Identification of Mycobacterium smegmatis and antibiotic resistance through the utilization of high titer mycobacteriophage concentrations and MALDI-TOF MS

The diagnosis of bacterial infections based on phage multiplication has the potential for profound clinical implications, particularly for antibiotic-resistant strains and the slow-growing Mycobacterium tuberculosis. The possibility of hastening the diagnosis of antibiotic-resistant mycobacterial infections was accomplished via the study of Mycobacterium smegmatis, a generally non-pathogenic, comparatively fast growing microorganism to M. tuberculosis. These proof-of-concept studies established that after transduction of M. smegmatis cells with bacteriophages, MALDI-TOF MS could be used to detect increased amounts of phage proteins. Recording the growth of M. smegmatis over an 8-hour period, starting with very low OD600 measurements, simulated bacterial loads in clinical settings. For the purposes of MALDI-TOF MS, the procedure for the most effective lethal exposure for M. smegmatis was determined to be a 1-hour incubation in a 95°C water bath. Successful precipitation of the lytic mycobacteriophages D29 and Giles was performed using chloroform and methanol and overlaid with 1-2 μL of α-cyano-4-hydoxycinnaminic acid, which allowed for more distinct and repeatable MALDI-TOF MS spectra. Phage D29 was found to produce an m/z peak at 18.477 kDa, which may have indicated a 2+-charged ion of the 34.8 kDa minor tail protein. The Giles proteins that were identified with MALDI-TOF MS have not been directly compared to protein values reported in the scientific literature. However, the MALDI-TOF MS spectra suggested that distinct peaks existed between M. smegmatis mc2155 and mycobacteriophages, indicating that successful infection with lytic phage and replication thereafter may have occurred. The distinct peaks between M. smegmatis and the phage can be used as indicators of the presence of mycobacteria. At this point, the limits of detection of each phage must be elucidated in order for MALDI-TOF MS spectra to be successfully implemented as a mechanism to rapidly detect antibiotic-resistant mycobacteria.