title: MALDI-TOF mass spectrometry identification of filamentous fungi in the clinical laboratory.
abstract: This study aimed to validate the effectiveness of a standardised procedure for the MALDI-TOF mass spectrometry (MS)-based identification on a large sample of filamentous fungi routinely identified in university hospitals' laboratories. Non-dermatophyte filamentous fungi prospectively isolated in the routine activity of five teaching hospitals in France were first identified by conventional methods in each laboratory and then by MS in one centre. DNA sequence-based identification resolved discrepancies between both methods. In this study, of the 625 analysed filamentous fungi of 58 species, 501 (80%) and 556 (89%) were correctly identified by conventional methods and MS respectively. Compared with the conventional method, MS dramatically enhanced the performance of the identification of the non-Aspergillus filamentous fungi with a 31-61% increase in correct identification rate. In conclusion, this study on a large sample of clinical filamentous fungi taxa demonstrates that species identification is significantly improved by MS compared with the conventional method. The main limitation is that MS identification is possible only if the species is included in the reference spectra library. Nevertheless, for the routine clinical laboratory, MS provides the means to attain markedly accurate results in filamentous fungi identification, which was previously restricted to only a few reference laboratories.
authors.affiliation: UMR MD3, Aix-Marseille Université, Marseille, France; Laboratoire de Parasitologie-Mycologie, APHM Timone, Marseille, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Ranque
authors.forename: Anne-Cécile
authors.initials: AC
authors.lastname: Normand
authors.forename: Carole
authors.initials: C
authors.lastname: Cassagne
authors.forename: Jean-Benjamin
authors.initials: JB
authors.lastname: Murat
authors.forename: Nathalie
authors.initials: N
authors.lastname: Bourgeois
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dalle
authors.forename: Martine
authors.initials: M
authors.lastname: Gari-Toussaint
authors.forename: Patrick
authors.initials: P
authors.lastname: Fourquet
authors.forename: Marijke
authors.initials: M
authors.lastname: Hendrickx
authors.forename: Renaud
authors.initials: R
authors.lastname: Piarroux
mesh_terms: D003883:Arthrodermataceae / Q000302:isolation & purification*; D005602:France; D005658:Fungi / Q000145:classification* / Q000302:isolation & purification*; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D011446:Prospective Studies; D017422:Sequence Analysis, DNA; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
keywords: MALDI-TOF; filamentous fungi; identification; routine laboratory