Sun Yue, Guo Jian, Chen Rong, Hu Liang, Xia Qihang, Wu Wenjuan, Wang Jinghua, Hu Fupin
Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China.
Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, China.
Med Mycol. 2021 Jan 4;59(1):81-86. doi: 10.1093/mmy/myaa037.
Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) holds promise as a potential tool for clinical identification of filamentous fungi. However, due to the lack of an appropriate extraction protocol and the difficulty of database building, the identification power of each system differs. In this study, we selected 126 clinical mould isolates comprising 28 species identified using internal transcribed spacer (ITS) sequencing as the reference method to evaluate three MALDI-TOF MS systems. When using cultures and sample preparation as recommended by the respective vendors, of the 126 strains tested, VITEK MS identified 121 (96.0%) to species-level and 124 (98.4%) to genus-level; Biotyper identified 53 (42.1%) to species-level and 54 (42.9%) to genus-level; Autof identified 74 (58.7%) to species-level and 76 (60.3%) to genus-level. For the Autof system, the tube extraction method recommended by the vendor performed better (59%) than the on-plate lysis (51%). Our study demonstrates that MALDI-TOF MS systems can successfully identify most clinically relevant fungi, while performance is still highly dependent on the database and sample preparation protocol.
基质辅助激光解吸/电离飞行时间质谱（MALDI-TOF MS）有望成为临床鉴定丝状真菌的潜在工具。然而，由于缺乏合适的提取方案以及数据库构建困难，每个系统的鉴定能力有所不同。在本研究中，我们选择了126株临床霉菌分离株，这些分离株包含28个物种，使用内转录间隔区（ITS）测序作为参考方法来评估三种MALDI-TOF MS系统。按照各供应商推荐的培养和样品制备方法，在测试的126株菌株中，VITEK MS在种水平上鉴定出121株（96.0%），在属水平上鉴定出124株（98.4%）；Biotyper在种水平上鉴定出53株（42.1%），在属水平上鉴定出54株（42.9%）；Autof在种水平上鉴定出74株（58.7%），在属水平上鉴定出76株（60.3%）。对于Autof系统，供应商推荐的试管提取方法（59%）比平板裂解方法（51%）表现更好。我们的研究表明，MALDI-TOF MS系统能够成功鉴定大多数临床相关真菌，但其性能仍高度依赖于数据库和样品制备方案。
