The implementation of MALDI-TOF MS in medical microbiology laboratories has revolutionized practices and significantly reduced turnaround times of identification processes. However, although bacteriology quickly benefited from the contributions of this technique, adjustments were necessary to accommodate the specific characteristics of fungi. MALDI-TOF MS is now an indispensable tool in clinical mycology laboratories, both for the identification of yeasts and filamentous fungi, and other innovative uses are gradually emerging. Based on the practical experience of our medical mycology laboratory, this review will present the current uses of MALDI-TOF MS and the adaptations we implemented, to allow their practical execution in a daily routine. We will also introduce some less mainstream applications, like those for fungemia, or even still under development, as is the case for the determination of sensitivity to antifungal agents or typing methods.

No abstract

Purpose Glioblastoma is one of the most aggressive primary brain cancers. The precise grading of tumors is important to adopt the best follow‐up treatment but complementary methods to histopathological diagnosis still lack in achieving an unbiased and reliable classification. Experimental design To progress in the field, a rapid Matrix Assisted Laser Desorption Ionization ‐ Time of Flight Mass spectrometry (MALDI‐TOF MS) protocole, devised for the identification and taxonomic classification of microorganisms and based on the analysis of whole cell extracts, was applied to glioma cell lines. Results The analysis of different human glioblastoma cell lines permitted to identify distinct proteomic profiles thus demonstrating the ability of MALDI‐TOF to distinguish different malignant cell types. Conclusions and clinical relevance In the study, the authors showed the ability of MALDI‐TOF profiling to discriminate glioblastoma cell lines, demonstrating that this technique could be used in complement to histological tumor classification. The proposed procedure is rapid and inexpensive and could be used to improve brain tumors classification and help propose a personalized and more efficient treatment.

Background The BioFire Bone and Joint Infection (BJI) Panel is a sample-to-answer test for the qualitative detection of nearly 40 different bacteria, yeast, and antimicrobial resistance (AMR) genes in synovial fluid (SF). The panel aims to improve on current culture-based diagnostics, particularly for detection of anaerobes (e.g. Finegoldia magna, Kingella kingae, Cutibacterium, Anaerococcus and Peptoniphilus species, and others) in about an hour. Analytical performance of the panel (Limit of Detection (LoD), analytical reactivity and specificity, interference, reproducibility), and specimen storage conditions are described. Methods LoD for each analyte was estimated from serial dilutions and confirmed at the lowest titer with ≥95% detection. A collection of >350 isolates representing genetic and geographic diversity of analytes was tested near LoD to assess analytical reactivity, and more than 420 near-neighbor, commensal, pathogenic, or environmental off-panel species were evaluated for assay specificity. Reproducibility was evaluated in a multi-laboratory multi-variable study, and the impact of storage and potentially interfering substances on the accuracy of test results was also assessed. Testing was performed with Investigational Use Only kits. Results The confirmed LoD for bacteria and yeast ranged from 100 - 10,000 CFU/mL. Sequence analysis and testing demonstrated clinically appropriate specificity and reactivity with a variety of isolates and different AMR gene types. Accurate and reproducible organism and AMR gene detection was observed with repeated testing of samples over several days (99.9% agreement with the expected results), and detection was not affected by potentially interfering substances nor by refrigerated sample storage. Conclusion The BioFire BJI Panel is a robust, accurate, and easy-to-use multiplex PCR test capable of detecting many aerobic and anaerobic bacteria, yeast, and AMR genes in synovial fluid specimens. Rapid and reliable molecular detection of possible BJI pathogens may advance the diagnosis and effective management of bone and joint infections. Note This panel has not been evaluated by the FDA or other regulatory agencies for diagnostic use. Disclosures Nicholas Francis, n/a, BioFire Diagnostics (Employee) Laurence Barbier, n/a, Biomerieux (Employee) Caroline Dubost, n/a, Biomerieux (Employee) Elodie Billet, n/a, Biomerieux (Employee) Joel Manwaring, n/a, BioFire Diagnostics (Employee) Josh Southwick, n/a, BioFire Diagnostics (Employee) Tyson Dawson, n/a, BioFire Diagnostics (Employee) Jess Gann, n/a, BioFire Diagnostics (Employee) Kevin Ekins, n/a, BioFire Diagnostics (Employee) Jennifer Arce, MS, BioFire Diagnostics/BioMerieux (Employee) Briana Flaherty, n/a, BioFire Diagnostics (Employee) Harmonie Durand, n/a, Biomerieux (Employee) Chris Cantrell, n/a, Biomerieux (Employee) Elizabeth Amiott, n/a, BioFire Diagnostics (Employee)