European Journal of Clinical Microbiology & Infectious Diseases最新文献

{"title":"Diagnostic tests performance in detecting Pneumocystis jirovecii: A systematic review and meta-analysis.","authors":"Ling Zhang, Caopei Zheng, Yuqing Sun, Xue Chen, Yu Wang, Hanxue Xiang, Ying Liang, Feili Wei, Yulin Zhang","doi":"10.1007/s10096-025-05051-6","DOIUrl":"https://doi.org/10.1007/s10096-025-05051-6","url":null,"abstract":"<p><strong>Background and objective: </strong>Pneumocystis jirovecii (Pj) pneumonia (PJP) is a life-threatening opportunistic infection primarily affecting immunocompromised individuals. Detecting Pj is challenging, particularly in distinguishing between Pj colonization (PJC) and infection. We aimed to systematically evaluate the diagnostic accuracy of various tests in differentiating Pj colonization from infection.</p><p><strong>Methods: </strong>Systematic reviews and meta-analyses were performed. Searches were conducted in PubMed, Embase, and Web of Science. Original clinical studies reporting sensitivity and specificity data for diagnostic tests such as quantitative polymerase chain reaction (qPCR), nested PCR, (1,3)-Beta-D glucan (BDG), metagenomic next-generation sequencing (mNGS), and digital PCR (ddPCR) to differentiate PJC from PJP were included. Quality assessment was performed using QUADAS-2 tool, and data processing followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Diagnostic performance was evaluated using either a random-effects or fixed-effects model.</p><p><strong>Results: </strong>Twenty-eight studies (2,550 patients, 1,445 with PJP) were included, with moderate methodological quality. The pooled sensitivity of these diagnostic tests was 0.80 (95% CI 0.77-0.82) and specificity was 0.83 (95% CI 0.81-0.85), with a diagnostic odds ratio (DOR) of 23.12. Among the individual tests, BDG (5 studies) showed high pooled sensitivity (0.83, 95% CI 0.77-0.88) but lower specificity (0.78, 95% CI 0.69-0.85). mNGS (3 studies) had the highest performance, with pooled sensitivity and specificity both at 0.87 (95% CI 0.80-0.92 and 95% CI 0.77-0.94, respectively), and the highest DOR of 41.57. qPCR (19 studies) demonstrated adequate pooled sensitivity (0.78, 95% CI 0.76-0.81) and high specificity (0.83, 95% CI 0.81-0.86), with a DOR of 20.44.</p><p><strong>Conclusion: </strong>While BDG has low specificity and mNGS is costly with no standardized interpretation, along with the limited number of relevant studies in BDG and mNGS, this meta-analysis concluded that qPCR remains valuable for distinguishing P. jirovecii infection from colonization. A well-designed randomized clinical trial that standardizes the technical aspects of the qPCR protocol is needed to assess its effectiveness and provide a solid basis for clinical diagnosis.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central-venous-catheter-related bloodstream infections in adult patients with sickle cell disease: a retrospective, two-centre study.","authors":"Matthieu Holub, David Lebeaux, Patrick Grohs, Laure Joseph, Olivier Pellerin, Geoffrey Cheminet, Najiby Kassis, Salomé Abdellaoui, Jacques Pouchot, Brigitte Ranque, Jean Benoit Arlet, Emmanuel Lafont","doi":"10.1007/s10096-024-05035-y","DOIUrl":"https://doi.org/10.1007/s10096-024-05035-y","url":null,"abstract":"<p><strong>Purpose: </strong>Although catheter-related infections are the leading cause of bloodstream infections in patients with sickle cell disease (SCD), data are scarce in adult patients. The objectives of the present study were to describe central-venous-catheter-related bloodstream infections in patients with SCD and identify risk factors.</p><p><strong>Methods: </strong>We conducted a retrospective, observational study of adult patients with SCD diagnosed with central-venous-catheter-related bloodstream infections between 2011 and 2023 in two SCD reference centres. Each patient with SCD and a bloodstream infection related to a totally implantable venous access port was matched with two control patients with SCD and an infection-free totally implantable venous access port.</p><p><strong>Results: </strong>Thirty-five (6.6%) of the 534 patients experienced a total of 69 central-venous-catheter-related bloodstream infections. Concomitant vaso-occlusive crises were observed for 81.2% of the infections. The 30-day mortality rate was 2.8%, and the infection recurrence rate was 45.7%. We observed 26 totally implantable venous access port-related bloodstream infections in 19 patients, with an incidence rate of 0.31 per 1000 catheter-days. After adjustment, the frequency of hospital admission for a vaso-occlusive crisis (odds ratio (OR) [95% confidence interval (CI)] = 1.6 [1.2-2.4]) and the presence of a psychiatric comorbidity (19.8 [4.0-148.1]) remained significantly associated with totally implantable venous access port-related bloodstream infections. Suboptimal antibiotic levels were observed in five (39%) of the 13 patients having undergone therapeutic drug monitoring. The treatment failed in four (80%) of the five patients, who presented with glomerular hyperfiltration.</p><p><strong>Conclusion: </strong>A central-venous-catheter-related bloodstream infection is a severe complication in adult patients with SCD and is associated with psychiatric comorbidities and severe SCD.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ceftazidime-avibactam tolerance and persistence among difficult-to-treat KPC-producing Klebsiella pneumoniae clinical isolates from bloodstream infections.","authors":"N Abichabki, G G Gaspar, L R Bortolato, D A F S Lima, L N Silva, R H C Pocente, J C Ferreira, T C Ogasawara, D Pereira, R R Guerra, C Wilhelm, P Barth, A F Martins, A Barth, G U L Braga, E C P De Martinis, J Bengtsson-Palme, F Bellissimo-Rodrigues, V R Bollela, A L C Darini, L N Andrade","doi":"10.1007/s10096-024-05005-4","DOIUrl":"10.1007/s10096-024-05005-4","url":null,"abstract":"<p><strong>Purpose: </strong>Tolerance and persistence occur \"silently\" in bacteria categorized as susceptible by antimicrobial susceptibility testing in clinical microbiology laboratories. They are different from resistance phenomena, not well-studied, and often remain unnoticeable. We aimed to investigate and characterize ceftazidime-avibactam (CZA) tolerance/persistence in 80 Klebsiella pneumoniae isolates from bloodstream infections.</p><p><strong>Methods: </strong>We used the Tolerance Disk Test (TDtest) to detect CZA tolerance/persistence and investigate the avibactam (AVI) influence on them, and time-kill assays with minimal duration for killing (MDK) determination to characterize/differentiate CZA tolerance from persistence, for selected isolates. Whole genome sequencing was performed for 49/80 selected isolates to investigate genes related to beta-lactam tolerance/persistence and resistance as well as phylogeny studies.</p><p><strong>Results: </strong>Tolerance/persistence to CZA was detected in 48/80 (60%) isolates, all extensively drug-resistant (XDR) or multidrug-resistant, carbapenem-resistant K. pneumoniae (CRKp), KPC producers, and previously categorized as susceptible (not resistant) to CZA. No heteroresistance was detected. CZA tolerance/persistence occurred due to ceftazidime tolerance/persistence and was not related to AVI in the CZA combination. 5/11 isolates were characterized as CZA-tolerant and 5/11 as CZA-persistent. The single (1/11) XDR and CRKp non-KPC producer was truly susceptible. All the CZA-tolerant/persistent isolates (ST11, ST258, ST340, ST437, ST16, ST17, and ST307) harbored the carbapenemase-encoding gene bla_KPC-2. Mutation in only two genes (rpoS and degQ) related to beta-lactam tolerance/persistence was found in only 7/49 CZA-tolerant/persistent isolates, suggesting the presence of yet unknown beta-lactam tolerance/persistence genes.</p><p><strong>Conclusion: </strong>Among the K. pneumoniae bloodstream isolates studied, 60%, previously categorized as susceptible to CZA, were, actually, tolerant/persistent to this antibiotic, all these KPC producers.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"343-353"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minocycline susceptibility in Stenotrophomonas maltophilia: a closer look at institutional data amid CLSI breakpoint revisions.","authors":"Patrick D Crowley, Portia Mira, Omar M Abu Saleh","doi":"10.1007/s10096-024-04995-5","DOIUrl":"10.1007/s10096-024-04995-5","url":null,"abstract":"<p><p>In this letter we respond Bakthavatchalam et al's brief report on susceptibility of Stenotrophomonas maltophilia to Minocycline in the setting of new susceptibility breakpoints. We outline our institution's experience with this organism and new data of susceptibility with the breakpoint of < 1 mg/L from the past 5 months showing 93.8% of 144 isolates remained susceptible.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"459-460"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management and prevention of Neisseria meningitidis and Neisseria gonorrhoeae infections in the context of evolving antimicrobial resistance trends.","authors":"Helen S Marshall, Jean-Michel Molina, Valérie Berlaimont, Aruni Mulgirigama, Woo-Yun Sohn, Béatrice Berçot, Shravani Bobde","doi":"10.1007/s10096-024-04968-8","DOIUrl":"10.1007/s10096-024-04968-8","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the relationships between Neisseria meningitidis (NM) and Neisseria gonorrhoeae (NG) at genetic, population, and individual levels; to review historical trends in antimicrobial resistance (AMR); to review the treatment and preventive landscapes and explore their potential impact on AMR.</p><p><strong>Methods: </strong>A narrative literature search was conducted in PubMed, with searches restricted to 2003-2023 and additional articles included based on expertise.</p><p><strong>Results: </strong>NM and NG are closely related bacterial pathogens causing invasive meningococcal disease (IMD) and gonorrhea, respectively. NM can currently be treated with most antibiotics and generally has a wild-type susceptibility profile, whereas NG is increasingly resistant even in the first line of treatment. These pathogens share 80-90% genetic identity and can asymptomatically cohabit the pharynx. While AMR has historically been rare for NM, recent reports show this to be an emerging clinical concern. Extensively drug-resistant NG are reported globally, with data available from 73 countries, and can lead to treatment failure. Importantly, Neisseria commensals within the normal microbiota in the pharynx can act as a genetic reservoir of resistance to extended-spectrum cephalosporins. Novel oral antibiotics are urgently needed to treat a growing threat from antibiotic-resistant NG, recognized as a major global concern to public health by the World Health Organization. Numerous vaccines are available to prevent IMD, but none are approved for gonorrhea. Research to identify suitable candidates is ongoing.</p><p><strong>Conclusion: </strong>Holistic management of AMR in IMD and gonorrhea should couple judicious use of existing antibiotics, optimization of vaccination programs, and development of novel antibiotics and vaccines.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"233-250"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population-based active surveillance of pertussis hospitalization rates in two cities of China.","authors":"Hanying Dai, Hanqing He, Yanyang Zhang, Juan Xu, Jie Che, Yao Zhu, Tao Fu, Chuanwei Chen, Qian Zhou, Bohan Chen, Yuan Gao, Aiping Qin, Maojun Zhang, Zhujun Shao","doi":"10.1007/s10096-024-05001-8","DOIUrl":"10.1007/s10096-024-05001-8","url":null,"abstract":"<p><strong>Purpose: </strong>Hospitalization is most common for severe pertussis cases and those with serious complications caused by pertussis. In mainland China, the immunization program consists of primary vaccinations at 3, 4, and 5 months, followed by a booster at 18 months with DTaP. It remains uncertain whether the first dose at 3 months, rather than 6 weeks as WHO recommended, may increase disease burden, as delayed immunization may lead to lagged protection. This study aimed to determine pertussis hospitalization rates by active surveillance in China, shedding light on immunization strategies for better disease control.</p><p><strong>Methods: </strong>From June 1, 2021, to May 31, 2022, two Chinese cities underwent a population-based active surveillance. Suspected pertussis cases were confirmed as pertussis cases through PCR and culture. Pertussis hospitalization rates were calculated by dividing the number of laboratory confirmed pertussis cases by the hospitalization coverage rate of surveillance hospitals and the resident population.</p><p><strong>Results: </strong>During the study period 2021-2022, pertussis hospitalization rate in Yiwu was 2.50/100,000 (95% CrI 2.48-2.53), while in Yongcheng, it was 7.90/100,000 (95% CrI 7.81-8.00). In both cities, infants aged < 1 year had the highest hospitalization rate (215.64/100,000: Yiwu; 217.65/100,000: Yongcheng), followed by the age group of 4-5 years (16.37/100,000: Yiwu; 65.70/100,000: Yongcheng).</p><p><strong>Conclusions: </strong>This study revealed significant pertussis hospitalization rates in China, particularly among infants aged < 1 year, highlighting the need of timely and early immunization. The higher hospitalization rates in the 4-5-year age group emphasize the importance of targeted preventive measures for preschool children to mitigate the impact of pertussis.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"355-364"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on diagnosis and management of all-cause encephalitis: a European survey of adult infectious diseases healthcare providers.","authors":"Marion Le Maréchal, Luisa A Diaz-Arias, Susan E Beekmann, Philip Polgreen, Jacob Bodilsen, Matthijs Brouwer, Kiran T Thakur, Jean-Paul Stahl, Arun Venkatesan","doi":"10.1007/s10096-024-04997-3","DOIUrl":"10.1007/s10096-024-04997-3","url":null,"abstract":"<p><p>There is a need to understand current practices, knowledge gaps and training needs of ID physicians regarding encephalitis. A questionnaire was sent to European ID specialists. 201 persons answered. Respondents were involved more often in infectious (64%) than autoimmune encephalitis (7.5%). Respondents reported not feeling comfortable in recognizing (60%), diagnosing (71%), or treating (85%) autoimmune encephalitis. There was a need for the publication of guidelines from the ESCMID for the management of encephalitis (89%). There is heterogeneity in confidence in recognizing, diagnosing, and treating autoimmune encephalitis. European guidelines may be helpful for physicians in daily care.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"449-452"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: diagnosis of neurobrucellosis in a non-endemic area child using metagenomic next-generation sequencing.","authors":"Hao Wu, Yanchun Wang, Xiaotao Yang, Tianjian Lu, Yonghan Luo","doi":"10.1007/s10096-024-05011-6","DOIUrl":"10.1007/s10096-024-05011-6","url":null,"abstract":"<p><p>Brucellosis with neurological symptoms at onset is rare in children and is frequently misdiagnosed or overlooked due to nonspecific clinical presentations, particularly in non-endemic areas. We report a case of neurobrucellosis in a child from a non-pastoral area, diagnosed via metagenomic next-generation sequencing (mNGS). The patient presented with headache and altered consciousness, accompanied by fever, projectile vomiting, seizures, and urinary incontinence. Physical examination indicated possible nuchal rigidity. Cerebrospinal fluid (CSF) analysis showed colorless and clear fluid, with a white blood cell count of 259 × 10⁶/L, 4.6% polymorphonuclear cells, positive protein qualitative test, protein level of 0.78 g/L, and glucose level of 1.66 mmol/L. Initial diagnosis suggested central nervous system infection, and empirical treatment led to improvement in consciousness. However, after a few days of stable body temperature, the patient experienced recurrent fever. Ultimately, mNGS of CSF identified Brucella melitensis, confirming neurobrucellosis. Following treatment with ceftriaxone, doxycycline, and rifampin, the patient's clinical symptoms improved significantly, and follow-up CSF analysis showed normalization of cell counts. This case highlights the early diagnostic utility of mNGS in CSF for neurobrucellosis and its role in differential diagnosis.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"443-447"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary embolism in children with mycoplasma pneumonia: can it be predicted?","authors":"Jiapu Hou, Ruiyang Sun, Xue Zhang, Wanyu Jia, Peng Li, Chunlan Song","doi":"10.1007/s10096-024-05014-3","DOIUrl":"10.1007/s10096-024-05014-3","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical characteristics of Mycoplasma pneumoniae (MP) pneumonia (MPP) combined with pulmonary embolism (PE) in children.</p><p><strong>Methods: </strong>291 hospitalized pediatric cases with MPP were enrolled from January 2018 to May 2024 and divided into the PE group (141 cases) and non-PE control group (150 cases). Clinical data of both groups were analyzed and compared.</p><p><strong>Results: </strong>C-reactive protein (CRP), D-dimer, lactate dehydrogenase (LDH), and interleukin 6 (IL-6) were significantly higher in the PE group than in the non-PE control group. There were 85 males and 56 females in the PE group. The PE group has male-to-female ratio of 3: 2,and hemoptysis was observed in 11 children (7.08%), chest pain in 29 children (20.60%), and pulmonary necrosis in 89 children (63.12%). In the receiver operator curve(ROC), the areas under the curve(AUC) for D-dimer, CRP, IL-6, and LDH were 0.964, 0.690, 0.632, and 0.765, respectively. In the ROC curve, the cutoff values for D-dimer, CRP, IL-6, and LDH were 0.8 µg/ml, 24.2 mg/L, 37.8 pg/ml, and 461 U/L, respectively.</p><p><strong>Conclusion: </strong>A proportion of children with MP infection combined with PE show atypical clinical symptoms. Children with MPP and elevated D-dimer levels, IL-6, CRP, erythrocyte sedimentation rate (ESR), and LDH may be prone to develop PE.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"393-403"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of high-molecular-weight proteins using MALDI-TOF MS and machine learning for the differentiation of clinically relevant Clostridioides difficile ribotypes.","authors":"Ana Candela, David Rodriguez-Temporal, Mario Blázquez-Sánchez, Manuel J Arroyo, Mercedes Marín, Luis Alcalá, Germán Bou, Belén Rodríguez-Sánchez, Marina Oviaño","doi":"10.1007/s10096-024-05023-2","DOIUrl":"10.1007/s10096-024-05023-2","url":null,"abstract":"<p><strong>Purpose: </strong>Clostridioides difficile is the main cause of antibiotic related diarrhea and some ribotypes (RT), such as RT027, RT181 or RT078, are considered high risk clones. A fast and reliable approach for C. difficile ribotyping is needed for a correct clinical approach. This study analyses high-molecular-weight proteins for C. difficile ribotyping with MALDI-TOF MS.</p><p><strong>Methods: </strong>Sixty-nine isolates representative of the most common ribotypes in Europe were analyzed in the 17,000-65,000 m/z region and classified into 4 categories (RT027, RT181, RT078 and 'Other RTs'). Five supervised Machine Learning algorithms were tested for this purpose: K-Nearest Neighbors, Support Vector Machine, Partial Least Squares-Discriminant Analysis, Random Forest (RF) and Light-Gradient Boosting Machine (GBM).</p><p><strong>Results: </strong>All algorithms yielded cross-validation results > 70%, being RF and Light-GBM the best performing, with 88% of agreement. Area under the ROC curve of these two algorithms was > 0.9. RT078 was correctly classified with 100% accuracy and isolates from the RT181 category could not be differentiated from RT027.</p><p><strong>Conclusions: </strong>This study shows the possibility of rapid discrimination of relevant C. difficile ribotypes by using MALDI-TOF MS. This methodology reduces the time, costs and laboriousness of current reference methods.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"417-425"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}