MALDI-TOF Mass Spectrometry in Clinical Microbiology: Progress and Remaining Challenges
MALDI-TOF MS has become the gold standard for microbial identification in clinical laboratories due to its simplicity and robustness, yet widespread adoption remains incomplete. This review identifies key areas for improvement including sample preparation optimisation, database expansion for underrepresented species, and the still-unfulfilled promise of MALDI-TOF-based antimicrobial susceptibility testing as a routine diagnostic tool.
The original study
Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry in Clinical Microbiology: What Are the Current Issues?
- Authors
- van Belkum A, Welker M, Pincus D, Charrier JP, Girard V
- Journal
- Annals of laboratory medicine
- Type
- Journal Article, Review
- PMID
- 28840984
Original abstract
Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) has revolutionized the identification of microbial species in clinical microbiology laboratories. MALDI-TOF-MS has swiftly become the new gold-standard method owing to its key advantages of simplicity and robustness. However, as with all new methods, adoption of the MALDI-TOF MS approach is still not widespread. Optimal sample preparation has not yet been achieved for several applications, and there are continuing discussions on the need for improved database quality and the inclusion of additional microbial species. New applications such as in the field of antimicrobial susceptibility testing have been proposed but not yet translated to the level of ease and reproducibility that one should expect in routine diagnostic systems. Finally, during routine identification testing, unexpected results are regularly obtained, and the best methods for transmitting these results into clinical care are still evolving. We here discuss the success of MALDI-TOF MS in clinical microbiology and highlight fields of application that are still amenable to improvement.