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Rapid Multiplex Antimicrobial Resistance Profiling and Bacterial Identification by LAP-MALDI Mass Spectrometry Biotyping

In brief

LAP-MALDI delivers species ID and resistance profile in three hours

The new liquid atmospheric pressure MALDI assay identified bacterial species with up to 100% accuracy and correctly classified common beta-lactam resistance genes (including OXA-48, KPC-3, VIM-1) from less than 5 µL of culture in about three hours. This rapid, multiplex approach could streamline diagnostics, but larger clinical studies are needed to confirm performance across diverse pathogens.

Journal
Advanced science (Weinheim, Baden-Wurttemberg, Germany) (Q1)
Published
31 July 2026
Study design
Unclassified
Evidence level
Level 5, Expert Opinion (CEBM 5)
Authors
Lily R Adair, Shabnam Iyer, Ian M Jones, Rainer Cramer
PMID
42536802
DOI
10.1002/advs.76927

Why clinicians should know about it

  • Picked for Microbiology (medical) (paper of the day, 1 August 2026): Rapid multiplex AMR profiling and bacterial ID by LAP‑MALDI MS

Abstract

Rapid and accurate characterization of antimicrobial resistance is essential for effective patient treatment and outcomes. Infection-causing microorganisms often harbour multi-drug resistance, requiring multiple tests for identification. Here, we present a multiplex functional assay using liquid atmospheric pressure (LAP) matrix-assisted laser desorption/ionization (MALDI) as next-generation MALDI biotyping technology, which can accurately determine antibiotic resistance/susceptibility within three hours from <5 µL of bacterial culture, employing a beta-lactam antibiotic panel. Strains with common resistance genes, including OXA-48, KPC-3, and VIM-1, as well as susceptible isolates, are easily and reliably classified. Concurrent with multi-drug testing, the same bacterial sample provides species-identifying lipid and protein profiles (up to 100% classification accuracy) and characterization through tandem mass spectrometry (MS/MS) protein sequencing, facilitated by LAP-MALDI's ability to generate multiply charged protein ions. Detection of multiple antibiotics, their degradation products and lipids/proteins with high mass accuracy, along with the possibility of protein sequencing, offers new diagnostic possibilities for clinical microbiology and antimicrobial stewardship that are less probability-based than conventional MALDI biotyping.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.