications of the terminal phosphate moieties of lipopolysaccharide-derived lipid A, which reduces overall membrane electronegativity. These modifications are readily identified by mass spectrometry (MS). In this study, we prospectively collected Acinetobacter baumannii complex clinical isolates from a hospital system in Pennsylvania over a 3-year period. All isolates were evaluated for colistin resistance using standard MIC testing by both agar dilution and broth microdilution, as well as genospecies identification and lipid A profiling using MS analyses. Overall, an excellent correlation between colistin susceptibility and resistance, determined by MIC testing, and the presence of a lipid A modification, determined by MS, was observed with a sensitivity of 92.9% and a specificity of 94.0%. Additionally, glycolipid profiling was able to differentiate A. baumannii complex organisms based on their membrane lipids. With the growth of MS use in clinical laboratories, a reliable MS-based glycolipid phenotyping method that identifies colistin resistance in A. baumannii complex clinical isolates, as well as other Gram-negative organisms, represents an alternative or complementary approach to existing diagnostics.

AB - Acinetobacter baumannii is a prevalent nosocomial pathogen with a high incidence of multidrug resistance. Treatment of infections due to this organism with colistin, a last-resort antibiotic of the polymyxin class, can result in the emergence of colistin-resistant strains. Colistin resistance primarily occurs via modifications of the terminal phosphate moieties of lipopolysaccharide-derived lipid A, which reduces overall membrane electronegativity. These modifications are readily identified by mass spectrometry (MS). In this study, we prospectively collected Acinetobacter baumannii complex clinical isolates from a hospital system in Pennsylvania over a 3-year period. All isolates were evaluated for colistin resistance using standard MIC testing by both agar dilution and broth microdilution, as well as genospecies identification and lipid A profiling using MS analyses. Overall, an excellent correlation between colistin susceptibility and resistance, determined by MIC testing, and the presence of a lipid A modification, determined by MS, was observed with a sensitivity of 92.9% and a specificity of 94.0%. Additionally, glycolipid profiling was able to differentiate A. baumannii complex organisms based on their membrane lipids. With the growth of MS use in clinical laboratories, a reliable MS-based glycolipid phenotyping method that identifies colistin resistance in A. baumannii complex clinical isolates, as well as other Gram-negative organisms, represents an alternative or complementary approach to existing diagnostics.

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