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Review
. 2021 Jun 12;9(6):1283.
doi: 10.3390/microorganisms9061283.

MALDI-TOF MS in a Medical Mycology Laboratory: On Stage and Backstage

Marie-Gladys Robert  1 , Muriel Cornet  2 , Aurélie Hennebique  2 , Tahinamandranto Rasamoelina  3 , Yvan Caspar  4 , Léa Pondérand  4 , Marie Bidart  5 , Harmonie Durand  5 , Marvin Jacquet  2 , Cécile Garnaud  2 , Danièle Maubon  2
Affiliations
Review

MALDI-TOF MS in a Medical Mycology Laboratory: On Stage and Backstage

Marie-Gladys Robert et al. Microorganisms. .

Abstract

The implementation of MALDI-TOF MS in medical microbiology laboratories has revolutionized practices and significantly reduced turnaround times of identification processes. However, although bacteriology quickly benefited from the contributions of this technique, adjustments were necessary to accommodate the specific characteristics of fungi. MALDI-TOF MS is now an indispensable tool in clinical mycology laboratories, both for the identification of yeasts and filamentous fungi, and other innovative uses are gradually emerging. Based on the practical experience of our medical mycology laboratory, this review will present the current uses of MALDI-TOF MS and the adaptations we implemented, to allow their practical execution in a daily routine. We will also introduce some less mainstream applications, like those for fungemia, or even still under development, as is the case for the determination of sensitivity to antifungal agents or typing methods.

Keywords: MALDI-TOF MS; antifungal susceptibility testing; diagnosis; fungi; medical mycology; microorganism identification.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Antifungal susceptibility testing with MALDI-TOF MS: example with echinocandin resistant Candida glabrata strains. (a) Panel A: Strains were incubated 4 h with 0.06 mg/L of anidulafungin. (b) Panel B: Strains were incubated 6 h with 0.06 mg/L of micafungin. S-I-R-S: sensitive- intermediate or resistant strains according to the EUCAST clinical breakpoints (https://eucast.org/astoffungi/clinicalbreakpointsforantifungals/ accessed on 3 May 2021). Each strain was tested in three different experiments, in triplicates.
Figure 2
Figure 2
Mind map resuming the present and possible future applications, limits and solutions of MALDI-TOF MS in the field of routine use in a medical mycology laboratory.
See this image and copyright information in PMC

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