title: Identification of Candida haemulonii Complex Species: Use of ClinProTools(TM) to Overcome Limitations of the Bruker Biotyper(TM), VITEK MS(TM) IVD, and VITEK MS(TM) RUO Databases.
abstract: Candida haemulonii is now considered a complex of two species and one variety: C. haemulonii sensu stricto, Candida duobushaemulonii and the variety C. haemulonii var. vulnera. Identification (ID) of these species is relevant for epidemiological purposes and for therapeutic management, but the different phenotypic commercial systems are unable to provide correct species ID for these emergent pathogens. Hence, we evaluated the MALDI-TOF MS performance for the ID of C. haemulonii species, analyzing isolates/strains of C. haemulonii complex species, Candida pseudohaemulonii and Candida auris by two commercial platforms, their databases and softwares. To differentiate C. haemulonii sensu sctricto from the variety vulnera, we used the ClinProTools(TM) models and a single-peak analysis with the software FlexAnalysis(TM). The Biotyper(TM) database gave 100% correct species ID for C. haemulonii sensu stricto, C. pseudohaemulonii and C. auris, with 69% of correct species ID for C. duobushaemulonii. Vitek MS(TM) IVD database gave 100% correct species ID for C. haemulonii sensu stricto, misidentifying all C. duobushaemulonii and C. pseudohaemulonii as C. haemulonii, being unable to identify C. auris. The Vitek MS(TM) RUO database needed to be upgraded with in-house SuperSpectra to discriminate C. haemulonii sensu stricto, C. duobushaemulonii, C. pseudohaemulonii, and C. auris strains/isolates. The generic algorithm model from ClinProTools(TM) software showed recognition capability of 100% and cross validation of 98.02% for the discrimination of C. haemulonii sensu stricto from the variety vulnera. Single-peak analysis showed that the peaks 5670, 6878, or 13750 m/z can distinguish C. haemulonii sensu stricto from the variety vulnera.
authors.affiliation: Department of Biophysics, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo, Brazil.
authors.forename: Rafaella C
authors.initials: RC
authors.lastname: Grenfell
authors.affiliation: Central Laboratory Division - LIM-03, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo São Paulo, Brazil.
authors.forename: Afonso R
authors.initials: AR
authors.lastname: da Silva Junior
authors.affiliation: Laboratory of Medical Mycology - LIM-53, Hospital das Clínicas FMUSP and Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo São Paulo, Brazil.
authors.forename: Gilda M B
authors.initials: GM
authors.lastname: Del Negro
authors.affiliation: Central Laboratory Division - LIM-03, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo São Paulo, Brazil.
authors.forename: Regina B
authors.initials: RB
authors.lastname: Munhoz
authors.affiliation: Laboratory of Medical Mycology - LIM-53, Hospital das Clínicas FMUSP and Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo São Paulo, Brazil.
authors.forename: Viviane M F
authors.initials: VM
authors.lastname: Gimenes
authors.affiliation: Bruker do Brasil Atibaia, Brazil.
authors.forename: Diego M
authors.initials: DM
authors.lastname: Assis
authors.affiliation: bioMérieux São Paulo, Brazil.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Rockstroh
authors.affiliation: Central Laboratory Division - LIM-03, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo São Paulo, Brazil.
authors.forename: Adriana L
authors.initials: AL
authors.lastname: Motta
authors.affiliation: Central Laboratory Division - LIM-03, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo São Paulo, Brazil.
authors.forename: Flavia
authors.initials: F
authors.lastname: Rossi
authors.affiliation: Department of Biophysics, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo, Brazil.
authors.forename: Luiz
authors.initials: L
authors.lastname: Juliano
authors.affiliation: Laboratory of Medical Mycology - LIM-53, Hospital das Clínicas FMUSP and Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo São Paulo, Brazil.
authors.forename: Gil
authors.initials: G
authors.lastname: Benard
authors.affiliation: Central Laboratory Division - LIM-03, Hospital das Clínicas da Faculdade de Medicina, Universidade de São PauloSão Paulo, Brazil; Laboratory of Medical Mycology - LIM-53, Hospital das Clínicas FMUSP and Instituto de Medicina Tropical de São Paulo, Universidade de São PauloSão Paulo, Brazil.
authors.forename: João N
authors.initials: JN
authors.lastname: de Almeida Júnior
keywords: Candida haemulonii complex species; ClinProToolsTM; MALDI-TOF mass spectrometry; Microflex LTTM; Vitek MSTM