Contribution of MALDI-TOF mass spectrometry in the microbiological diagnosis and clinical management of patients suffering from infectious diseases

First, we confirmed the accurate performance of MALDI-TOF MS in the identification of routine isolates, regardless of whether the Biotyper (92.7% correct species identification) or VITEK MS (93.2%) (n=986) commercial system was used, and demonstrated the supremacy of this technology over conventional identification techniques for fastidious bacteria, including Campylobacter and related organisms (98.3%, 72.2% and 79.9% correct species identification by Biotyper, Vitek NH Card and API Campy, respectively; n=234).

Second, we showed that the direct MALDI-TOF MS identification of bacteria from positive blood cultures was not only feasible but also led to an 24-h reduction in the time-to-identification. In an adult population, more than 13% of the direct identifications from positive blood cultures resulted in the faster adaptation of the antimicrobial treatment.

Third, we demonstrated that MALDI-TOF MS could easily be implemented in a network, which was associated with significant cost savings and reduction in the time-to-identification. Finally, our promising Blastocystis subtyping results suggest that the number of MALDI-TOF MS applications may be increased.

In the future, automation of the technique will make its use in clinical laboratories even easier, eliminating the use of conventional identification techniques. Improvement of the preanalytical procedures is also important to make MALDI-TOF MS a suitable instrument for resistance and toxicity mechanism detection and subtyping.