Identification of yeasts from clinical samples using MALDI-TOF MS
Article Sidebar
Main Article Content
Abstract
Objective: This research aimed to identify the yeasts from the clinical specimens by comparing MALDI-TOF MS using extended direct transfer technique (EDT-MALDI) and the conventional method.
Methods: This study was a retrospective cohort. The samples were the 557 yeasts isolated from the clinical specimens in the Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Thailand by comparing between the EDT-MALDI and the conventional method. The data were analyzed by using McNemar Test. Moreover, the unit cost and the turnaround time of the both methods were calculated. The other data such as age, sex, wards, types of the specimens and the prevalence of the species of yeasts, were collected and analyzed.
Results: The result showed that the EDT-MALDI can identify the yeast isolates into the species level more accurately than the conventional method at 100% and 93.2%, respectively. The conventional method was limited for correctly identification of Trichosporon asahii, Cryptococcus neoformans, some non-albicans Candida, Magnusiomyces capitatus, and Candida rugosa. However, both methods were not significantly different from each other. Even though the threshold score of the EDT-MALDI was reduced from ≥ 2 to ≥ 1.7, this will increase the acceptable results without effect to specificity, accuracy, and reliability in the species level. The EDT-MALDI was faster than the conventional method for at least 24 hours. Moreover, the unit cost of EDT-MALDI is lower than the conventional method (68 baht/test and 116 baht/test, respectively). In this data, the elderly female admitted to the hospital were the most patients who found yeast in specimens. Candida albicans (54.04%) were the most isolated species, followed by Candida tropicalis (26.21%).
Conclusion: The EDT-MALDI was a suitable method for the yeast identification in the routine laboratory because it was provided a shorter time of analysis, obtained reliable results and less expensive unit cost.
Article Details
References
Gavalda J, Meije Y, Fortun J, Roilides E, Saliba F, Lortholary O, et al. Invasive fungal infections in solid organ transplant recipients. Clin Microbiol Infect. 2014; 7: 27-48.
Eggimann P, Que YA, Revelly JP, Pagani JL. Preventing invasive candida infections. Where could we do better? J Hosp Infect. 2015; 89:302-8.
Arendrup MC, Boekhout T, Akova M, Meis JF, Cornely OA, Lortholary O. ESCMID and ECMM joint clinical guidelines for the diagnosis and management of rare invasive yeast infections. Clin Microbiol Infect. 2014; 20: 76-98.
Bille E, Dauphin B, Leto J, Bougnoux ME, Beretti JL, Lotz A, et al. MALDI-TOF MS Andromas strategy for the routine identification of bacteria, mycobacteria, yeasts, Aspergillus spp. and positive blood cultures. Clin Microbiol Infect. 2012; 18: 1117-25.
Emonet S, Shah HN, Cherkaoui A, Schrenzel J. Application and use of various mass spectrometry methods in clinical microbiology. Clin Microbiol Infect. 2010; 16: 1604-13.
Bader O, Weig M, Taverne-Ghadwal L, Lugert R, Gross U, Kuhns M. Improved clinical laboratory identification of human pathogenic yeasts by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Clin Microbiol Infect. 2011; 17: 1359-65.
Lacroix C, Gicquel A, Sendid B, Meyer J, Accoceberry I, François N, et al. Evaluation of two matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) systems for the identification of Candida species. Clin Microbiol Infect. 2014; 20:153-8.
Buchan BW, Ledeboer NA. Advances in identification of clinical yeast isolates by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol. 2013; 51: 1359-66.
Goyer M, Lucchi G, Ducoroy P, Vagner O, Bonnin A, Dalle F. Optimization of the preanalytical steps of matrix-assisted laser desorption ionization-time of flight mass spectrometry identification provides a flexible and efficient tool for identification of clinical yeast isolates in medical laboratories. J Clin Microbiol. 2012;50: 3066-8.
Stevenson LG, Drake SK, Shea YR, Zelazny AM, Murray PR. Evaluation of matrix-assisted laser desorption ionization-time of flight mass spectrometry for identification of clinically important yeast species. J Clin Microbiol. 2010;48: 3482-6.
Sendid B, Ducoroy P, François N, Lucchi G, Spinali S, Vagner O, et al. Evaluation of MALDI-TOF mass spectrometry for the identification of medically-important yeasts in the clinical laboratories of Dijon and Lille hospitals. Med Mycol. 2013; 51: 25-32.
Cassagne C, Cella AL, Suchon P, Normand AC, Ranque S, Piarroux R. Evaluation of four pretreatment procedures for MALDI-TOF MS yeast identification in the routine clinical laboratory. Med Mycol. 2013; 51: 371-7.
Fraser M, Brown Z, Houldsworth M, Borman AM, Johnson EM. Rapid identification of 6328 isolates of pathogenic yeasts using MALDI-ToF MS and a simplified, rapid extraction procedure that is compatible with the Bruker Biotyper platform and database. Med Mycol. 2016; 54: 80-8.
Sumitra DL, Megha M. Speciation of Candida species isolated from clinical specimens by using chrom agar and conventional methods. Int J Sci Res Pub. 2014; 4: 1-5.
Marinho SA, Teixeira AB, Santos OS, Cazanova RF, Ferreira CA, Cherubini K, et al. Identification of Candida spp. by phenotypic tests and PCR.Braz J Microbiol. 2010; 41: 286-94.
Bishop JA, Chase N, Lee R, Kurtzman CP, Merz WG. Production of white colonies on CHROMagar Candida medium by members of the Candida glabrata clade and other species with overlapping phenotypic traits. J Clin Microbiol. 2008; 46: 3498-500.
Murray PR. What is new in clinical microbiologymicrobial identification by MALDI-TOF mass spectrometry: a paper from the 2011 William Beaumont Hospital Symposium on molecular pathology. J Mol Diagn. 2012; 14: 419-23.
Cassagne C, Normand AC, L'Ollivier C, Ranque S, Piarroux R. Performance of MALDI-TOF MS platforms for fungal identification. Mycoses. 2016; 59: 678-90.
Gorton RL, Seaton S, Ramnarain P, McHugh TD, Kibbler CC. Evaluation of a short, on-plate formic acid extraction method for matrixassisted laser desorption ionization-time of flight mass spectrometry-based identification of clinically relevant yeast isolates. J Clin Microbiol. 2014; 52: 1253-5.
Vlek A, Kolecka A, Khayhan K, Theelen B, Groenewald M, Boel E, et al. Interlaboratory comparison of sample preparation methods, database expansions, and cutoff values for identification of yeasts by matrix-assisted laser desorption ionization-time of flight mass spectrometry using a yeast test panel. J Clin Microbiol. 2014; 52: 3023-9.
Dhiman N, Hall L, Wohlfiel SL, Buckwalter SP, Wengenack NL. Performance and cost analysis of matrix-assisted laser desorption ionizationtime of flight mass spectrometry for routine identification of yeast. J Clin Microbiol. 2011; 49:1614-6.
Jamal WY, Ahmad S, Khan ZU, Rotimi VO. Comparative evaluation of two matrixassisted laser desorption/ionization time-offlight mass spectrometry (MALDI-TOF MS) systems for the identification of clinically significant yeasts. Int J Infect Dis. 2014; 26:167-70.
Steensels D, Verhaegen J, Lagrou K. Matrixassisted laser desorption ionization-time of flight mass spectrometry for the identification of bacteria and yeasts in a clinical microbiological laboratory: a review. Acta Clin Belg. 2011; 66: 267-73.
Deak E, Charlton CL, Bobenchik AM, Miller SA, Pollett S, McHardy IH, et al. Comparison of the Vitek MS and Bruker Microflex LT MALDI-TOF MS platforms for routine identification of commonly isolated bacteria and yeast in the clinical microbiology laboratory. Diag Microbiol Infect Dis. 2015; 81: 27-33.
Bernhard M, Weig M, Zautner AE, Gross U, Bader O. Yeast on-target lysis (YOTL), a procedure for making auxiliary mass spectrum data sets for clinical routine identification of yeasts.J Clin Microbiol. 2014; 52: 4163-7.
Sahand IH, Maza JL, Eraso E, Montejo M, Moragues MD, Aguirre JM, et al. Evaluation of CHROM-Pal medium for the isolation and direct identification of Candida dubliniensis in primary cultures from the oral cavity. J Med Microbiol.2009; 58: 1437-42.
Hospenthal DR, Beckius ML, Floyd KL, Horvath LL, Murray CK. Presumptive identification of Candida species other than C. albicans, C. krusei, and C. tropicalis with the chromogenic medium CHROMagar Candida. Ann Clin Microbiol Antimicrob. 2006; 5: 1.
Eraso Elena, D. Moragues Marıa, Villar-Vidal Marıa, H. Sahand Ismail, Gonzalez-Gomez Nagore, Ponton Jose´, et al. Evaluation of the new chromogenic medium Candida ID 2 for isolation and identification of Candida albicans and other medically important Candida Species.J Clin Microbiol. 2006; 44: 3340-5.
Esposto MC, Prigitano A, Romeo O, Criseo G, Trovato L, Tullio V, et al. Looking for Candida nivariensis and C. bracarensis among a large Italian collection of C. glabrata isolates: results of the FIMUA working group. Mycoses. 2013; 56:394-6.
Mattede M, Piras C, Mattede KD, Ferrari AT, Baldotto LS, Assbu MS. Urinary tract infections due to Trichosporon spp. in severely ill patients in an intensive care unit. Rev Bras Ter Intensiva.2015; 27: 247-51.
Brandolt TM, Klafke GB, Goncalves CV, Bitencourt LR, Martinez AM, Mendes JF, et al. Prevalence of Candida spp. in cervical-vaginal samples and the in vitro susceptibility of isolates. Braz J Microbiol. 2017; 48: 145-50.