title: Viridans Group Streptococci clinical isolates: MALDI-TOF mass spectrometry versus gene sequence-based identification.
abstract: Viridans Group Streptococci (VGS) species-level identification is fundamental for patients management. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has been used for VGS identification but discrimination within the Mitis group resulted difficult. In this study, VGS identifications with two MALDI-TOF instruments, the Biotyper (Bruker) and the VITEK MS (bioMérieux) have been compared to those derived from tuf, soda and rpoB genes sequencing. VGS isolates were clustered and a dendrogram constructed using the Biotyper 3.0 software (Bruker). RpoB gene sequencing resulted the most sensitive and specific molecular method for S. pneumonia identification and was used as reference method. The sensitivity and the specificity of the VITEK MS in S. pneumonia identification were 100%, while the Biotyper resulted less specific (92.4%). In non pneumococcal VGS strains, the group-level correlation between rpoB and the Biotyper was 100%, while the species-level correlation was 61% after database upgrading (than 37% before upgrading). The group-level correlation between rpoB and the VITEK MS was 100%, while the species-level correlation was 36% and increases at 69% if isolates identified as S. mitis/S. oralis are included. The less accurate performance of the VITEK MS in VGS identification within the Mitis group was due to the inability to discriminate between S. mitis and S. oralis. Conversely, the Biotyper, after the release of the upgraded database, was able to discriminate between the two species. In the dendrogram, VGS strains from the same group were grouped into the same cluster and had a good correspondence with the gene-based clustering reported by other authors, thus confirming the validity of the upgraded version of the database. Data from this study demonstrated that MALDI-TOF technique can represent a rapid and cost saving method for VGS identification even within the Mitis group but improvements of spectra database are still recommended.
authors.affiliation: Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Angeletti
authors.affiliation: Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Giordano
authors.initials: G
authors.lastname: Dicuonzo
authors.affiliation: Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Avola
authors.affiliation: Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Crea
authors.affiliation: Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Etleva
authors.initials: E
authors.lastname: Dedej
authors.affiliation: Microbiology Institute, AO 'Papa Giovanni XXIII' (formerly AO 'Ospedali Riuniti') of Bergamo, Bergamo, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Vailati
authors.affiliation: Microbiology Institute, AO 'Papa Giovanni XXIII' (formerly AO 'Ospedali Riuniti') of Bergamo, Bergamo, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Farina
authors.affiliation: Clinical Pathology and Microbiology Laboratory, University Hospital Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: De Florio
mesh_terms: D015373:Bacterial Typing Techniques / Q000379:methods*; D060005:Genotyping Techniques; D012680:Sensitivity and Specificity; D012984:Software; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D034363:Viridans Streptococci / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification / Q000378:metabolism