Abstract

More than 20 different species of Mucorales can be responsible for human mucormycosis. Accurate identification to the species level is important. The morphological identification of Mucorales is not reliable, and the currently recommended identification standard is the molecular technique of sequencing the internal transcribed spacer regions. Nevertheless, matrix-assisted laser desorption ionization time-of-flight mass spectrometry has been shown to be an accurate alternative for the identification of bacteria, yeasts, and even filamentous fungi. Therefore, 38 Mucorales isolates, belonging to 12 different species or varieties, mainly from international collections, including 10 type or neo-type strains previously identified by molecular methods, were used to evaluate the usefulness of matrix-assisted laser desorption ionization time-of-flight mass spectrometry for the identification of human pathogenic Mucorales to the species level. One to three reference strains for each species were used to create a database of main spectrum profiles, and the remaining isolates were used as test isolates. A minimum of 10 spectra was used to build the main spectrum profile of each database strain. Interspecies discrimination for all the isolates, including species belonging to the same genus, was possible. Twenty isolates belonging to five species were used to test the database accuracy, and were correctly identified to the species level with a log-score >2. In summary, matrix-assisted laser desorption ionization time-of-flight mass spectrometry is a reliable and rapid method for the identification of most of the human pathogenic Mucorales to the species level.

Highlights

  • Mucormycosis is a life-threatening infection that is associated with a high mortality rate of about40% [1]

  • The aim of the present study was to evaluate the accuracy of MALDI-TOF mass spectrometry for the identification of Mucorales to the species level from pure cultures

  • MALDI-TOF mass spectrometry is widely used for the identification of bacteria [28] and yeasts [16]

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Summary

Introduction

Mucormycosis is a life-threatening infection that is associated with a high mortality rate of about40% [1]. Mucormycosis is a life-threatening infection that is associated with a high mortality rate of about. The diagnosis of the disease remains difficult, and the poor outcome of the infection is related to the virulence of the fungi, and its resistance to most of the systemic antifungal drugs that are currently available [2]. An increase of the incidence of mucormycosis has been observed in the post-voriconazole era [3], and many cases of breakthrough infections in patients treated with voriconazole have been reported [4,5]. J. Fungi 2019, 5, 56; doi:10.3390/jof5030056 www.mdpi.com/journal/jof.

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