Analysis of high-molecular-weight proteins using MALDI-TOF MS and Machine Learning for the differentiation of clinically relevant Clostridioides difficile ribotypes
Candela, A.; Rodriguez-Temporal, D.; Blazquez-Sanchez, M.; Arroyo, M. J.; Marin, M.; Alcala, L.; Bou, G.; Rodriguez-Sanchez, B.; Oviano, M.
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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. 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 and Light-Gradient Boosting Machine. 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.
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