| Literature DB >> 35448614 |
Claudia Honsig1, Brigitte Selitsch1, Marlene Hollenstein2, Matthias G Vossen3, Kathrin Spettel1, Birgit Willinger1.
Abstract
Invasive infections caused by filamentous fungi constitute a leading cause of morbidity and mortality in immunocompromised patients. Rapid and reliable identification of filamentous fungi is essential for the early initiation of appropriate treatment. In the present study, 230 filamentous fungi isolates identified by conventional methods were investigated using MALDI-TOF MS (Bruker Daltonics, Bremen, Germany) in combination with the Filamentous Fungi Library 3.0 provided by the manufacturer. Three different sample preparation methods were applied as recommended by the manufacturer and identification rates were compared using the criteria provided by the manufacturer. Application of the more time-consuming sample preparation methods clearly improved identification at the species level. Thus, the identification rate increased from 48.9% using the simplest method to 76.1% with the most laborious procedure. Misidentifications did not occur. Furthermore, the reliability of an in-house threshold for species identification was investigated. The reduced threshold increased the rate of isolates correctly identified at the species level by up to 86.4%. As no misidentification was made at the genus level and only one misidentification of minor significance occurred at the species level, this threshold could be validated for routine use in our laboratory. In conclusion, regarding the high identification rates achieved, this commercial platform proved suitable for implementation in routine diagnosis.Entities:
Keywords: MALDI-TOF MS; filamentous fungi; identification
Year: 2022 PMID: 35448614 PMCID: PMC9025689 DOI: 10.3390/jof8040383
Source DB: PubMed Journal: J Fungi (Basel) ISSN: 2309-608X
Isolates included in the study (n = 230). Clinical isolates (n = 185) identified with high confidence (at species level) (n = 161) and only identified with low confidence (at genus level) (n = 24), respectively. Reference strains (n = 45). Abbreviations: n: number; library: Bruker Filamentous Fungi Library 3.0; ✓: included in the library; -: not included in the library.
| Genus |
| Species | Included in Library | n Clinical Isolates | n Reference Strains |
|---|---|---|---|---|---|
|
| 6 |
| - | 1 | |
|
| - | 1 | |||
|
| - | 1 | |||
|
| - | 1 | 2 | ||
|
| 6 |
| ✓ | 3 | |
|
| - | 1 | |||
|
| ✓ | 2 | |||
|
| 81 |
| ✓ | 1 | 2 |
|
| ✓ | 15 | |||
|
| ✓ | 1 | |||
|
| ✓ | 9 | |||
|
| ✓ | 15 | |||
|
| ✓ | 16 | |||
|
| ✓ | 1 | |||
|
| ✓ | 1 | |||
|
| ✓ | 13 | |||
|
| ✓ | 5 | |||
|
| ✓ | 2 | |||
|
| 5 |
| - | 1 | |
|
| - | 3 | |||
|
| - | 1 | |||
|
| 6 |
| ✓ | 1 | |
|
| ✓ | 1 | 1 | ||
|
| ✓ | 1 | |||
|
| ✓ | 2 | |||
|
| 8 |
| - | 6 | |
|
| ✓ | 1 | |||
|
| ✓ | 1 | |||
|
| 5 |
| ✓ | 5 | |
|
| 24 |
| ✓ | 3 | |
|
| ✓ | 8 | |||
|
| ✓ | 8 | |||
|
| ✓ | 5 | |||
|
| 14 |
| ✓ | 11 | 2 |
|
| ✓ | 1 | |||
|
| 9 |
| ✓ | 5 | 2 |
|
| ✓ | 1 | |||
|
| ✓ | 1 | |||
|
| 3 |
| ✓ | 2 | 1 |
|
| 13 |
| ✓ | 3 | 2 |
|
| ✓ | 1 | |||
|
| ✓ | 1 | |||
|
| ✓ | 1 | |||
|
| ✓ | 1 | 1 | ||
|
| ✓ | 3 | |||
|
| 1 | - | 1 | ||
|
| 8 |
| ✓ | 7 | 1 |
|
| 5 |
| - | 1 | 1 |
|
| ✓ | 2 | 1 | ||
|
| 11 |
| ✓ | 2 | 2 |
|
| ✓ | 5 | 2 | ||
|
| 12 |
| ✓ | 6 | |
|
| - | 2 | 4 | ||
|
| 4 |
| ✓ | 4 | |
|
| 3 |
| - | 1 | 1 |
|
| - | 1 | |||
|
| 6 |
| ✓ | 6 | |
| total | 230 | 185 | 45 |
Clinical isolates identified at the species level and reference strains included in the Filamentous Fungi Library 3.0 (n = 184). Results of the MALDI-TOF MS using three different sample preparation procedures. Interpretation of results, i.e., identification with high confidence (at the species level) or low confidence (at the genus level), according to the manufacturer’s recommendations. Abbreviations: n: number, ID hc.: number of isolates identified with high confidence (at the species level), ID lc.: number of isolates identified with low confidence (at the genus level), no ID: number of isolates not identified.
| Clinical Isolates and Reference Strains | MALDI-TOF MS | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Extended Direct Transfer | Extraction | Liquid Cultivation | ||||||||||
| Genus |
| Species |
| ID hc. | ID lc. | no ID | ID hc. | ID lc. | no ID | ID hc. | ID lc. | no ID |
|
| 3 |
| 3 | 2 | 1 | - | 2 | 1 | - | 2 | 1 | - |
|
| 80 |
| 3 | 1 | 1 | 1 | - | 1 | 2 | 2 | 1 | - |
|
| 15 | 7 | 5 | 3 | 12 | 1 | 2 | 15 | - | - | ||
|
| 1 | - | 1 | - | 1 | - | - | - | 1 | - | ||
|
| 9 | 5 | 1 | 3 | 6 | 2 | 1 | 9 | - | - | ||
|
| 15 | 10 | 4 | 1 | 14 | - | 1 | 15 | - | - | ||
|
| 16 | 9 | 4 | 3 | 6 | 10 | - | 13 | 3 | - | ||
|
| 1 | 1 | - | - | 1 | - | - | 1 | - | - | ||
|
| 13 | 9 | 2 | 2 | 9 | 2 | 2 | 8 | 1 | 4 | ||
|
| 5 | 4 | 1 | - | 5 | - | - | 5 | - | - | ||
|
| 2 | 2 | - | - | - | 1 | 1 | 2 | - | - | ||
|
| 4 |
| 1 | - | - | 1 | - | - | 1 | - | - | 1 |
|
| 2 | - | - | 2 | - | - | 2 | - | - | 2 | ||
|
| 1 | - | - | 1 | - | - | 1 | - | - | 1 | ||
|
| 5 |
| 5 | 5 | - | - | 3 | 1 | 1 | 5 | - | - |
|
| 19 |
| 3 | - | - | 3 | - | 2 | 1 | 3 | - | - |
|
| 8 | 1 | 6 | 1 | 4 | 2 | 2 | 7 | 1 | - | ||
|
| 8 | 4 | 3 | 1 | 4 | 4 | - | 8 | - | - | ||
|
| 3 |
| 3 | 3 | - | - | 3 | - | - | 3 | - | - |
|
| 10 |
| 5 | - | 1 | 4 | - | 3 | 2 | 2 | 2 | 1 |
|
| 1 | - | - | 1 | - | - | 1 | - | - | 1 | ||
|
| 1 | - | 1 | - | - | - | 1 | 1 | - | - | ||
|
| 1 | - | 1 | - | - | 1 | - | - | 1 | - | ||
|
| 2 | - | - | 2 | 1 | - | 1 | 1 | - | 1 | ||
|
| 8 |
| 8 | 5 | 2 | 1 | 5 | 3 | - | 8 | - | - |
|
| 12 |
| 12 | 9 | 1 | 2 | 10 | - | 2 | 9 | - | 3 |
|
| 4 |
| 4 | - | - | 4 | 1 | 2 | 1 | - | 3 | 1 |
|
| ||||||||||||
|
| 1 |
| 1 | - | - | 1 | - | - | 1 | - | - | 1 |
|
| 13 |
| 13 | 2 | 6 | 5 | 9 | 3 | 1 | 7 | 2 | 4 |
|
| 8 |
| 7 | 5 | 1 | 1 | 6 | 1 | - | 5 | - | 2 |
|
| 1 | - | - | 1 | - | 1 | - | - | 1 | - | ||
|
| 3 |
| 3 | 3 | - | - | 3 | - | - | 3 | - | - |
|
| 11 |
| 7 | 2 | 2 | 3 | 6 | 1 | - | 3 | 4 | - |
|
| 4 | 1 | 1 | 2 | 3 | 1 | - | 3 | - | 1 | ||
| Total n | 184 | 90 | 45 | 49 | 114 | 43 | 27 | 140 | 21 | 23 | ||
| Total % | 100% | 48.9% | 24.5% | 26.6% | 62.0% | 23.4% | 14.7% | 76.1% | 11.4% | 12.5% | ||
Clinical isolates identified at the species level and reference strains included in the Filamentous Fungi Library 3.0 (n = 184). Number (%) of correctly identified isolates at the species level using three different sample preparation procedures. Manufacturer: when applying the manufacturer’s instructions, in-house: when applying a threshold of 1.70.
| Sample Preparation Procedure | Number (%) Isolates Identified at the Species Level | |
|---|---|---|
| Manufacturer | In-House | |
| Extended direct transfer | 90 (48.9%) | 134 (72.8%) |
| Extraction | 114 (62.0%) | 155 (84.2%) |
| Liquid cultivation | 140 (76.1%) | 159 (86.4%) |
Isolates identified at the genus level and included in the Filamentous Fungi Library 3.0 (n = 23). Results of the MALDI-TOF MS using three different sample preparation procedures. Interpretation of results, i.e., identification with high confidence (at the species level) or with low confidence (at the genus level), according to the manufacturer’s recommendations. Abbreviations: n: number, ID hc.: number of isolates identified with high confidence (at species level), ID lc.: number of isolates identified with low confidence (at the genus level), no ID: number of isolates not identified.
| Clinical Isolates | MALDI-TOF MS | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Extended Direct Transfer | Extraction | Liquid Cultivation | ||||||||
| Genus |
| ID hc. | ID lc. | no ID | ID hc. | ID lc. | no ID | ID hc. | ID lc. | no ID |
| 2 | 1/ | 1 | - | 1/ | 1 | - | 2/ | - | - | |
| 1 | - | 1 | - | 1/ | - | - | 1/ | - | - | |
| 2 | - | - | 2 | - | - | 2 | - | - | 2 | |
| 1 | - | - | 1 | - | - | 1 | - | - | 1 | |
| 5 | 1/ | 4 | - | 2/ | 1 | 2 | 4/ | - | - | |
| 1 | - | - | 1 | - | 1 | - | - | 1 | - | |
| 1 | - | 1 | - | 1/ | - | - | 1/ | - | - | |
| 3 | - | 1 | 2 | - | - | 3 | 1/ | - | 2 | |
| 1 | - | - | 1 | - | 1 | - | 1/ | - | - | |
| 6 | - | 1 | 5 | - | 2 | 4 | - | 3 | 3 | |
| Total n | 23 | 2 | 9 | 12 | 5 | 6 | 12 | 11 | 4 | 8 |
| Total % | 100% | 8.7% | 39.1% | 52.2% | 21.7% | 26.1% | 52.2% | 47.8% | 17.3% | 34.8% |
Isolates identified at the genus level and included in the Filamentous Fungi Library 3.0 (n = 23). Number (%) of isolates identified at the species level using three different sample preparation procedures. Manufacturer: when applying the manufacturer’s instructions, in-house: when applying a threshold of 1.70.
| Sample Preparation Procedure | Number (%) Isolates Identified at the Species Level | |
|---|---|---|
| Manufacturer | In-House | |
| Extended direct transfer | 2 (8.7%) | 9 (39.1%) |
| Extraction | 5 (21.7%) | 10 (43.5%) |
| Liquid cultivation | 11 (47.8%) | 12 (52.02%) |