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Background  MALDI-TOF MS is an analytical method that has recently become integral in the identification of microorganisms in clinical laboratories. It relies on databases that majorly employ pattern recognition or fingerprinting. Biomarker based databases have also been developed and there is optimism that these may be superior to pattern recognition based databases. This study compared the performance of ribosomal biomarker based MALDI-TOF MS and conventional methods in the identification of selected bacteria and yeast.    Methods  The study was a cross sectional study identifying clinically relevant bacteria and yeast isolated from varied clinical specimens submitted to a clinical laboratory. The identification of bacteria using conventional Vitek 2™ automated system, serotyping and MALDI-TOF MS was performed as per standard operating procedures. Comparison of sensitivities were then carried out using Pearson Chi-Square test and  p -value of <0.05 was considered statistically significant. Secondary outcomes analyzed included the major and minor error rates.    Results  Of the 383 isolates MALDI-TOF MS and conventional methods identified 97.6 and 95.7% ( p  = 0.231) to the genus level and 97.4 and 88.0% ( p  = 0.000) to the species level respectively. Biomarker based MALDI-TOF MS was significantly superior to Vitek 2™ in the identification of Gram negative bacteria and Gram positive bacteria to the species level. For the Gram positive bacteria, significant difference was observed in the identification of Coagulase negative  Staphylococci  ( p  = 0.000) and  Enterococcus  ( p  = 0.008). Significant difference was also observed between serotyping and MALDI-TOF MS ( p  = 0.005) and this was attributed to the lack of identification of  Shigella  species by MALDI-TOF MS. There was no significant difference observed in the identification of yeast however some species of  Candida  were unidentified by MALDI-TOF MS.    Conclusion  Biomarker based MALDI-TOF MS had good performance in a clinical laboratory setting with high sensitivities in the identification of clinically relevant microorganisms.

bmc microbiology

Comparison of biomarker based Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) and conventional methods in the identification of clinically relevant bacteria and yeast