Abstract
MALDI-TOF MS technology has made possible revolutionary advances in the diagnosis of infectious diseases. Besides allowing rapid and reliable identification of bacteria and fungi, this technology has been recently applied to the detection of antimicrobial resistance. Several approaches have been proposed and evaluated for application of MALDI-TOF MS to antimicrobial susceptibility testing of bacteria, and some of these have been or might be applied also to yeasts. In this context, the comparison of proteomic profiles of bacteria/yeasts incubated with or without antimicrobial drugs is a very promising method. Another recently proposed MALDI-TOF MS-based approach for antifungal susceptibility testing is the application of the semi-quantitative MALDI Biotyper antibiotic susceptibility test rapid assay, which was originally designed for antimicrobial susceptibility testing of bacteria, to yeast isolates. Increasingly effective and accurate MS tools and instruments as well as the possibility to optimize analytical parameter settings for targeted applications have generated an expanding area in the field of clinical microbiology diagnostics, paving the way for the development and/or optimization of rapid methods for antifungal susceptibility testing in the near future. In the present study, the state of the art of MALDI-TOF MS applications to antifungal susceptibility testing is reviewed, and cutting-edge developments are discussed, with a particular focus on methods allowing rapid detection of drug resistance in pathogenic fungi causing systemic mycoses.
Highlights
During the last two decades, MALDI-TOF MS technology has rapidly evolved toward new applications in the field of clinical diagnostic microbiology, generating a novel, robust and accurate tool for rapid identification of bacteria and yeasts (Kliem and Sauer, 2012; Richter et al, 2012; Spanu et al, 2012; Szabados et al, 2012; Idelevich et al, 2014; Barnini et al, 2015; Antimicrobial Susceptibility Testing by MALDI-TOF MSFlorio et al, 2018b)
Considerable efforts have been made in order to apply MALDI-TOF MS technology to the detection of antimicrobial resistance, especially for multi-drug resistant (MDR) microorganisms causing systemic infections (Nordmann et al, 2011; Cantòn et al, 2012; Patel and Bonomo, 2013; Lamoth et al, 2018), which represent a major concern for public health (Walsh, 2010; Walsh and Gamaletsou, 2013; Lee et al, 2016; Barchiesi et al, 2017)
The present review provides a synthetic, updated overview of the proposed methods based on MALDI-TOF MS and aimed at yielding rapid and accurate information regarding antimicrobial resistance of clinically relevant fungi
Summary
During the last two decades, MALDI-TOF MS technology has rapidly evolved toward new applications in the field of clinical diagnostic microbiology, generating a novel, robust and accurate tool for rapid identification of bacteria and yeasts The emergence and diffusion of bacterial and fungal pathogens resistant to multiple drugs and the high incidence of hospital-acquired bloodstream infections (BSIs) have made the purpose of developing new methods for rapid and reliable antimicrobial susceptibility testing an urgent issue In this context, considerable efforts have been made in order to apply MALDI-TOF MS technology to the detection of antimicrobial resistance, especially for multi-drug resistant (MDR) microorganisms causing systemic infections (Nordmann et al, 2011; Cantòn et al, 2012; Patel and Bonomo, 2013; Lamoth et al, 2018), which represent a major concern for public health (Walsh, 2010; Walsh and Gamaletsou, 2013; Lee et al, 2016; Barchiesi et al, 2017). The present review provides a synthetic, updated overview of the proposed methods based on MALDI-TOF MS and aimed at yielding rapid and accurate information regarding antimicrobial resistance of clinically relevant fungi
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