---
title: "Machine learning on MALDI-TOF MS for rapid detection of ceftriaxone-resistant nontyphoidal Salmone"
id: "pubmed-42803168"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42803168"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42803168/"
doi: "10.1128/spectrum.00984-26"
published_at: "2026-09-28T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Machine learning on MALDI-TOF MS for rapid detection of ceftriaxone-resistant nontyphoidal Salmone
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42803168
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42803168/)
- **DOI:** [10.1128/spectrum.00984-26](https://doi.org/10.1128%2Fspectrum.00984-26)
- **Published At:** 2026-09-28T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Rising rates of **ceftriaxone-resistant** nontyphoidal Salmonella (NTS) threaten pediatric treatment, while conventional antimicrobial susceptibility testing (AST) is time-consuming and delays therapy. - MALDI-TOF MS is routinely used for rapid microbial identification but does not directly report resistance phenotypes. - The study combined routinely generated **MALDI-TOF MS** spectra with a machine learning classifier (Light Gradient Boosting Machine, **LGB**) to predict ceftriaxone (CRO) resistance in NTS isolates. - Data comprised 472 NTS isolates yielding 1,414 spectra collected from three medical centers; models were developed and validated internally and externally. - A parsimonious LGB model using only seven spectral features achieved an AUC of 0.94 in training, 0.88 in internal validation, 0.79 in one external validation, and 0.80 in a second external validation. - The model was deployed as an interactive Streamlit web interface to demonstrate potential laboratory usability and to facilitate further evaluation. - Authors present this work as a proof-of-concept for rapid preliminary prediction of **ceftriaxone resistance** in NTS from MALDI-TOF MS spectra but note that further large-scale, prospective, multicenter validation is required before clinical implementation. - Detailed clinical impact metrics, prospective performance, and operational diagnostic pathways were not reported in the abstract and require follow-up in full study reports.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # Utilizing machine learning and MALDI-TOF MS platform for rapid detection of ceftriaxone-resistant nontyphoidal _Salmonella_ [Jintao Xia](https://pubmed.ncbi.nlm.nih.gov/?term=Xia+J&cauthor_id=42803168)[#](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China."), [Jun Ren](https://pubmed.ncbi.nlm.nih.gov/?term=Ren+J&cauthor_id=42803168)[#](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-equal-contrib-explanation "Contributed equally")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-2 "Department of Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China."), [Shifu Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+S&cauthor_id=42803168)[#](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-equal-contrib-explanation "Contributed equally")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-3 "Department of Clinical Microbiology, Children's Hospital Affiliated to Shandong University \(Jinan Children's Hospital\), Jinan, China."), [Mengyu Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+M&cauthor_id=42803168)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-4 "Department of Clinical Laboratory, Wanbei Coal Electric Group General Hospital, Suzhou, Anhui Province, China."), [Xiaochen Sun](https://pubmed.ncbi.nlm.nih.gov/?term=Sun+X&cauthor_id=42803168)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-5 "Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China."), [Chao Fang](https://pubmed.ncbi.nlm.nih.gov/?term=Fang+C&cauthor_id=42803168)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China."), [Shixing Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+S&cauthor_id=42803168)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China."), [Xiucai Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+X&cauthor_id=42803168)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China."), [Yining Zhao](https://pubmed.ncbi.nlm.nih.gov/?term=Zhao+Y&cauthor_id=42803168)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China."), [Lijia Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+L&cauthor_id=42803168)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-6 "Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, Zhejiang, China.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-7 "Zhejiang Key Laboratory of Neonatal Diseases, Hangzhou, China."), [Shiqiang Shang](https://pubmed.ncbi.nlm.nih.gov/?term=Shang+S&cauthor_id=42803168)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China."), [Shengjie Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+S&cauthor_id=42803168)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-2 "Department of Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China."), [Wenjun Cao](https://pubmed.ncbi.nlm.nih.gov/?term=Cao+W&cauthor_id=42803168)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-2 "Department of Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China."), [Mingming Zhou](https://pubmed.ncbi.nlm.nih.gov/?term=Zhou+M&cauthor_id=42803168)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#full-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China.") Affiliations Expand ### Affiliations * 1 Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China. * 2 Department of Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China. * 3 Department of Clinical Microbiology, Children's Hospital Affiliated to Shandong University (Jinan Children's Hospital), Jinan, China. * 4 Department of Clinical Laboratory, Wanbei Coal Electric Group General Hospital, Suzhou, Anhui Province, China. * 5 Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. * 6 Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, Zhejiang, China. * 7 Zhejiang Key Laboratory of Neonatal Diseases, Hangzhou, China. # Contributed equally. * PMID: **42803168** * DOI: [ 10.1128/spectrum.00984-26 ](https://doi.org/10.1128/spectrum.00984-26) Item in Clipboard # Utilizing machine learning and MALDI-TOF MS platform for rapid detection of ceftriaxone-resistant nontyphoidal _Salmonella_ Jintao Xia et al. Microbiol Spectr. 2026. Show details Display options Display options Format Abstract PubMed PMID Microbiol Spectr Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Microbiol+Spectr%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Microbiol+Spectr%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803168/) . 2026 Sep 28:e0098426. doi: 10.1128/spectrum.00984-26. Online ahead of print. ### Authors [Jintao Xia](https://pubmed.ncbi.nlm.nih.gov/?term=Xia+J&cauthor_id=42803168)[#](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-equal-contrib-explanation "Contributed equally")[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China."), [Jun Ren](https://pubmed.ncbi.nlm.nih.gov/?term=Ren+J&cauthor_id=42803168)[#](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-equal-contrib-explanation "Contributed equally")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-2 "Department of Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China."), [Shifu Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+S&cauthor_id=42803168)[#](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-equal-contrib-explanation "Contributed equally")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-3 "Department of Clinical Microbiology, Children's Hospital Affiliated to Shandong University \(Jinan Children's Hospital\), Jinan, China."), [Mengyu Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+M&cauthor_id=42803168)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-4 "Department of Clinical Laboratory, Wanbei Coal Electric Group General Hospital, Suzhou, Anhui Province, China."), [Xiaochen Sun](https://pubmed.ncbi.nlm.nih.gov/?term=Sun+X&cauthor_id=42803168)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-5 "Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China."), [Chao Fang](https://pubmed.ncbi.nlm.nih.gov/?term=Fang+C&cauthor_id=42803168)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China."), [Shixing Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+S&cauthor_id=42803168)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China."), [Xiucai Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+X&cauthor_id=42803168)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China."), [Yining Zhao](https://pubmed.ncbi.nlm.nih.gov/?term=Zhao+Y&cauthor_id=42803168)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China."), [Lijia Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+L&cauthor_id=42803168)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-6 "Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, Zhejiang, China.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-7 "Zhejiang Key Laboratory of Neonatal Diseases, Hangzhou, China."), [Shiqiang Shang](https://pubmed.ncbi.nlm.nih.gov/?term=Shang+S&cauthor_id=42803168)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China."), [Shengjie Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+S&cauthor_id=42803168)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-2 "Department of Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China."), [Wenjun Cao](https://pubmed.ncbi.nlm.nih.gov/?term=Cao+W&cauthor_id=42803168)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-2 "Department of Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China."), [Mingming Zhou](https://pubmed.ncbi.nlm.nih.gov/?term=Zhou+M&cauthor_id=42803168)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803168/#short-view-affiliation-1 "Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China.") ### Affiliations * 1 Department of Laboratory Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, China. * 2 Department of Clinical Laboratory, Eye & ENT Hospital, Fudan University, Shanghai, China. * 3 Department of Clinical Microbiology, Children's Hospital Affiliated to Shandong University (Jinan Children's Hospital), Jinan, China. * 4 Department of Clinical Laboratory, Wanbei Coal Electric Group General Hospital, Suzhou, Anhui Province, China. * 5 Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. * 6 Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases, Hangzhou, Zhejiang, China. * 7 Zhejiang Key Laboratory of Neonatal Diseases, Hangzhou, China. # Contributed equally. * PMID: **42803168** * DOI: [ 10.1128/spectrum.00984-26 ](https://doi.org/10.1128/spectrum.00984-26) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract Ceftriaxone (CRO) is a first-line antibiotic for pediatric nontyphoidal _Salmonella_ (NTS) infections, but rising resistance threatens public health. Conventional antimicrobial susceptibility testing remains time-consuming, delaying treatment. Although MALDI-TOF MS enables rapid microbial identification, it lacks inherent resistance detection. This study integrates MALDI-TOF MS with machine learning to predict CRO resistance in NTS. Using 472 isolates (1,414 spectra) from three medical centers, we developed and validated a model based on the Light Gradient Boosting Machine (LGB) algorithm. With only seven features, LGB achieved AUCs of 0.94 (training), 0.88 (internal validation), 0.79 (external validation 1), and 0.80 (external validation 2). We further deployed the model as an interactive Streamlit web interface to demonstrate its potential usability and facilitate future laboratory evaluation. This approach provides a proof-of-concept framework for rapid preliminary prediction of ceftriaxone resistance in NTS using routinely generated MALDI-TOF MS spectra. However, further large-scale, prospective, multicenter validation is required before this model can be implemented as a routine clinical susceptibility testing tool. **Importance:** The increasing prevalence of ceftriaxone-resistant nontyphoidal _Salmonella_ in pediatric patients, particularly in cases requiring antimicrobial therapy, highlight
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