Current status of MALDI-TOF mass spectrometry in

clinical microbiology

Tsung-Yun Hou ^a,b,c, Chuan Chiang-Ni ^d,e,f, Shih-Hua Teng ^g,*

^a Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Wan Fang Hospital, Taipei

Medical University, Taipei, Taiwan

^b Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College

of Medicine, Taipei Medical University, Taipei, Taiwan

^c Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital,

National Defense Medical Center, Taipei, Taiwan

^d Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan

^e Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan

^f Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan

^g Bruker Taiwan Co., Ltd., Taipei, Taiwan

Mass spectrometry (MS) is a type of analysis used to determine what molecules make up a sample, based on the mass spectrum that are created by the ions. Mass spectrometers are able to perform traditional target analyte identification and quantitation; however, they may also be used within a clinical setting for the rapid identification of bacteria. The causative agent in sepsis is changed over time, and clinical decisions affecting the management of infections are often based on the outcomes of bacterial identification. Therefore, it is essential that such identifications are performed quickly and interpreted correctly. Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometer is one of the most popular MS instruments used in biology, due to its rapid and precise identification of genus and species of an extensive range of Gram-negative and positive bacteria. Microorganism identification by Mass spectrometry is based on identifying a characteristic spectrum of each species and then matched with a large database within the instrument. The present review gives a contemporary perspective on the challenges and opportunities for bacterial identification as well as a written report of how technological innovation has advanced MS. Future clinical applications will also be addressed, particularly the use of MALDI-TOF MS in the field of microbiology for the identification and the analysis of antibiotic resistance.

Keywords: Antibiotic susceptibility testing, MALDI-TOF MS, Mass spectrometry, Microbiology, Microorganism identification