title: Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry for rapid identification of fungal rhinosinusitis pathogens.
abstract: OBJECTIVE
  Filamentous fungi are among the most important pathogens, causing fungal rhinosinusitis (FRS). Current laboratory diagnosis of FRS pathogens mainly relies on phenotypic identification by culture and microscopic examination, which is time consuming and expertise dependent. Although matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) MS has been employed to identify various fungi, its efficacy in the identification of FRS fungi is less clear.
  
  
  METHODS
  A total of 153 FRS isolates obtained from patients were analysed at the Clinical Laboratory at the Beijing Tongren Hospital affiliated to the Capital Medical University, between January 2014 and December 2015. They were identified by traditional phenotypic methods and Bruker MALDI-TOF MS (Bruker, Biotyper version 3.1), respectively. Discrepancies between the two methods were further validated by sequencing.
  
  
  RESULTS
  Among the 153 isolates, 151 had correct species identification using MALDI-TOF MS (Bruker, Biot 3.1, score ≥2.0 or 2.3). MALDI-TOF MS enabled identification of some very closely related species that were indistinguishable by conventional phenotypic methods, including 1/10 Aspergillus versicolor, 3/20 Aspergillus flavus, 2/30 Aspergillus fumigatus and 1/20 Aspergillus terreus, which were misidentified by conventional phenotypic methods as Aspergillus nidulans, Aspergillus oryzae, Aspergillus japonicus and Aspergillus nidulans, respectively. In addition, 2/2 Rhizopus oryzae and 1/1 Rhizopus stolonifer that were identified only to the genus level by the phenotypic method were correctly identified by MALDI-TOF MS.
  
  
  CONCLUSIONS
  MALDI-TOF MS is a rapid and accurate technique, and could replace the conventional phenotypic method for routine identification of FRS fungi in clinical microbiology laboratories.
authors.affiliation: Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Yanfei
authors.initials: Y
authors.lastname: Huang
authors.affiliation: State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, PR China.
authors.forename: Jinglin
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Mingxin
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhu
authors.affiliation: Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Mei
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Haitong
authors.initials: H
authors.lastname: Gu
authors.affiliation: Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Xue
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Shaoya
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.
authors.forename: Xinxin
authors.initials: X
authors.lastname: Lu
mesh_terms: D001230:Aspergillus / Q000235:genetics / Q000302:isolation & purification; D005658:Fungi / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D012220:Rhinitis / Q000175:diagnosis / Q000382:microbiology*; D017422:Sequence Analysis, DNA; D012852:Sinusitis / Q000175:diagnosis / Q000382:microbiology; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods*