MALDI-TOF Mass Spectrometry in the Clinical Microbiology Laboratory

Matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) has been adapted to generate protein mass spectra from whole bacteria and other microorganisms. These spectra can be compared to a reference database for rapid and accurate taxonomic classification of unknown organisms at the genus, species, and, in some instances, strain levels. The recent development of integrated commercial MALDI-TOF MS instruments has made this technology available for use in European diagnostic clinical microbiology laboratories, where it has been employed successfully to identify organisms from colonies, as well as from cultured blood and primary urine specimens. This article reviews the principles of MADLI-TOF MS and the recent literature evaluating its performance in the clinical laboratory.