Rapid Screening of Methicillin-Resistant <i>Staphylococcus aureus</i> Using MALDI-TOF MS and Machine Learning: A Randomized, Multicenter Study
Bibliographic record
Abstract
High Resolution Image Download MS PowerPoint Slide Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of healthcare-associated infections including bacteremia. The rapid detection of MRSA is essential for prompt treatment and improved outcomes. However, traditional MRSA screening and confirmatory tests based on bacterial cultures with antimicrobial susceptibility tests and/or molecular diagnostics are time-consuming (>2 days), labor-intensive, and costly. We report that AMRQuest software, which was developed using logistic regression-based machine learning and matrix-assisted laser desorption/ionization-time-of-flight spectra of S. aureus isolates, can be successfully implemented in clinical microbiology laboratories to screen MRSA and identify bacterial species simultaneously, with the cefoxitin disk diffusion test as a reference. Analytical sensitivity, specificity, percent agreement, and Cohen’s kappa values were calculated to determine the accuracy of the AMRQuest software. The minimum sample size of the testing set for statistical analysis was determined considering the local prevalence of MRSA infections. MRSA screening was performed using 537 consecutive S. aureus isolates, including 231 MRSA and 306 methicillin-susceptible S. aureus isolates, from three tertiary-care hospitals. The results from the AMRQuest software were similar to those obtained using the reference method, cefoxitin disk diffusion testing, making it a powerful method for the rapid detection of MRSA prior to traditional antibiotic resistance testing.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".