Dermatophyte identification using matrix-assisted laser desorption ionization-time of flight mass spectrometry

J Clin Microbiol. 2011 Dec;49(12):4067-71. doi: 10.1128/JCM.01280-11. Epub 2011 Sep 28.

Abstract

The performance of the Bruker Biotyper matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometer (MS) for the identification of dermatophytes from clinical cultures was compared to that of dermatophyte identification using 28S rRNA gene sequencing. The MALDI Biotyper library (MBL; version 3.0) was used alone and in combination with a supplemented library containing an additional 20 dermatophyte spectra (S-MBL). Acquired spectra were interpreted using both the manufacturer-recommended scores (genus, ≥1.7; species, ≥2.0) and adjusted cutoff values established by this study (genus, ≥1.5; species, ≥1.7); identifications required a minimum 10% difference in scores between the top two different organisms to be considered correct. One hundred well-characterized, archived dermatophyte isolates and 71 fresh dermatophyte cultures were evaluated using both libraries and both sets of cutoff criteria. Collectively, the S-MBL significantly outperformed the MBL at both the genus (93% versus 37.4%; P < 0,0001) and species (59.6% versus 20.5%; P < 0.0001) levels when using the adjusted score criteria. Importantly, application of the lowered cutoff values significantly improved genus (P = 0.005)- and species (P < 0.0001)-level identification for the S-MBL, without leading to an increase in misidentifications. MALDI-TOF MS is a cost-effective and rapid alternative to traditional or molecular methods for dermatophyte identification, provided that the reference library is supplemented to sufficiently encompass clinically relevant, intraspecies strain diversity.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Arthrodermataceae / chemistry*
  • Arthrodermataceae / classification*
  • Arthrodermataceae / isolation & purification
  • Dermatomycoses / diagnosis
  • Dermatomycoses / microbiology
  • Diagnostic Errors / statistics & numerical data
  • Humans
  • Microbiological Techniques / methods*
  • Molecular Diagnostic Techniques / methods
  • Sensitivity and Specificity
  • Sequence Analysis, DNA / methods
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / methods*