Comparison of Two Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry Methods with Conventional Phenotypic Identification for Routine Identification of Bacteria to the Species Level

Abstract

Bacterial identification relies primarily on culture-based methodologies requiring 24 h for isolation and an additional 24 to 48 h for species identification. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) is an emerging technology newly applied to the problem of bacterial species identification. We evaluated two MALDI-TOF MS systems with 720 consecutively isolated bacterial colonies under routine clinical laboratory conditions. Isolates were analyzed in parallel on both devices, using the manufacturers' default recommendations. We compared MS with conventional biochemical test system identifications. Discordant results were resolved with "gold standard" 16S rRNA gene sequencing. The first MS system (Bruker) gave high-confidence identifications for 680 isolates, of which 674 (99.1%) were correct; the second MS system (Shimadzu) gave high-confidence identifications for 639 isolates, of which 635 (99.4%) were correct. Had MS been used for initial testing and biochemical identification used only in the absence of high-confidence MS identifications, the laboratory would have saved approximately US$5 per isolate in marginal costs and reduced average turnaround time by more than an 8-h shift, with no loss in accuracy. Our data suggest that implementation of MS as a first test strategy for one-step species identification would improve timeliness and reduce isolate identification costs in clinical bacteriology laboratories now.

Comparison of two matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry methods and API 20AN for identification of clinically relevant anaerobic bacteria

“…The identification of anaerobes by MS offers several advantages in comparison with the conventional routine method. Shortening the time period required to identify an organism from days to a few minutes will improve the clinical outcome for the patients (Cherkaoui et al, 2010). There is a great and significant impact on time to identification of biochemically inert, fastidious and slowgrowing anaerobic cocci (Tan et al, 2012).…”

“…The system was operated as described by Cherkaoui et al (2010). The colonies were picked up from the anaerobic Brucella blood agar and inoculated onto the MALDI target plate.…”

A multi-center ring trial for the identification of anaerobic bacteria using MALDI-TOF MS

“…The main conclusion is that identification obtained with MALDI-TOF MS is superior to phenotypic methods regarding the reliability of the identification [1,4]. Compared with phenotypic methods, it is much faster and cheaper, once the equipment is purchased [2]. Since only a minute sample is required for analysis, MALDI-TOF MS is particularly useful for identification of several fastidious and poorly growing species.…”

Mass spectrometry: a revolution in clinical microbiology?

“…Their performance is in any case higher than phenotypic identification systems [11 -13] . We could note that no statistically significant difference was identified between the platforms for clinically relevant bacteria [11,14] .…”