Rapid detection of ceftriaxone-resistant Salmonella by matrix-assisted laser desorption–ionization time-of-flight mass spectrometry combined with the ratio of optical density

Abstract Background The increased resistance rate of Salmonella to third-generation cephalosporins represented by ceftriaxone (CRO) may result in the failure of the empirical use of third-generation cephalosporins for the treatment of Salmonella infection in children. The present study was conducted to evaluate a novel method for the rapid detection of CRO-resistant Salmonella (CRS). Methods We introduced the concept of the ratio of optical density (ROD) with and without CRO and combined it with matrix-assisted laser desorption–ionization time-of-flight mass spectrometry (MALDI-TOF MS) to establish a new protocol for the rapid detection of CRS. Results The optimal incubation time and CRO concentration determined by the model strain test were 2 h and 8 µg/ml, respectively. We then conducted confirmatory tests on 120 clinical strains. According to the receiver operating characteristic curve analysis, the ROD cutoff value for distinguishing CRS and non-CRS strains was 0.818 [area under the curve: 1.000; 95% confidence interval: 0.970–1.000; sensitivity: 100.00%; specificity: 100%; P