title: Performance of a matrix-assisted laser desorption ionization-time-of-flight mass spectrometry system for the identification of bacterial isolates in the clinical routine laboratory.
abstract: BACKGROUND
  Matrix-Assisted Laser Desorption Ionization-Time-of-Flight Mass Spectrometry (MALDI-TOF MS) has emerged as a new tool for the fast and reliable identification of microorganisms. We evaluated the performance of a MALDI-TOF MS-system for the identification of various clinical isolates in the routine microbiology setting.
  
  
  METHODS
  For the evaluation study a set of 1116 bacterial isolates were collected in the routine microbiology laboratory. Additonally 108 isolates of strain culture collections (ATTC, DSMZ) were utilized. Identification of the bacterial isolates was perfomed with a Microflex LT mass spectrometer in combination with the MALDI-Biotyper 2.0 software (Bruker Daltonik GmbH, Bremen, Germany). The results of the MALDI-TOF MS were compared to phenotypic bacterial identification systems used in our routine laboratory. Discrepancies were resolved by 16 S rDNA-sequencing.
  
  
  RESULTS
  Of the 108 reference strains tested, 101 (93.5%) were correctly identified to species level. Overall, 1062 (95.2%) of the 1116 strains collected in the routine laboratory were correctly identified with the MALDI-Biotyper. Accuracy for the identification of Enterobacteriaceae, non-fermenting gram-negative rods, staphylococci, enterococci and streptococci with the MALDI-Biotyper was 95.5%, 79.7%, 99.5%, 100% and 93.7%, respectively. Results were available in 12 minutes for direct smear and in 20 min with an extraction method.
  
  
  CONCLUSIONS
  The MALDI-TOF method proves to be a fast and reliable method for the identification of the most important bacterial isolates in the clinical laboratory.
authors.affiliation: Department of Microbiology, Laboratory Limbach, Heidelberg, Germany. ulrich.eigner@labor-limbach.de
authors.forename: Ulrich
authors.initials: U
authors.lastname: Eigner
authors.forename: Martin
authors.initials: M
authors.lastname: Holfelder
authors.forename: Klaus
authors.initials: K
authors.lastname: Oberdorfer
authors.forename: Ulrike
authors.initials: U
authors.lastname: Betz-Wild
authors.forename: Daniela
authors.initials: D
authors.lastname: Bertsch
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Fahr
mesh_terms: D001419:Bacteria / Q000302:isolation & purification*; D017931:DNA Primers; D003955:Diagnostic Tests, Routine / Q000379:methods*; D006090:Gram-Negative Bacteria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D010641:Phenotype; D016133:Polymerase Chain Reaction; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods*
chemical_list: D017931:DNA Primers