Identification of Uncommon Clinically Important Yeasts and Moulds by the Bruker Biotyper Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) System in a Global Antifungal Surveillance Program
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Abstract
We report the evaluation of the Bruker Biotyper MS (BMS) system for the identification (ID) of 437 isolates of uncommon species of Candida (106 isolates; 17 species), non-Candida yeasts (100 isolates, 16 species), Aspergillus (164 isolates; 11 species) and non-Aspergillus moulds (57 isolates; 36 species) collected from 68 laboratories in 2012. Using confidence scores of ≥1.7 to <2.0 for genus only ID and scores of ≥2.0 for species-level ID, BMS correctly IDed 89.8% of yeasts and 85.5% of moulds to the genus level and 71.3% and 73.3%, respectively, to the species-level. Applying a lower threshold of >1.7 for species-level ID to isolates included in the BMS database improved the accuracy of species ID from 88.7% to 99.0% for Candida, from 65.4% to 91.3% for non-Candida yeasts and from 78.6% to 85.4% for moulds. BMS gave a result of no identification to those species not included in the database and generated very few (5 total, all moulds) mis-IDs, all of which were correctly IDed at the genus-level.
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How to Cite
CASTANHEIRA, Mariana et al.
Identification of Uncommon Clinically Important Yeasts and Moulds by the Bruker Biotyper Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) System in a Global Antifungal Surveillance Program.
Medical Research Archives, [S.l.], n. 3, june 2015.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/145>. Date accessed: 15 nov. 2024.
Keywords
MALDI-TOF, yeasts, moulds, surveillance
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Section
Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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Aspergillus species. Clin Microbiol Infect 2011;17:750-5.
Alastruey-Izquierdo A, Mellado E, Pelaez T, Peman J, Zapico S, Alvarez M, et al. Population-based survey of filamentous fungi and antifungal resistance in Spain (FILPOP Study). Antimicrob Agents Chemother 2013;57:3380-7.
Arendrup MC, Dzajic E, Jensen RH, Johansen HK, Kjaeldgaard P, Knudsen JD, et al. Epidemiological changes with potential implication for antifungal prescription recommendations for fungaemia: data from a nationwide fungaemia surveillance programme. Clin Microbiol Infect 2013;19:E343-E53.
Azie N, Neofytos D, Pfaller M, Meier-Kriesche HU, Quan SP, Horn D. The PATH (Prospective Antifungal Therapy) Alliance registry and invasive fungal infections: Update 2012. Diagn Microbiol Infect Dis 2012;73:293-300.
Balajee SA, Sigler L, Brandt ME. DNA and the classical way: identification of medically important molds in the 21st century. Med Mycol 2007;45:475-90.
Balajee SA, Borman AM, Brandt ME, Cano J, Cuenca-Estrella M, Dannaoui E, et al. Sequence-based identification of Aspergillus, Fusarium, and Mucorales species in the clinical mycology laboratory: Where are we and where should we go from here? J Clin Microbiol 2009;47:877-84.
Borman AM, Szekely A, Palmer MD, Johnson EM. Assessment of accuracy of identification of pathogenic yeasts in microbiology laboratories in the United Kingdom. J Clin Microbiol 2012;50:2639-44.
Brandt ME, Park BJ. Think fungus-prevention and control of fungal infections. Emerg Infect Dis 2013;19:1688-9.
Brown GD, Denning DW, Gow NA, Levitz SM, Netea MG, White TC. Hidden killers: human fungal infections. Sci Transl Med 2012;4:165rv13.
Buchan BW, Ledeboer NA. Advances in identification of clinical yeast isolates by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol 2013;51:1359-66.
Cassagne C, Ranque S, Normand AC, Fourquet P, Thiebault S, Planard C, et al. Mould routine identification in the clinical laboratory by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. PLoS One 2011;6:e28425.
Cassagne C, Cella AL, Suchon P, Normand AC, Ranque S, Piarroux R. Evaluation of four pretreatment procedures for MALDI-TOF MS yeast identification in the routine clinical laboratory. Med Mycol 2013;51:371-7.
Castanheira M, Woosley LN, Diekema DJ, Jones RN, Pfaller MA. Candida guilliermondii and other species of Candida misidentified as Candida famata: Assessment by Vitek2, ITS sequence analysis and Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry in two global surveillance programs. J Clin Microbiol 2013;51:117-24.
Cendejas-Bueno E, Gomez-Lopez A, Mellado E, Rodriguez-Tudela JL, Cuenca-Estrella M. Identification of pathogenic rare yeast species in clinical samples: Comparison between phenotypical and molecular methods. J Clin Microbiol 2010;48:1895-9.
Chen JH, Yam WC, Ngan AH, Fung AM, Woo WL, Yan MK, et al. Advantages of using matrix-assisted laser desorption ionization-time of flight mass spectrometry as a rapid diagnostic tool for identification of yeasts and mycobacteria in the clinical microbiological laboratory. J Clin Microbiol 2013;51:3981-7.
De Carolis E, Posteraro B, Lass-Florl C, Vella A, Florio AR, Torelli R, et al. Species identification of Aspergillus, Fusarium and Mucorales with direct surface analysis by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Clin Microbiol Infect 2012;18:475-84.
Dhiman N, Hall L, Wohlfiel SL, Buckwalter SP, Wengenack NL. Performance and cost analysis of matrix-assisted laser desorption ionization-time of flight mass spectrometry for routine identification of yeast. J Clin Microbiol 2011;49:1614-6.
Latouche GN, Daniel HM, Lee OC, Mitchell TG, Sorrell TC, Meyer W. Comparison of use of phenotypic and genotypic characteristics for identification of species of the anamorph genus Candida and related teleomorph yeast species. J Clin Microbiol 1997;35:3171-80.
Linton CJ, Borman AM, Cheung G, Holmes AD, Szekely A, Palmer MD, et al. Molecular identification of unusual pathogenic yeast isolates by large ribosomal subunit gene sequencing: 2 years of experience at the United kingdom mycology reference laboratory. J Clin Microbiol 2007;45:1152-8.
Meletiadis J, Arabatzis M, Bobola M, Tsiveriotis K, Hini S, Petinaki E, et al. Comparative evaluation of three commercial identification systems using common and rare bloodstream yeast isolates. J Clin Microbiol 2011;49:2722-7.
Miceli MH, Diaz JA, Lee SA. Emerging opportunistic yeast infections. Lancet Infect Dis 2011;11:142-51.
Miceli MH, Lee SA. Emerging moulds: epidemiological trends and antifungal resistance. Mycoses 2011;54:e666-e78.
Patel R. Matrix-assisted laser desorption ionization-time of flight mass spectrometry in clinical microbiology. Clin Infect Dis 2013;57:564-72.
Pfaller MA, Diekema DJ. Rare and emerging opportunistic fungal pathogens: Concern for resistance beyond Candida albicans and Aspergillus fumigatus. J Clin Microbiol 2004;42:4419-31.
Pfaller MA, Diekema DJ, Gibbs DL, Newell VA, Bijie H, Dzierzanowska D, et al. Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: 10.5-year analysis of susceptibilities of noncandidal yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing. J Clin Microbiol 2009;47:117-23.
Pfaller MA, Diekema DJ. Epidemiology of invasive mycoses in North America. Crit Rev Microbiol 2010;36:1-53.
Pfaller MA, Woosley LN, Messer SA, Jones RN, Castanheira M. Significance of molecular identification and antifungal susceptibility of clinically significant yeasts and moulds in a global antifungal surveillance program. Mycopathologia 2012;174:259-71.
Pfaller MA, Messer SA, Woosley LN, Jones RN, Castanheira M. Echinocandin and triazole antifungal susceptibility profiles of opportunistic yeast and mould clinical isolates (2010-2011); Application of new CLSI clinical breakpoints and epidemiological cutoff values to characterize geographic and temporal trends of antifungal resistance. J Clin Microbiol 2013;51:2571-81.
Pounder JI, Simmon KE, Barton CA, Hohmann SL, Brandt ME, Petti CA. Discovering potential pathogens among fungi identified as nonsporulating molds. J Clin Microbiol 2007;45:568-71.
Sanguinetti M, Porta R, Sali M, La Sorda M, Pecorini G, Fadda G, et al. Evaluation of VITEK 2 and RapID yeast plus systems for yeast species identification: experience at a large clinical microbiology laboratory. J Clin Microbiol 2007;45:1343-6.
Stevenson LG, Drake SK, Shea YR, Zelazny AM, Murray PR. Evaluation of matrix-assisted laser desorption ionization-time of flight mass spectrometry for identification of clinically important yeast species. J Clin Microbiol 2010;48:3482-6.
Van Herendael BH, Bruynseels P, Bensaid M, Boekhout T, De Baere T, Surmont I, et al. Validation of a modified algorithm for the identification of yeast isolates using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). Eur J Clin Microbiol Infect Dis 2012;31:841-8.
Aspergillus species. Clin Microbiol Infect 2011;17:750-5.
Alastruey-Izquierdo A, Mellado E, Pelaez T, Peman J, Zapico S, Alvarez M, et al. Population-based survey of filamentous fungi and antifungal resistance in Spain (FILPOP Study). Antimicrob Agents Chemother 2013;57:3380-7.
Arendrup MC, Dzajic E, Jensen RH, Johansen HK, Kjaeldgaard P, Knudsen JD, et al. Epidemiological changes with potential implication for antifungal prescription recommendations for fungaemia: data from a nationwide fungaemia surveillance programme. Clin Microbiol Infect 2013;19:E343-E53.
Azie N, Neofytos D, Pfaller M, Meier-Kriesche HU, Quan SP, Horn D. The PATH (Prospective Antifungal Therapy) Alliance registry and invasive fungal infections: Update 2012. Diagn Microbiol Infect Dis 2012;73:293-300.
Balajee SA, Sigler L, Brandt ME. DNA and the classical way: identification of medically important molds in the 21st century. Med Mycol 2007;45:475-90.
Balajee SA, Borman AM, Brandt ME, Cano J, Cuenca-Estrella M, Dannaoui E, et al. Sequence-based identification of Aspergillus, Fusarium, and Mucorales species in the clinical mycology laboratory: Where are we and where should we go from here? J Clin Microbiol 2009;47:877-84.
Borman AM, Szekely A, Palmer MD, Johnson EM. Assessment of accuracy of identification of pathogenic yeasts in microbiology laboratories in the United Kingdom. J Clin Microbiol 2012;50:2639-44.
Brandt ME, Park BJ. Think fungus-prevention and control of fungal infections. Emerg Infect Dis 2013;19:1688-9.
Brown GD, Denning DW, Gow NA, Levitz SM, Netea MG, White TC. Hidden killers: human fungal infections. Sci Transl Med 2012;4:165rv13.
Buchan BW, Ledeboer NA. Advances in identification of clinical yeast isolates by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol 2013;51:1359-66.
Cassagne C, Ranque S, Normand AC, Fourquet P, Thiebault S, Planard C, et al. Mould routine identification in the clinical laboratory by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. PLoS One 2011;6:e28425.
Cassagne C, Cella AL, Suchon P, Normand AC, Ranque S, Piarroux R. Evaluation of four pretreatment procedures for MALDI-TOF MS yeast identification in the routine clinical laboratory. Med Mycol 2013;51:371-7.
Castanheira M, Woosley LN, Diekema DJ, Jones RN, Pfaller MA. Candida guilliermondii and other species of Candida misidentified as Candida famata: Assessment by Vitek2, ITS sequence analysis and Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry in two global surveillance programs. J Clin Microbiol 2013;51:117-24.
Cendejas-Bueno E, Gomez-Lopez A, Mellado E, Rodriguez-Tudela JL, Cuenca-Estrella M. Identification of pathogenic rare yeast species in clinical samples: Comparison between phenotypical and molecular methods. J Clin Microbiol 2010;48:1895-9.
Chen JH, Yam WC, Ngan AH, Fung AM, Woo WL, Yan MK, et al. Advantages of using matrix-assisted laser desorption ionization-time of flight mass spectrometry as a rapid diagnostic tool for identification of yeasts and mycobacteria in the clinical microbiological laboratory. J Clin Microbiol 2013;51:3981-7.
De Carolis E, Posteraro B, Lass-Florl C, Vella A, Florio AR, Torelli R, et al. Species identification of Aspergillus, Fusarium and Mucorales with direct surface analysis by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Clin Microbiol Infect 2012;18:475-84.
Dhiman N, Hall L, Wohlfiel SL, Buckwalter SP, Wengenack NL. Performance and cost analysis of matrix-assisted laser desorption ionization-time of flight mass spectrometry for routine identification of yeast. J Clin Microbiol 2011;49:1614-6.
Latouche GN, Daniel HM, Lee OC, Mitchell TG, Sorrell TC, Meyer W. Comparison of use of phenotypic and genotypic characteristics for identification of species of the anamorph genus Candida and related teleomorph yeast species. J Clin Microbiol 1997;35:3171-80.
Linton CJ, Borman AM, Cheung G, Holmes AD, Szekely A, Palmer MD, et al. Molecular identification of unusual pathogenic yeast isolates by large ribosomal subunit gene sequencing: 2 years of experience at the United kingdom mycology reference laboratory. J Clin Microbiol 2007;45:1152-8.
Meletiadis J, Arabatzis M, Bobola M, Tsiveriotis K, Hini S, Petinaki E, et al. Comparative evaluation of three commercial identification systems using common and rare bloodstream yeast isolates. J Clin Microbiol 2011;49:2722-7.
Miceli MH, Diaz JA, Lee SA. Emerging opportunistic yeast infections. Lancet Infect Dis 2011;11:142-51.
Miceli MH, Lee SA. Emerging moulds: epidemiological trends and antifungal resistance. Mycoses 2011;54:e666-e78.
Patel R. Matrix-assisted laser desorption ionization-time of flight mass spectrometry in clinical microbiology. Clin Infect Dis 2013;57:564-72.
Pfaller MA, Diekema DJ. Rare and emerging opportunistic fungal pathogens: Concern for resistance beyond Candida albicans and Aspergillus fumigatus. J Clin Microbiol 2004;42:4419-31.
Pfaller MA, Diekema DJ, Gibbs DL, Newell VA, Bijie H, Dzierzanowska D, et al. Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: 10.5-year analysis of susceptibilities of noncandidal yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing. J Clin Microbiol 2009;47:117-23.
Pfaller MA, Diekema DJ. Epidemiology of invasive mycoses in North America. Crit Rev Microbiol 2010;36:1-53.
Pfaller MA, Woosley LN, Messer SA, Jones RN, Castanheira M. Significance of molecular identification and antifungal susceptibility of clinically significant yeasts and moulds in a global antifungal surveillance program. Mycopathologia 2012;174:259-71.
Pfaller MA, Messer SA, Woosley LN, Jones RN, Castanheira M. Echinocandin and triazole antifungal susceptibility profiles of opportunistic yeast and mould clinical isolates (2010-2011); Application of new CLSI clinical breakpoints and epidemiological cutoff values to characterize geographic and temporal trends of antifungal resistance. J Clin Microbiol 2013;51:2571-81.
Pounder JI, Simmon KE, Barton CA, Hohmann SL, Brandt ME, Petti CA. Discovering potential pathogens among fungi identified as nonsporulating molds. J Clin Microbiol 2007;45:568-71.
Sanguinetti M, Porta R, Sali M, La Sorda M, Pecorini G, Fadda G, et al. Evaluation of VITEK 2 and RapID yeast plus systems for yeast species identification: experience at a large clinical microbiology laboratory. J Clin Microbiol 2007;45:1343-6.
Stevenson LG, Drake SK, Shea YR, Zelazny AM, Murray PR. Evaluation of matrix-assisted laser desorption ionization-time of flight mass spectrometry for identification of clinically important yeast species. J Clin Microbiol 2010;48:3482-6.
Van Herendael BH, Bruynseels P, Bensaid M, Boekhout T, De Baere T, Surmont I, et al. Validation of a modified algorithm for the identification of yeast isolates using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). Eur J Clin Microbiol Infect Dis 2012;31:841-8.